Wait and See or Not – Scoliosis


November 14, 2019


Who is this for?

Parents with children and pre-teens ages 8-13.


When to consider?

If a doctor or you as the parent suspect a spinal curve is developing in a child, the typical answer is wait and see.  The first diagnosis of scoliosis is a 10 degree curve.  Bracing is not recommended until 25 degrees.


How can Posture Alignment Therapy help?

This wait and see period is an opportune time for Posture alignment therapy to help your child.  Improving posture during the growing period can help develop correct spine curves while the vertebrae turn from more cartilage to bone.


What is the goal?

The goal is to avoid needing to brace or requiring surgery. Parents that experience this stage of using a brace for their child’s scoliosis find it can be difficult and extremely frustrating when the child is going through so many other phases of development and change. Even more challenging is reaching the stage that your child has to go through major surgery to place rods in their spine. Scoliosis is a progressive disease, so any slowing of progression is beneficial.


Why does this time-frame matter?

The electronics and frequent sitting encourage a bent forward position and affect the curves front to back. The academic demands at younger ages results in more sitting as well. The leaning or turning to one side for long periods of time, which follows comfort and habit, allows for the curves that are side to side, lateral, and rotational. The hip muscles don’t have to work as much which provide the support to hold up the spine. The current young generation is partaking in this more passive lifestyle at a younger age when the bones are solidifying.


What does Posture Alignment therapy do?

The exercises, positions and postures from the Egoscue Method help by evening out the shoulders and hips and allow the spine to follow a more balanced path. Secondly, young children today will need to learn about keeping more functional movement patterns for their bodies that their convenient world won’t provide. As technology progresses us, so does our needs for proper self-care.


If you teach your children to brush your teeth everyday why not teach them to take care of their spine.


Contact with any questions.  Written by Randee Engelhard, Physical Therapist and Posture Alignment Specialist certified in the Egoscue Method.


Potential for Scoliosis Take 2 - Menopause

July 18, 2019


Many women  who were diagnosed  with scoliosis as a teen with a lower degree of spinal curve were just monitored.  Fantastic if you didn’t need a brace or surgery.  The problem is  scoliosis has a secondary window where it can sneak up on you -  after menopause.


Why does it change again?

Hormones, osteoporosis, postural habits, decrease in activity.  Hormones from different organs in the body all have influence over bone growth and re-structuring of bones.  The cause of loss of bone density can be too much or not enough of hormones.  Like anything else balance is key.


Who is most at risk?

A women whose curve started in adolescence is more at risk.    However, adult scoliosis can develop with aging and degeneration whether you had it as a teenage or not.


What are other risk factors?

Poor nutritional habits, steroid medications, thyroid medications, diabetes type 1 all play a role in weakening the bone which can result in excessive spinal curves


How does the scoliosis start if I didn’t have the curve as a teen?

Degeneration of the vertebrae that occurs more on one side of each vertebrae allows for the spine to bend.


What can I do?

Be proactive! Posture Alignment programs like the Egoscue Method help prevent progression.  Even better they can help stop pain that is a result of spinal changes.


Contact with any questions.  Written by Randee Engelhard Physical Therapist and Posture Alignment Specialist certified in the Egoscue Method.




Inflammation – A buzz word in 2017

September 26, 2017


Holistic healthcare is a topic that I have been personally invested in for the past five years.  Due to my interest level, I have researched and read many books, articles, internet pages and blogs.  I have identified a multitude of amazing practitioners, working to help people heal and optimize their health.  I have found that the common denominator identified in most of my research has been Inflammation. It is being correlated to many diseases and/or symptoms identified by those suffering from chronic pain.  Today’s blog will focus on the connection of inflammation to chronic pain, ways to naturally decrease inflammation in the body and medical conditions inflammation has been linked to.


As a physical therapist practicing for almost 20 years, I have treated many injuries and chronic conditions in the orthopedic setting. A portion of treatment typically focuses on managing or decreasing inflammation, in order to allow a joint to move without pain more effortlessly.  The body uses inflammation to help heal by bringing in good blood and cells to repair tissue.  When there is too much persistent inflammation, this can become problematic, resulting in the manifestation of more pain.  The suffix -itis by definition is inflammation.  When there is inflammation and pain recovery is lengthier, it may become a chronic condition.  Examples of some of the diagnoses you may have with -itis include: tendonitis, bursitis, synovitis, osteoarthritis or rheumatoid arthritis.


