Pediatric Physical Therapists work with infants, niños, and adolescents from birth through 21 years of age who have conditions that limit their physical abilities. Patients are treated for a variety of different reasons including bone, muscle, and nerve injuries; sport-related injuries; neurological conditions; and genetic disorders.
Treatment focuses on improving range of motion, fuerza, and movement patterns to decrease pain/discomfort and to increase function.
Common diagnoses treated include, but are not limited to:
– Developmental Delay
– Brachial Plexus Injury
– ACL/MCL Repairs
– Cerebral Palsy
– Spina Bifida
– Neonatal Withdrawal Syndrome
– Toe Walking
– Down Syndrome
– Muscular Dystrophy
– Recurrent Dislocations
– Shoulder Injuries
– Back Pain
– Hypotonia/Low Muscle Tone
– Hypertonia/High Muscle Tone
– Erb’s Palsy
– Chromosomal Abnormalities
– Neurological Impairments
– Spinal Muscular Atrophy
– Osteogenesis Imperfecta
– Rett Syndrome
*not an all inclusive list
What happens during the evaluation?
At the first visit the PT will check your child’s strength, development, and ask several questions regarding their history and day-to-day life. We like to get the whole picture when treating your child to determine how to best address your concerns. If there is a delay in your child’s development it will be determined that day and the PT will work with you on developing a treatment plan that fits your child’s specific needs.
What will my child do in PT?
Therapy sessions are often play-based with age-appropriate activities and games that encourage muscular strengthening and challenge endurance. PT can be hard work, so we try to make it as fun as possible. Depending on your child’s goals, we will work on things like balancing on one foot, challenge coordination skills by playing catch, or help your child to develop protective responses over an exercise ball. A home exercise program will also be developed specifically for your child.
What is a home exercise program (HEP) and why is it important?
A home exercise program is exactly as it sounds, a group of exercises prescribed by the physical therapist to perform at home. HEPs are important because oftentimes patients are only seen 1 or 2 times a week for 30 minutes to an hour. In order to make real changes in strength, flexibilidad, and functionality these exercises need to be performed throughout the week. Don’t worry, we will never send you home with an exercise we don’t feel confident your child can accomplish. Safety is our number one goal.
As parents and guardians, you play the primary role in your child’s development and success. We are here to provide guidance, education, and support so that your child may achieve their full potential. During treatments we will educate you on things like:
– Correct form and technique of exercises
– How to adapt toys for play
– Equipment that can be used to improve mobility
– Use of orthotics to improve functional movement
What is Torticollis?
Torticollis is the tightening of muscles on one side of the neck. The primary muscle that is affected is called the sternocleidomastoid or SCM. Tightening of the SCM can be caused by a variety of reasons which are broken down into two categories, congenital or acquired.
Congenital torticollis is tightness a child is born with and is commonly caused from the baby’s position in the womb. Congenital torticollis may also occur if there is trauma or damage to the SCM during the birthing process. Less common reasons include malformation of the bones of the neck, and certain syndromes that affect muscle and bone development.
Acquired torticollis occurs after birth and is related to an irritation to the SCM muscle. This type of torticollis may be caused by gastroesophageal reflux (GERD), problems with vision, soft tissue infections of the neck, or muscle spasms. In addition to physical therapy, children with acquired torticollis often require additional support from a specialist to address the underlying cause.
Infants with torticollis generally have a head that tilts towards the side of the affected muscle and a chin that points away from the affected muscle, as seen in the image below.
Treatment for torticollis often includes soft tissue work to break up adhesions, strengthening of the muscles on the other side of the neck to help hold the head in a midline position, and encouraging play to the middle and affected side.
What is Plagiocephaly?
Plagiocephaly is the flattening of the skull that is due to repeated pressure over one area. This flattening is very common and very treatable, and is not painful for your child. Plagiocephaly ranges from mild to severe and can be categorized based on where the flattening is occurring, as seen in the image below.
Premature infants are more likely to develop plagiocephaly due to the increased pliability of the bones of their skull. Full term babies may also have plagiocephaly that could be caused by sleeping in the same position, tightening of neck musculature on one side (torticollis) leading to a preference to look to one side more than the other, or from their positioning in the womb.
Treatment for plagiocephaly is determined by severity, ranging from repositioning during daily activities to use of corrective headbands. More severe plagiocephaly can result in facial asymmetry and problems with vision if left untreated. Below is an image of the head band commonly used to treat plagiocephaly. This band is worn 23 hours a day, helping to relieve pressure over the flattened area.
Patients with plagiocephaly are often referred to a neurosurgeon or plastic surgeon before beginning treatment with a headband for a second opinion. This is also to ensure the child does not have craniosynostosis, which is an early fusion of the skull soon after birth. Craniosynostosis often presents the same as plagiocephaly but is much more uncommon and requires surgery to correct.