“The last two trimesters, we go to the clinic,” said Sanchez. “When you treat the people and see them getting better, the reward is so great, it’s almost kind of addictive.”

He wanted to broaden his holistic healthcare résumé, but there was one part of studying at New York College of Health Professions that he wasn’t willing to commit to again—the commute to its campus in Syosset, Long Island.

As it turns out, he’ll be working towards a combined bachelor’s and master’s degree in acupuncture this fall at the same school, but much closer to home.

On Aug. 29, classes will start at the New York College of Health Professions’ brand new site inside The Riverside Church on the Upper West Side.

“They’re clearing space out for us and I’m literally configuring the classrooms, just trucking stuff in,” said Lisa Pamintuan, president of the college.

The school was founded in 1981 as The New Center for Wholistic Health Education and Research. Since then, it has expanded its programming to include coursework in massage therapy, acupuncture, Oriental medicine, holistic nursing and Asian bodywork.

It also offers degree levels from certificate programs to master of science, and is currently in the final stages of implementing a doctoral program in Oriental medicine.

Classes take place at the school’s main campus in Syosset and at a 35acre medical facility in Luo Yang, China.

But recently, they decided it was time to expand.

The Riverside Church site currently has about 50 students preparing to start this month, with new students continuing to enroll on a daily basis.

“One of the things is the demand,” said Pamintuan. “We’ve had a lot of requests from people asking us to open in Manhattan or the tristate area. We’ve been looking at different locations throughout, and we were selective in making sure it was a good academic environment.”

One of the reasons the school has had so much success in the holistic health world, Pamintuan explained, is that, while there are many programs in New York that provide the training required to take the state licensing exam in massage or acupuncture, New York College offers a higher level of education.

“We offer a degree program that incorporates the required licensing but at a college credit degree level,” she said.

At the Riverside site, students will be able to take advantage of that high level of training in all of the same degree programs that are offered at the Long Island Campus. They’ll have to complete just one credit in Syosset during their time at the college.

Pamintuan believes the demand for what New York College of Health Professions has to offer is skyrocketing and will continue to grow. The Riverside Church site is just one step the college is taking as it works to meet that demand, moving to even more locations and expanding its degree programs.

“The overall plan is to start with this location and make sure that the students who are enrolled there have everything they need,” she said. “Then, open up in other locations.”

For students like Sanchez, the expansion couldn’t have come at a better time.

“You learn so much about yourself and the people you’re treating, so it’s a reciprocal learning experience,” he said of his time in the massage therapy program. “I trust the acupuncture program will do the same for me.”

He’s looking forward to the easy commute and to exploring the community of holistic practitioners on the Upper West Side.

Pamintuan is thinking about Sanchez and the others who will be sitting next to him as she arranges furniture in the school’s first New York City home.

“It’s important that wherever we go, we have to have the best of the best for our students and for the community,” she said.

Elementary school children hang key chains from their zippers to express themselves. Teenagers press patches with band names onto the fabric. In the ’90s, the Jansport logo on your pack made you cool, and no kid would have dreamed of using more than one strap.

But aside from providing yet another avenue for adolescent identity, backpacks, weighed down with piles of heavy textbooks, may also be causing poor posture and back pain in children.

"We know that back pain is on the rise," said Dr. Scott Bautch, a spokesperson for the American Chiropractic Association who has conducted various research studies on back pain in children. "By the age of 14, many children are having back pain that affects their daily lives."

This fact can be attributed to many of the modern behaviors of young people, explained Luke Bongiorno, a Manhattan-based physical therapist and managing director of NY SportsMed & Physical Therapy. These include hours spent sitting in front of computers and the rounded posture associated with texting.

"Everything else is compounding the problem," said Bongiorno, "so it’s even more important to pay attention to backpacks now."

Researchers have known for years that too much weight in backpacks could cause issues in children, and the mechanics are fairly simple. When a lot of weight is placed in a backpack, especially if it hangs below the waist, the body is placed under a certain amount of stress.

