Live Aligned with Dr. Brent

Season 1 of Live Aligned with Dr. Brent has officially wrapped! Thank you for listening, for sharing these episodes, and for trusting me with your time. There's more coming your way, including some bonus episodes, before Season 2 launches. Before we head into a short break, I'm inviting you to help shape what's next. If there's a topic you want covered, a guest you'd love to hear from, or a question you want answered on the show, I want to know. Head to drbrentanderson.com to share a topic, guest suggestion, or question for the show

A scoliosis diagnosis can feel like a verdict — especially for a parent watching their child's spine curve, or an adult told their pain is "just" asymmetry. But what does that diagnosis actually mean, and what can be done about it? Dr. Brent Anderson sits down with Dr. Lise Stolze, a doctor of science in orthopedic physical therapy, Schroth educator, and owner of Stolze Therapies in Denver, Colorado, to unpack the real story behind scoliosis. Dr. Stolze breaks down the difference between structural (idiopathic) and functional scoliosis, explains how Cobb angle and vertebral rotation determine diagnosis and progression risk, and reveals why the curve you can't see from behind — the loss of lumbar lordosis in the sagittal plane — often matters more than the one you can. She and Dr. Brent walk through what parents should watch for during growth spurts, how bracing combined with the Schroth method changes outcomes for adolescents, and why postmenopausal women make up so much of her adult caseload. They also dig into surgical options like vertebral tethering and spinal fusion, and how people with significant curves can still run marathons, play golf, and live full, active lives. IN THIS EPISODE: The difference between structural and functional scoliosis, and why it matters for treatment How Cobb angle, vertebral rotation, and wedging are used to diagnose and stage scoliosis Why sagittal plane posture and lumbar lordosis loss predict disability more than the visible curve The evidence behind combining bracing with Schroth therapy for adolescents What causes adult-onset scoliosis and why postmenopausal women are especially at risk The core principles of the Schroth method: axial elongation, decompression, and rotational breathing How to weigh sport and activity participation against curve progression risk RESOURCES MENTIONED: Stolze Therapies, Scoliosis, Spine and Movement Arts (Denver, CO) Pilates Adaptations for People with Scoliosis, a course by Dr. Lise Stolze and Hagit Bedeshevsky, offered through Polestar Pilates SSOL Schroth educator training SOURCES & CITATIONS: Weinstein SL, et al. BrAIST (Bracing in Adolescent Idiopathic Scoliosis Trial), referenced by Dr. Stolze as a landmark study on bracing effectiveness in adolescents.  Schwab F, et al. Retrospective study of approximately 600–800 adult scoliosis patients identifying sagittal plane alignment, lumbar curve presence, and trunk shift as predictors of surgical need, referenced by Dr. Stolze. Use the code DRBRENT to save 10% off any Polestar Pilates Teacher Trainings sold on polestarpilates.com. Applies only to Pay in Full.

For anyone who's ever been told their spine is "degenerating" or that they're a millimeter from paralysis, the fear can feel as debilitating as the condition itself. In this episode, Dr. Brent sits down with his own neurosurgeon, Dr. Allan Levi — Chairman of Neurological Surgery at the University of Miami Miller School of Medicine and Chief of Neurosurgery at Jackson Memorial Hospital — for a full-disclosure conversation about lumbar spinal stenosis, one year after Dr. Levi performed the surgery that gave Dr. Brent his leg back. Dr. Levi breaks down what stenosis actually is, why imaging findings so often don't match a patient's symptoms, and why some people walk around with "severe" degenerative changes on MRI and no pain at all. Together they trace the full continuum of care, from physical therapy and diagnostic epidural injections to the decision points around laminectomy versus fusion, and what recovery really looks like at each stage. It's a candid, myth-busting conversation for anyone facing a stenosis diagnosis or supporting a patient through one. IN THIS EPISODE: What lumbar spinal stenosis is and how degenerative versus congenital stenosis differ Why MRI findings alone don't tell the whole story, and how symptoms guide treatment The role of epidural injections as both a diagnostic and therapeutic tool How surgeons decide between a laminectomy and a spinal fusion What recovery timelines and movement restrictions look like after each procedure Why waiting too long for surgery can lead to worse outcomes — and why urgency isn't always warranted How to find the right spine specialist and know when a second opinion is worth seeking RESOURCES MENTIONED: University of Miami Miller School of Medicine, Department of Neurological Surgery Jackson Memorial Hospital DEFINITIONS: Lumbar spinal stenosis — Narrowing of the spinal canal in the lower back, usually from a combination of enlarged facet joints and bulging discs, which can compress the nerve roots. Neurogenic claudication — The pattern of back, buttock, and leg pain triggered by walking or standing and relieved by sitting, caused by nerve compression from stenosis. Spondylolisthesis — A condition where one vertebra slides forward relative to the one below it; often described by patients as a "slip." Laminectomy — A surgical procedure that removes the lamina (back part of the vertebra) to create more space for compressed nerve roots, without fusing the spine. Spinal fusion — A surgical procedure that joins two or more vertebrae together with bone growth and hardware, typically used when the spine is unstable. SOURCES & CITATIONS: Machado GC, Ferreira PH, Yoo RIJ, Harris IA, Pinheiro MB, Koes BW, van Tulder MW, Rzewuska M, Maher CG, Ferreira ML. Surgical options for lumbar spinal stenosis. Cochrane Database of Systematic Reviews. 2016;11:CD012421. doi:10.1002/14651858.CD012421. Machado GC, Ferreira PH, Harris IA, Pinheiro MB, Koes BW, van Tulder M, Rzewuska M, Maher CG, Ferreira ML. Effectiveness of Surgery for Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis. PLoS ONE. 2015;10(3):e0122800. doi:10.1371/journal.pone.0122800. Use the code DRBRENT to save 10% off any Polestar Pilates Teacher Trainings sold on polestarpilates.com. Applies only to Pay in Full.