If you are suffering from chronic pain, you may have an injury or condition rooted in inflammation.  The question you might ask is, “What can I do to reduce it besides medication?”  There are many dietary and lifestyle changes to implement in order to help decrease overall inflammation in the body, resulting in decreased pain. Some of those changes are listed below with links to more information:


  • Balancing the Omega’s 3, 6, 9 to improve the ratio by eating more fish, changing the oils you cook with, and supplements. Surprisingly, many of the vegetable oils we frequently eat are high in Omega 6’s and if they are not balanced with the Omega 3’s it creates excessive inflammation.  You can change the oils you use at home to help with the balance.


  • Acid/Base ph balance in the body working to increase alkalinity through food choices – Fruit are the most alkaline foods especially the melons.



  • Supplements or using foods that have anti-inflammatory properties Turmeric, Curcumin, Ginger, alpha-lipoic acid, fish oil.  Functional medicine practitioners can help determine which are best for your body.



  • Evaluate the need to remove gluten, dairy and/or sugar from your diet which all have been linked to inflammation. Celiac testing vs gluten intolerance testing, Reactive aspects of dairy include – lactose, casein and whey (you may have a problem with one or all the components)


  • Manage stress levels through meditation or exercise.


  •  Avoiding the main Nightshade Vegetables – White Potatoes, Peppers, Tomatoes, and Eggplant which can lead to inflammation.



  • Food Sensitivity/intolerance blood testing with elimination and reintroduction of foods.  This provides guidance in choosing what to avoid.  You can also carefully do elimination diets on your own.  An important piece is that food sensitivity reactions tend to occur within a few hours to about 4 days making it more difficult to discover then a food allergy that causes hives or an anaphylactic shock.




  • Posture Alignment Therapy based on the Egoscue Principles helps realign the body to bring it closer to its design resulting decreased pain.


With dietary changes, it is important to take the different food philosophies and identify what your body responds to best.  There are many styles: vegan, vegetarian, paleo, fruitarian, elimination diets based on food sensitivities, general inflammatory foods, auto-immune diet and a diet based on the China study, just to name some of them.



Medical conditions today are typically treated by reducing symptoms.  Some Doctors and other practitioners are focusing more on the why and root cause of these symptoms for example:  headaches, joint pain, muscle pain, high blood pressure, itchy skin, rashes, abdominal pain, elevated blood sugar, fatigue and many others.  Inflammation may be one significant piece of the puzzle as to the root cause of so many chronic diseases.  Our environment and the toxins in it may affect our bodies negatively. There are so many conditions that inflammation causes, including but, not limited to: auto-immune diseases, cancer, chronic fatigue syndrome, fibromyalgia, diabetes, gastrointestinal reflux/GERD, colitis, asthma, heart disease, dementia and skin condition such as eczema, psoriasis, and rosacea.  The information above can help you decrease the inflammation which may allow you to decrease medication use, decrease symptoms and/or slow the progression of conditions.



Inflammation may not be a buzzword for the teens of today, but it certainly seems to come up in conversation frequently when talking about health or among healthcare professionals.   Life expectancy has gone up but, what about the quality of your life. As I work with clients with physical therapy or through my posture alignment program, it is instrumental to note how other varying factors may be influencing the symptoms you may be experiencing.  Reducing the overall inflammation in your body may help decrease the level of pain and potentially aide with many of the above diseases or symptoms associated with them.   It is about changing the approach of how we treat one’s body as a whole, from the inside out.  As Dr. Mark Hyman states, it is about optimal health.  Start with altering one thing in your lifestyle today.


Contact  Randee Engelhard, Physical Therapist and Postural Alignment Specialist, with any questions or to schedule an appointment in person or through Skype/Facetime at


Other Resources:


Contact  Randee Engelhard, Physical Therapist and Postural Alignment Specialist, with any questions or to schedule an appointment in person or through Skype/Facetime at

Part II How do I know if my back pain symptoms are coming from the Sacroiliac joint dysfunction?