Muscles tell the brain that they’re stressed and the brain responds by telling other muscles in the spine and shoulders to work harder. "All the messages are saying, ‘We’ve got to protect, cramp down, tighten,’" said Bongiorno, so the muscles tighten, causing compression of the spine.

Because of the strain on the lower back, the body pulls the shoulders forward to keep itself upright, causing bad posture, added Dr. Joseph Herrera, director of sports medicine in the Department of Rehabilitation and Physical Medicine at Mount Sinai Medical Center. And while bad posture is not deadly, it can cause serious pain and imbalances in the body and may even lead to longer-term issues, like chronic tendonitis, said Bongiorno.

Thankfully, most of the time the issues are reversible and the pain can be temporary if the problem is recognized and postural habits are corrected.

"Kids are really resilient," said Herrera, "and the body has a tendency to heal itself." The longer the problem goes on, though, the harder it is to reverse.

Rather than wait for issues to develop, there are plenty of ways to prevent damage caused by heavy backpacks.

One obvious solution is to limit the amount of weight in the backpack. The American Chiropractic Association suggests on its website that a backpack should be no heavier than 5-10 percent of a child’s body weight. Choosing a smaller backpack is an easy way to limit weight.

Children should always carry their backpacks with the straps on both shoulders, as using one strap will cause an imbalance in the muscles, further affecting posture.

Most experts agree, however, that the most important step is choosing a better backpack. Last year, Bautch worked with The North Face to develop models that would reduce strain on the body.

Some of the features he says are key to preventing back issues are: comfortable straps that are anatomically adapted for males and females, a good fit against the back (the contact point) and the presence of compartments that force children to pack their backpacks efficiently, with the heaviest items closer to the body.

Bautch, Bongiorno and Herrera all stressed the importance of waist straps, but lamented the fact that it’s nearly impossible to get kids to actually wear them.

"We have to find a way to make waist straps cool," said Bongiorno.

Bautch agreed, and said that while he has trouble getting even his own children to wear them, the key may be teaching kids the correct way to wear backpacks as early as possible.

"Most of our postural habits are learned between 4 and 7," he said. "That’s when we have our greatest learning curve. Teenagers, unfortunately, aren’t amenable to correction."

But lately, less meaty (and creamy) food options have been showing up all over town.

In the past six months, a vegan pop-up restaurant, Wildflower, opened for three days on the Lower East Side, and a vegan pop-up shop debuted in Williamsburg. Candle 79, the Upper East Side vegan mecca, launched a line of frozen foods to be sold at Whole Foods, and the Soft Serve Fruit Co. opened a Union Square location to peddle their vegan version of frozen yogurt.

And while vegans in New York are not a new phenomenon, this newest trend towards plant-based diets seems to be focused less on stopping the slaughter of animals and more on starting to pay attention to a major American issue— our health.

"It’s a concept whose time has come, and it feels like some big changes have been made in the past year," said Brian Wendel, the creator of Forks Over Knives, a feature documentary on the benefits of a plant-based diet, which played at Landmark Sunshine Cinemas on the Lower East Side this past May. "I foresee more coming in the near future."

Wendel said that he had been aware of the general benefits of a plant-based diet for years, but that after reading The China Study, he was shocked by how convincing and expansive the evidence for eliminating meat and dairy from diets really was.

"I just thought, ‘Enough is enough,’" he said. "We’re talking about a diet that can not only prevent, but can reverse many degenerative diseases."

The China Study, written by Dr. T. Colin Campbell and his son Thomas M. Campbell, summarizes the results of the China Project, a survey focused primarily on research in rural China. The project cited more than 8,000 statistically significant associations between dietary factors and disease and is often called the

most comprehensive study of health and nutrition ever conducted.

Campbell’s main conclusion was that people who ate the most animal-based foods got the most chronic diseases. For example, he demonstrated that cancer growth could literally be "turned on" by animal protein.