"My sciatica is killing me" — it's one of the most common complaints in healthcare, and one of the most misunderstood. For the millions who experience burning, shooting pain down the leg, the real obstacle often isn't the injury itself — it's the fear, confusion, and outdated messaging that come with it. Dr. Brent Anderson sits down with his longtime mentor and friend Dr. John Sievert, a Fellow of the American Academy of Orthopedic Manual Therapy with over 40 years of clinical experience, to set the record straight. Together they unpack what sciatica actually is (a description of symptoms, not a diagnosis) and why the language clinicians use can either deepen fear or restore confidence. Drawing on real patient stories, they explore why imaging findings are so often misread as verdicts rather than clues, why 90% of these cases resolve with movement and education rather than surgery, and how a strong therapeutic alliance changes outcomes as much as any hands-on technique. It's a conversation about replacing fear with hope — and understanding that, as John puts it, movement is medicine. In this episode: Why "sciatica" describes a symptom pattern, not a medical diagnosis The difference between radicular pain and true radiculopathy How MRI and imaging findings are frequently over-interpreted and can increase fear and disability Real patient stories showing how catastrophizing language slows recovery The role of therapeutic alliance and motivational interviewing in patient outcomes Red-flag symptoms that mean it's time to seek emergency care Practical home-care strategies for calming an irritated nerve and returning to movement Resources mentioned: Body Logic Physical Therapy — [email protected] Instagram: @Sievert.John (photography) Evidence in Motion (EIM) Kaiser Permanente Northern California Orthopedic Residency Program Motivational Interviewing Network of Trainers (MINT) Use the code DRBRENT to save 10% off any Polestar Pilates Teacher Trainings sold on polestarpilates.com. Applies only to Pay in Full.

Why does knee pain so often start somewhere other than the knee? For decades, clinicians treated the knee in isolation — until dynamic imaging research revealed the real story: it's often the femur moving under the kneecap, not the kneecap tracking poorly, that drives the pain. Dr. Brent Anderson sits down with Dr. Christopher Powers, professor and associate chair in the Division of Biokinesiology and Physical Therapy at USC, to unpack what that discovery means for how we understand and treat the knee. Dr. Powers has spent his career studying the hip's role in knee health, and in this conversation he explains "glute amnesia" — the surprisingly common phenomenon where patients simply can't activate their glute muscles, even when they want to. He and Dr. Brent trace the connection from sedentary lifestyles and lost childhood movement patterns all the way to a troubling rise in ACL injuries among kids as young as ten. Along the way, they make the case for prevention, screening, and looking at movement — not just strength — as the real key to lasting knee health. In this episode: How dynamic imaging changed our understanding of patellar tracking and hip-knee mechanics What "glute amnesia" is and why so many patients can't activate their glutes Three activation exercises shown to improve neural connection to the glutes Why ACL injuries are showing up in children as young as ten years old The link between hip strength and future ACL injury risk Gender differences in movement patterns and injury risk Why movement strategy, not isolated strength, is the real key to prevention Definitions: Glute amnesia — A reduced ability of the brain to activate the gluteal muscles, often from disuse, making it hard to strengthen them until activation is restored first. Arthrogenic inhibition — A reflex where pain or swelling in a joint causes the surrounding muscles to shut down or weaken. Valgus — An inward collapse of the knee, often seen during walking, running, or squatting, that signals poor hip control. Patellofemoral joint — The joint where the kneecap (patella) meets the thighbone (femur); problems here are a common source of knee pain. Neuroplasticity — The brain's ability to change its connections to muscles over time, for better or worse, based on how often those muscles are used.