Heather Engelbert, PT, PRC
Give us a brief history of your background and how you became interested in the Postural Restoration Institute?
I graduated from the College of St. Catherine’s in 1999 and my first job sent me for an intensive week long course in women’s’ health issues the week after I started. I learned early on to appreciate a stable pelvis and the many influences of the pelvis above and below. I began to question why I was always seeing similar dysfunctions in people and figuring out there must be something to this. Then after hearing what a phenomenal course Postural Respiration was from several co-workers (Karen Jiran, Carrie Langer), I took my first course. It fit well into my treatment regime and it filled a void in my practice.
What led you to the area of woman’s health?
When I accepted my first job, I was hired to do general orthopedics and women’s health. It was an area that I knew little about in regards to physical therapy and after a little research, I thought it was an area that probably needed to grow. After my initial training, my schedule was immediately full with women’s health patients. The patients I was treating, although very complex, particularly for a new graduate, were very rewarding to work with and very appreciative of any help I could give them. I took many courses early on from many energetic instructors such as Hollis Herman and Kathe Wallace, their passion for what they taught was contagious. And, treating so many complex and chronic patients just furthered my quest to seek out additional research and treatment options. I was looking for more answers to why I was seeing similar patterns in my patient population. PRI fit perfectly into my treatment scheme.
How have you been able to integrate PRI and your knowledge of woman’s health?
PRI is the first line of treatment for me. I feel it is important to achieve neutrality throughout the pelvis and ribcage or your rehab may fail. Tonic muscles must be inhibited and weak muscles must be strengthened, this task is impossible if the muscles are not in the proper position, they are under constant stain and duress. It is also important to incorporate proper breathing mechanics into pelvic floor rehab because of the role the pelvic floor plays in respiration and to help reduce sympathetic tone (often present in hypertonic dysfunctions). Proper breathing is difficult, at best, when the diaphragm is in a poor position for respiration.
Who have your mentors been throughout the years?
I have been very fortunate to have a strong network of colleagues that have been trained in PRI and women’s health. Gayla Pleggenkuhle, Debra Reagan, Jeanna Viramontes MTP, PRC, Laurie Xiong & Tammy Kasprowicz are trained in both PRI and women’s health. Karen Jiran and Carrie Langer, were a tremendous influence on me and really ignited interests and excitement to me and many other OSI colleagues to take more PRI courses. I think the work Ron and PRI has done is amazing and inspirational. I think PRI is at the forefront of physical therapy, it integrates a system not a body part, it validates my foundation as a therapist.
In 2007, you earned the designation of Postural Restoration Certification through the Postural Restoration Institute. What made you decide to go through this process?
I completely believe that PRI has something to offer everyone. I, like many PRC therapists, have seen the patients that failed at everything else but do well with PRI. It fits in with my philosophy, I have had many successes with it, and I wanted to be able to support PRI, clinically and educationally.
Has becoming certified presented any new opportunities you feel you wouldn’t have had otherwise?
Yes, I think it has given me confidence in allowing me to present myself and represent PRI in a positive light. I think it has opened doors for multiple referral sources and opportunities for marketing the complete biomechanical picture. I feel like I am always learning, and I want to be able to validate my training as a PRI therapist. It also associates me with a whole network of people that speak the same language and understand PRI principles.
Coming in March, PRI is hosting its 1st Interdisciplinary Integration course that includes you as a guest speaker. What do you plan on covering at this course?
We hope to apply PRI principles and techniques specifically to the pelvic floor, introduce the concepts of asymmetry and how an asymmetrical pelvis and ribcage can contribute to pelvic floor dysfunction and develop an understanding of how the respiratory diaphragm integrates with the pelvic diaphragm. Specific PRI tests and treatments will be introduced specifically for incontinence, pelvic pain and prolapse.
How will individuals practicing in woman’s health benefit from this presentation?
There are many excellent pelvic dysfunction courses but I have not heard any of them speak of the asymmetries of the pelvic floor and how asymmetry may cause dysfunction. Many of the patients that I have seen, that have failed at previous rehab, are not in a neutral position. In order to effectively and neurologically retrain a healthy muscle pattern, you must have neutrality. I have found through clinical experience, once in neutral, additional rehab including up/down training of the pelvic floor, manual therapies and bladder retraining is much more successful. Many pelvic floor dysfunction patients have multiple biomechanical issues; with the PRI approach the whole system is being addressed. PRI has positively changed how I treat pelvic floor dysfunction, it is a non- invasive approach and can be successfully applied to all patients.
How will individuals who aren’t practicing in woman’s health benefit from this presentation?
I hope to generate an understanding of how the pelvic floor functions in conjunction with the polyarticular chains and the influence it has on posture, stability and respiration. Participants should gain an understanding of how to screen for pelvic floor dysfunction, how to initiate treatment for specific pelvis dysfunction and know when it is appropriate to refer to a specialist.
Are there any projects or publications you plan on working on in 2009?
There are several things I would like to accomplish in 2009: I would like to initiate a study on the effects of a PRI treatment program on female high school athletes with urinary incontinence. A recent study showed >40% of female athletes reported some sort of incontinence, an alarming number. I think the female athlete provides a whole array of unique challenges; I would love to be able to reach out to this population and provide appropriate training and education. I would like to complete the write ups for several case studies to present for educational or publication purposes. I would like to, with the help of colleagues, complete a two day course integrating women’s health concepts with PRI. I assist in an annual one day course at the College of St. Catherine, introducing women’s health issues and PRI, it is a wonderful opportunity to mentor students and I would love the opportunity to expand on this. I am very excited to be a part of the upcoming Interdisciplinary Course and look forward to growing with PRI.