Forks Over Knives relied heavily on information from The China Study, and on research done by Dr. Caldwell B. Esselstyn Jr., a prominent researcher at the Cleveland Clinic who has shown that heart disease can be prevented, and sometimes reversed, by switching individuals from animal to plantbased diets.

Despite the amount of evidence on how much healthier a vegan diet can be, most nutritionists still advocate a balanced meal complete with animal protein. Last month, the USDA released new dietary guidelines in the form of a diagram called MyPlate. While the diagram does emphasize eating more fruits and vegetables, it features a separate section for both dairy and protein (protein from either meat or vegan sources, such as soy or legumes.)

And many people, including some nutritionists, do recommend meat and dairy as sources of nutrients such as calcium and protein.

Amy Shapiro, MS, RD, the founder of Real Nutrition NYC near Madison Square Park, said that animal products are not at all necessary to maintain a healthy diet, but that in order to be a healthy vegan, you have to be more diligent about your diet.

"People say they’re going vegan, and they grab lots of carbs because it’s easy and cheap," she said. "But it takes a lot of work to make sure you’re getting the nutrients from the food you choose to eat."

For instance, Shapiro explained that Americans tend to think they need more protein than they really do, and it’s actually easy for vegans to get an adequate amount. They just need to know where to find it—in foods like tofu, seitan, beans, lentils and nuts.

"It’s a really dedicated lifestyle," Shapiro said. It may take more than a few pop-up shops and new vegan businesses for New Yorkers to consider committing.

Still, Wendel said that his Forks Over Knives is starting to change the minds of New Yorkers and people around the country little by little. It has had steady audience approval ratings of over 90 percent, and the movie’s Facebook wall is covered with the comments of recent viewers swearing off meat and dairy for all time.

"It’s going to be one of those things where we’re going to look back in 100 years and think that these behaviors [eating animal products] were bizarre," said Wendel. "We’ll say, ‘Wow! Back then, not only did they drink the milk of another species, but they went around convincing themselves that there were health benefits!’"

"Is this our fault?" Rather than answering, Dr. Adrienne, a social worker who leads stress reduction groups at NYU Fertility Center and the author of On Fertile Ground: Healing Infertility, asks them to consider their own question, "Why did you ask me that?" Most likely, the answer is that they’ve heard that stress prevents conception. The woman has probably been told that she’s doing too much and to "just relax," so that her in vitro fertilization treatments will work and the baby will come.

The trouble is, it may not. No matter how many hours she spends with her feet up.

"When you talk about IVF, the level of stress [of the patient] has no impact on whether or not the treatment will be successful," said Dr. Alan Copperman, the director of reproductive endocrinology and infertility at RMA of New York and the vice-chairman of obstetrics, gynecology and reproductive science at the Mount Sinai School of Medicine.

As evidence, Dr. Copperman cited a largescale review of research on the topic, published in the British Medical Journal this past February. The meta-analysis examined data from 14 studies with more than 3,500 participating women, and concluded that emotional distress was not related to the likelihood of pregnancy.

Despite this review, many people still blame infertility on stress. Dr. Georgia Witkin, a clinical psychologist at RMA of New York and an assistant professor and director of the Stress Research Program at Mount Sinai Medical Center, explained that this usually comes from the fact that the couple and their well-meaning family and friends are searching for explanations to regain their sense of control.

"It makes you feel like you can do something about it," she said. "You say, ‘I can get this under control, it’s just stress.’" Dr. Witkin also said that since highpowered, business-oriented women tend to wait longer to have children, people might attribute childbearing issues to their intensely busy lives rather than to the most likely reason for their infertility: age.

The real issue to consider is that while stress may not cause infertility, to say that infertility causes stress is a serious understatement. One widely cited study published by researchers at Harvard Medical School in 1993 showed that the psychological symptoms associated with infertility are similar to those associated with other serious medical conditions, such as cancer and cardiac rehabilitation.