July 26, 2017


     In this blog post you will learn about the sacroiliac joint, also known as the SI joint.   My strong interest in the SI joint is from personal experience.  Being an active teenager I enjoyed tumbling and cheerleading, I had my first back injury to the sacroiliac joint at the age of 15; I didn’t know what caused me such so much pain at such a young age.  Fast-forward to becoming a physical therapist many years later, I began to really understand what had caused my terrible back pain that was inching into my buttocks.  Over the years, I have had some re-occurrences in this area of my back.  This pain motivated me to keep digging deeper and learn more about how to best treat sacroiliac dysfunction.   The details we will look closer at are: who does sacroiliac dysfunction typically affect, what is the mechanism of the injury or what causes it, and the current trends resulting in changes over the past 25 years.


    Historically, sacroiliac joint misalignment happens to more petite active females (men you are not off the hook yet…. read on).   The reason for this is the joint surfaces in the female pelvis are smaller and flatter allowing for more motion.  Women go through hormonal changes which cause ligament laxity to all joints.  Ligaments that are stretched or lax around a joint do not support the area as well therefore, the joint can shift easier.  The females tend to have a habit of one leg standing, leaning onto one hip which tends to create imbalance as well.  Again, Sacroiliac dysfunction is a small shifting of bones which results in muscle imbalance, muscle spasms and sometimes pressure on a nerve.


    Let us move on to the mechanisms that tend to cause Sacroiliac dysfunction. Think back to some of the incidents you might have experienced.  You might have had a fall into a seated position jolting the pelvis.  A second possible cause is a vertical force on an extended leg for example, if you miss a step when walking, stepping off a curb, or jumping over something such as to avoid a puddle.   Another mechanism is a golf swing especially when the club hits the ground when you expected to have ease of movement with follow-through when you hit the ball.  Other onsets include sudden bending or rotating, lifting or carrying heavy objects.


     The current trend brings us back to the issue of frequency with male vs. female. In my first years as a therapist, I did see sacroiliac dysfunction typically in the young petite, active female. The trend in physical therapy today is the misalignments are happening much more frequently over all, and equally to men and women.  The reason I believe this change has occurred is due to all the sports and activities such as triathlons, marathons, cross fit, orange theory, boot camp and other highly intense activities that adults, teenagers and children are participating in. Sacroiliac dysfunction happens when you are more active due to the joint being micro-mobilized while exercising making it more mobile.  If a joint is hypermobile it shifts and moves easier.


    The bad news is the pain caused by sacroiliac dysfunction can be very frustrating and debilitating.  The good news is it is one of more treatable aspects to low back pain.   We looked at who, SI dysfunction typically affects, what causes it, and the current trends which brings about how frequent this is occurring.  If any of this sounds familiar and is what you are experiencing yourself, know that there are great therapists out there to help with this condition.


Contact Randee Engelhard, Physical Therapist and Postural Alignment Specialist, for realignment of your sacroiliac joint as well as overall posture alignment which can be done in person or through Skype/Facetime at



Is Your Back Pain a Pain in Your "Butt?"

June 22, 2017


Welcome to my blog, My name is Randee Engelhard and I am a Physical therapist and Posture Alignment Specialist.


As a physical therapist, one of my areas of expertise is the sacroiliac joint, the focus of this week’s topic.  Many people that have low back pain find that the pain radiates down into their buttocks, as well as, further down their leg. This “butt” pain is sometimes caused by the sacroiliac joint dysfunction.  I will share with you what the sacroiliac joint is, the symptoms it might cause, and how it can be treated.


The sacroiliac joints, otherwise known as the SI Joint, are on each side of the sacrum connecting the spine to the hip bones (Ilium).  The hip bones meet in the front at a joint between the two pubic bones.  The hips support the upper body and control the lower body making this area a problematic one where medical challenges are likely to result.  When there is a small movement of the bones a misalignment, whether it be the hip, sacrum, or pubic bone, it may result in pressure on a nerve or a muscle imbalance. This further causes muscles spasms, trigger point pain, nerve pain, weakness or change in sensation.




