Eight Years, a Yard Sale, and a Back Room Full of Sombreros
How a Dreary November Day Turned Into a Practice That Changed My Life (and Theirs)
There are some things you can count on me to remember.
My kids’ birthdays.
Our dog’s gotcha day.
And then there are things I should remember… like my own business anniversary.
February 27th marked 8 years in my office for Carrie Pagliano Physical Therapy. Eight. Years.
In so many ways it feels like yesterday. In other ways, it feels like a lifetime ago.
In October 2017, after 11 years at Georgetown University Hospital and 18 years as a practicing PT, I stepped out to do a little home care. I told myself it was just to “see.” To decide if it was finally time to do this on my own.
Thanksgiving weekend, I was out on a walk and passed a yard sale in front of a garden-style apartment building. I almost kept walking. Instead, I stopped.
Tom and Bob—the owners—were clearing out a front office space they’d just decided to rent to the business next door (a builder company that eventually went bankrupt and skipped out on their lease… police eviction and all… but that’s another story).
They mentioned they had a back storage space and offered to show it to me.
Floor to ceiling junk.
Sombreros.
Old chemistry books.
Things I still can’t identify.
Collectors? Hoarders? We’ll never know.
I said, “If you ever want to rent it, let me know.”
Two days later, I called them.
They said yes.
Managing the Momentum of Big Moves
Here’s the part that feels very on-brand for me.
The week before I opened my doors, I was sworn in as President of the Academy of Pelvic Health Physical Therapy.
Clearly… I’ve never had an issue taking on more than one big thing at a time.
New brick-and-mortar business.
National leadership role.
Two young kids.
Sure. Why not?
Looking back, it sounds mildly unhinged. At the time, it just felt like momentum. Like when you know you’re supposed to step forward, even if you don’t yet know how it’s all going to work.
Eight years ago, solo PT practices were rare. Especially in pelvic health. Pre-pandemic, the idea of stepping away from insurance-dictated care and building something independent felt… risky.
I asked a few friends how to do it. I didn’t love the answers.
So I decided to do it my way.
I negotiated a lease. Picked carpet. Chose paint. Shopped at IKEA…A LOT. (And you know what comes after that) Learned more about occupancy permits and Arlington County signage regulations than any human should ever need to know (spoiler: the hoops are MANY). Passed inspection.
Voila. I was a business.
Pivoting Through the Unexpected
Two steady years of patient care came to a grinding halt on March 17, 2020, when I closed in-person sessions because of COVID.
After a few days of complimentary check-ins, I pivoted fully to telehealth. Not totally foreign—I’d done virtual second and third opinions before—but suddenly it was everything.
Meanwhile, my kids were “homeschooling” first and third grade.
I consolidated my schedule. Waited until after they got up. Took my daughter to the office with me. Did telehealth while she played with toys in the corner. Hosted the occasional virtual classroom check-in from my treatment table. Turned my clinic gym into snack central.
That went on for months. A few sporadic in-person sessions in May. Back to 50% in October 2020. In the 5+ years since then, the office has settled into the new normal of a hybrid practice—currently 75% in-person, 25% virtual.
Survival, Seasoning, and the Second Opinion
If I’m honest, it wasn’t until 2023 or 2024 that I felt like I even partially stepped out of fight-or-flight as a parent and a business owner.
By then I’d already passed the five-year mark. I’d watched small businesses around me close. Survival felt like a miracle.
Eight years in, I’m used to my head being down and when I pop up, I realize I’m still here. A little wiser. A little clearer. A little more “seasoned” as a business owner.
Pelvic floor PT isn’t the secret we’re shouting from the rooftops anymore. Around the DC area, it’s much closer to standard of care. That’s progress.
It also means more providers. More practices. More options.
Which has naturally gently nudged me to niche down.
Now, a lot of what I do is second opinions. The cases where someone did “all the right things” and still isn’t where she wants to be. The runner told to stop running. The lifter told to stop lifting. The mom with prolapse navigating return to sport. The woman in perimenopause who is finally done leaking and done pretending it’s fine. That’s super cool to be able to give options when someone was told there were none.
The Power of Saying “Yes”
The beautiful part about living in the Arlington/DC area? There is no shortage of active, driven women who want to feel strong in their bodies at every stage.
And I’m humbled each day to get to help them.
Last Sunday, I was out on a long run when a woman passed me going the opposite direction. A few minutes later, she circled back.
“You changed my life,” she said.
She was a former patient. Four years out. Training for Boston.
She told me I talked to her about “dinosaurs…” the other providers who had told her no, but I had said “yes.”
It’s those moments. The unexpected ones. The ones you can’t plan or manufacture.
All made possible because on a dreary November day I stopped at a yard sale and asked to see a messy back room.
Because eight years ago I decided to hang a shingle.
Because sometimes you leap before you fully know how the landing will feel.
It still feels ridiculous to write this much about it. I don’t naturally shout things from the rooftops. But this is my way of saying thank you.
To the Arlington/DC community.
To the women who trust me in person.
To the virtual clients all over the world.
To my family and friends who let me turn a storage unit full of sombreros into a business.
Eight years later… we’re still here.
And if you’re standing at your own version of that yard sale moment—wondering if you can hold more than one big thing at a time—what would happen if you just said yes?