"It’s a bio, psycho, social and spiritual crisis," said Adrienne. "I’m sure you can imagine that when it’s a crisis of that proportion, there’s nothing that’s untouched."

Psychologically, the turmoil associated with a lack of control over the outcome of a situation can be incredibly hard to bear, and in most cases, there’s no definite endpoint to the turmoil.

The hormones involved with IVF affect the woman’s emotions, and the couple’s relationship is tested by a series of difficult decisions and a process that can easily unravel a healthy sex life.

Socially, the couple may feel isolated, resentful and unable to relate to friends and family with new babies and their own judgments about the process the couple is undertaking.

In her individual and group sessions with women and couples, Adrienne seeks to shift the focus from self-blame and guilt to address all of the possible issues they may be confronting.

In the end, coping with the stress of the process may not influence the results, but it will certainly create a healthy, happier couple.

"I want them to feel like they’re in control," Adrienne said, "not of being fertile, but of how they navigate through the journey, whether it’s to pregnancy, adoption or child-free living."

He went to see a podiatrist, who then diagnosed him with plantar fasciitis and heel spurs. "One of the first questions my doctor asked was how often I wore sandals," said DeFrancisco. "And when I told him, he said that my problems most likely stemmed from the shoes I had been wearing."

His footwear of choice? DeFrancisco had been wearing flip-flops almost every single day for six years.

While most people vary their footwear much more frequently, warmer days do mean that more and more New Yorkers are hitting the streets in their Havaianas. And with the familiar sound of rubber smacking concrete comes a familiar concern: Can wearing flip-flops cause damage to your feet?

"The problem is that they give absolutely no support," said Dr. Marlene Reid, a spokesperson for the American Podiatric Medical Association. "It’s like running around barefoot, but worse, because sometimes your toes have to scrunch down to keep the shoes on."

One study, published in 2008 in the Journal of the American Podiatric Medical Association, found that flipflops significantly increased pressure on the bottom of the foot, as compared to sneakers. This pressure, the researchers wrote, "has been correlated to an increased risk of foot deformity."

The pressure is heightened when you factor in the non-pliant city streets New Yorkers tread on. "The flip-flop is so thin that it offers little shock absorption," said Dr. Krista Archer, a Manhattan podiatric surgeon affiliated with Lenox Hill Hospital.

In 2010, Dr. Justin Shroyer, a researcher at Auburn University in Alabama, published a study in the Journal of the American Podiatric Medical Association that looked at how flip-flops affect the way in which a person moves while walking or running.

His study found that flip-flops, as compared to sneakers, shortened the wearer’s stride and increased a measurement called "ankle angle" as the individual swung their leg through mid-stride.

According to Dr. Shroyer, the shortened stride matters because it leads to an overall increase in the number of steps an individual takes, increasing pressure on the foot.

The increased ankle angle is an indication that the struggle to keep the flip-flop on the foot (by curling the toes down) could be causing strain. "Your body is trying to pull your foot up to swing the leg through, but in inadvertently trying to keep the flipflop on, it’s pulling the foot down," said Dr. Shroyer. "So the muscle that’s pulling the foot up has to work harder. Because it’s working more and it’s such a repetitive motion, it’s a chronic effect that leads to lower leg pain and ankle pain."

And no, it is not normal (or healthy) for the bottoms of your feet to be coated in a black film after a full day walking the summer streets. "City streets are gross and there’s no protection against dirt and grime!" said Dr. Reid.

While wearing sneakers every day would technically be the best idea, experts concede that for most people, and especially in a fashion-focused city, that is not a practical alternative.

Other footwear options are at least somewhat kinder.

"The good thing about a ballet flat or a flat sandal with a buckle is that your toes aren’t working hard to keep the shoe on," said Dr. Archer.

If you’re going to wear flip-flops, you can minimize the harm by choosing a style that the American Podiatric Medical Association has given their "seal of approval" to. A full list, available on their website (apma.org), includes brands like Fit Flop and Chaco, which offer better support.