The sacroiliac dysfunctions or misalignment tends to cause localized low lumbar pain and commonly the pain will radiate into the buttocks and go down as far as the knee. This is a possible manifestation of the symptom “sciatica” which includes pain down the leg, as well as tingling, numbness, or weakness.   Sciatica is a symptom of an underlying medical condition. Common lower back problems that can cause sciatica symptoms include a lumbar herniated disc, degenerative disc disease, spondylolisthesis, spinal stenosis or piriformis syndrome.   People can have one or more of the above conditions or none and have a sacroiliac dysfunction or misalignment.


How can the sciatic type symptoms, more specifically those caused by sacroiliac joint misalignment, be treated?  Sometimes good old fashion icing and rest due the trick and our bodies can naturally heal themselves.  As the muscles relax the shift in the sacroiliac joint can go back in to place.   Gentle stretching, massage and exercise can help with the radiating pain, tingling and/or numbness.  Other times the low back and sacral area can be a bit more stubborn. If this does not work, another option is to have a realignment of the area through muscle energy techniques which are gentle mobilizations. First, the area is assessed for which bones have shifted up or down, forward or back, rotated or tilted.  The therapist helps shift the bones back into place with the help of your muscles.  My preferred technique is gentle and slow.   These techniques are different then other adjustments that are more forceful or generalized.


Pain in the low back and buttocks or legs can be one of the most debilitating symptoms to have.  It can interfere with work, sleep or sports and leisure.  Understanding the sacroiliac joints and their locations, the symptoms they can cause and how to treat this area can improve quality of life.  We are searching for optimal health and this is one area that can stop you in your tracks or allow you to lead an active life.


Contact Randee Engelhard, Physical Therapist and Postural Alignment Specialist,  for realignment of your sacroiliac joint as well as overall posture alignment which can be done in person or through Skype/Facetime or

Who is Freddy Function??

May 22, 2017




Who is Freddy Function???


Freddie function is the model used by Egoscue University® in teaching posture alignment therapy.  Freddy Function represents vertical alignment of the the main weight bearing joints (shoulders, hips, knees and ankles)


The design of our body is to have all four sets of load joints (shoulders, hips, knees, and ankles) level and parallel with one another.  The two side of each shoulder should be mirror images for bilateral body symmetry.  One should be balanced front to back and right to left.  Decreasing these imbalances helps improve a myriad of bodily symptoms.


The closer our bodies are to this textbook posture the better we will feel. One analogy applicable to this philosophy pertains to car maintenance. To illustrate, if one has a tire that is bald or the thread is wearing thin, they expect a mechanic to change the tire, and do a balance and alignment, to prevent additional uneven wear.   One can apply the same principle to our bodies, aligning ones body helps decrease or eliminate pain as well as improve other symptoms. When our internal organs are pushed together, this may decrease proper digestion.   Improved alignment can help in this arena as well.  Another example involves vertigo, and how it relates to head position.  As we change the head position, the frequency and intensity of vertigo will decrease or disappear.


An interesting piece of information I learned during my training for Posture Alignment through Egoscue University relates to the direction of our feet when we stand.  Most people stand with their feet turned out a bit.  Although not as common, some individuals walk pigeon toed or with their feet turned in. If one were to sit on a bench as a passerby, they may observe that most people tend to walk with their feet turned out.


During physical therapy school, I learned that the normal stance was “feet facing forward” or turned out up to 7 degrees.  Pete Egoscue wrote in his books that the ideal position is to have both feet facing forward.  I returned to my textbooks and realized the feet being turned out or externally rotated is based on “norms.”  A norm is different from an ideal.  A norm is based on a measurement of a group of people and what the trend is.  However, this is not what is best for our body.  I have observed that most people do not have both feet turning out equally either.  This means that their weight is not evenly distributed throughout their body.  This lack of distribution may inadvertently cause pain to occur on one side of the body. It is interesting when many people come to see a physical therapist citing that one knee hurts more than the other one.  The person may rationalize the pain by stating that they are getting older. However, I may pose the question and suggest that it is both knees that are getting older, and not just one.  This has to do with our imbalances in our body.


Posture Alignment Therapy can help you realign your body to help minimize the physical consequences of being imbalanced.  It may make you feel younger as you get older.  Don’t we all want that!


Randee Engelhard,  MPT, PAS


Posture Alignment Specialist and Physical Therapist





Posture Alignment Specialist

Licensed Physical Therapist


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