"There are some that have a built-in arch, and some that have a deeper setting for the heel," said Dr. Reid. "Those are better."

In the end, your best bet is to save the flip-flops for sandy surfaces or the occasional picnic in Sheep Meadow.

If it’s too late to save your soles, don’t try to walk away from the problem. "If you have pain, don’t ignore it, and don’t keep wearing shoes that are causing the pain," warned Dr. Archer. "If you switch to better shoes and it still hurts, see a doctor."

Years later, he still gets the urge to run whenever the weather warms up.

"The problem is that I never learned to go jogging," he said. "When I go for a run, I go for a hard run. And it’s amazing how quickly those injuries come back."

Gemdjian uses his personal experience to inform his work with clients, many of whom, like him, engage in "weekend warrior" behavior, diving head first into intense physical activity after a long time away or without ever having tried it.

Whether getting suddenly seriously physical is the result of the changing seasons, the desire to return to a missed sport or weekend workouts that attempt to make up for weeknights dedicated to happy hour, a common result is likely: injury.

Statistics related to sports injuries,

especially confined to
weekend warriors, are difficult to quantify, but Gemdjian estimated that
about 70 to 80 percent of his clients have had a sports-related injury
at some point in their past.

Some
of the most common include impact injuries like shin splints and knee
pain, ankle sprains, back pain, shoulder injuries, rotator cuff
tendonitis and hip pain.

And
certain sports are associated with particular injuries based on the
movements required, said Stephanie C. Petterson, a physical therapist
and the regional clinical director for Sports Physical Therapy of New
York, which has 10 offices throughout Manhattan. For example, runners
often get plantar fasciitis, golfers may experience lower back pain and
rotator cuff strain and swimmers usually suffer from shoulder
impingement.

While all athletes and casual exercisers are susceptible to injury, weekend warriors are particularly vulnerable.

Carol
Otis, a physician who specializes in sports medicine and is a Fellow of
the American College of Sports Medicine, said that ideally, an
individual should be consistently increasing the intensity of a workout
by about 10 percent per week. Weekend warriors go from zero to 100 all
at once.

"There’s
a learning curve with getting back into the groove of any activity,"
said Matt McCulloch, the director of Kinected, a downtown Pilates studio
that specializes in injury prevention. "For example, if you only play
tennis in the summer, the muscles that you use in tennis you don’t use
during the rest of the year. So it takes a while to get your technique
back up to where it was the season before."

McCulloch
explained that because of this, a weekend warrior will operate with a
faulty technique or mechanics. They may also lack the flexibility,
strength and stamina necessary for the activity or use equipment with
faulty ergonomics, which can affect movement patterns.

"These things seem small, but when you’re not working out regularly, they add up quickly and set you up for injury," he said.

McCulloch
created a workshop called "Anatomy of a Weekend Warrior," giving New
Yorkers the chance to come in at the beginning of the summer to learn
how to practice preventive maintenance before jumping back into their
Central Park softball league. It’s like their spring training.

In
addition to education, McCulloch uses Pilates techniques to help
prevent injury. "Pilates focuses on increasing the stability of joints
and at the same time balancing out the muscles that support the joints,
so you don’t have overuse injuries," he explained. It also helps people
understand how their body moves, allowing them to isolate and focus on
one part of their body.

For
weekend warriors who aren’t quite ready to book a Pilates session,
Gemdjian said there are many ways to prevent injuries while working out
at the gym or with a trainer. "Warming muscles up is absolutely key," he
said. A 10 to 15 minute warm-up should not be about static stretching,
but should consist of a gradual build-up to the movements you’re about
to make, like a relaxed volley in tennis or slow strides leading up to a
run.

During the
workout, pay attention to your body, do active stretches between sets
and drink lots of water to prevent cramping up. When you’re finished,
cool down properly and stretch, but avoid overstretching already
flexible muscles. "If it’s tight, stretch it," said Gemdjian. "If not,
leave it alone."

Finally,
correct potentially dangerous movement patterns by working with
someone, like a trainer, prior to jumping into the activity. If you do
experience pain, it may be time to see a physical therapist.

In the end, weekend warriors, just take it easy.

"A
lot of these guys think they’re still as athletic as they were when
they were 20, and, to put it lightly, they’re not," said McCulloch.

Replace that dream of the major leagues with a Central Park diamond and focus on fun rather than glory.

At gyms like Equinox, there’s a huge bump in business that starts in March and climaxes in June, according to David Harris, vice president of personal training.

"My business takes off this time of year," said Christy Maskeroni, a registered dietician who is the nutritionist-in-residence at the luxury fitness center CLAY on 14th Street.

Maskeroni said that 80 to 85 percent of her clients are women, and they come to her already seeded with the latest ideas about weight loss. Should I try the Dukan diet like Kate Middleton? Should I start a juice cleanse?

While juice cleanses are more mainstream, and diet pills are still out there, increasingly, nutritionists are focusing less on ways to help their patients lose as
many pounds as possible for that week in the Hamptons, and more on
helping them make a complete lifestyle shift in which healthy habits
based on whole, unprocessed foods rule out the need for dieting.

"In
my eyes, people still want the quick fix—what can I do as quickly as
possible," said Maskeroni. "My goal is to explain the importance of food
as fuel and the process of how weight loss works."

Even
Weight Watchers, which used to assign the same amount of points to an
Oreo as an apple (because the calorie counts were the same) has jumped
on the whole foods bandwagon. Last December, they updated their system
for the first time in 14 years, allowing participants to enjoy unlimited
fruits and vegetables and assigning higher point values to processed
foods.

"We had to
change the system because of what we now know about nutrition," said
Janice Mielarczyk, the head of New York City Weight Watchers. "There’s
so much information about how our bodies process the food, and it’s not
just about calories."

Andrea
Moss, a health counselor and founder of Moss Wellness who specializes
in weight loss, welcomes this change. Before she attended the Institute
for Integrative Nutrition, she was 45 pounds heavier and had tried every
diet out there, including one that only allowed her to eat for one hour
per day. Now, she helps her clients achieve balance over dieting. She
calls whole foods like produce, whole grains, nuts and fish "honest
foods" because the body knows how to get nutrients from them and is left
feeling satisfied.

"If
you’re eating an imbalanced diet— for example, not getting enough
protein or complex carbohydrates—your body may send up sweet cravings
all the time," she explained, "and it’s very hard to deny those cravings
since your body can be screaming them at you."

For
example, lots of women trying to lose weight reach for artificial
sweeteners like Splenda, but the body recognizes the sweet taste and
prepares itself for sugar intake. When it doesn’t get it, it craves
sugar for the rest of the day, making weight loss harder.

Some
of Moss’ top tips for safe, healthy weight loss are to increase fiber
intake, switch to wheat bread and brown rice, eat healthy fats found in
fish and nuts and to switch from refined sugar to a natural alternative
like honey, maple syrup or stevia. Plan ahead, and choose healthy foods
and exercise that you enjoy.

If
you really need to drop more weight quickly, juice cleanses can be OK,
but listen to your body. If you feel faint, make a beeline for the
nearest Shake Shack.

Another
unlikely component to weight loss? "Most importantly, sleep, sleep,
sleep," stressed Maskeroni. "The hormone that makes you feel hungry is
elevated in those that aren’t sleeping enough, so you’ll feel hungry
more often."

Following
an integrative nutrition plan like Moss’ or Maskeroni’s will allow you
to shed about a pound per week. So, you may not be the svelte figure
you’d imagined by the time you make your first trip out to Long Beach in
June, but it will likely last much longer.

"If
you want to lose weight and keep it off, it has to always be about a
lifestyle shift," said Moss. "There is no quick fix that will last
forever."