10 Things You Didn’t Know A Pediatric PT Can Help With

In honor of October being Physical Therapy Month, we wanted to share a list of things that you may not realize a pediatric physical therapist can help your child with. If any of these resonate with you, call your local pediatric physical therapist to ask questions. Happy Physical Therapy Month!

1. Yes we work with BABIES! Pediatric PT treats newborns for things like torticollis, plagiocephaly, and delayed achievement of milestones.
2. Yes we facilitate BREASTFEEDING! Pediatric PT can help you and your baby with the following things: positioning, range of motion and mobility for access (latching), relaxation, and proper trunk and pelvic stability.
3. Yes we support POSTURE and ERGONOMICS! Pediatric PT can analyze and teach both you (lifting safety) and your child (posture, backpacks, handwriting, and more).
4. Yes we address challenges related to TOILETING and BEDWETTING! Pediatric PT works with your child to strengthen the pelvic floor, develop routines, and educate in all areas that affect toileting.
5. Yes we provide NUTRITION SCREENING! Pediatric PT does nutritional screening to promote health and wellness, address obesity, and enhance rehabilitation.
6. Yes we address CONCUSSIONS! Pediatric PT performs pre- and post-concussion screens including subsequent vestibular rehabilitation.
7. Yes we analyze FOOTWEAR! Pediatric PT assesses proper fit and function of shoes for sports, everyday use, and even picking out their first pair.
8. Yes we facilitate development of COORDINATED PLAY SKILLS! Pediatric PT helps your child keep up with their peers by working on body awareness and coordination for skills such as bike riding, monkey bars, skipping, jumping jacks, and more.
9. Yes we support YOUTH ATHLETES! Pediatric PT not only treats injuries but prevents them through running and movement analyses, and performance enhancement training.
10. Yes we perform GROSS MOTOR CHECK-UPS! Pediatric PT helps ensure your child is on track with their gross motor skills by recommending annual check-ups just like you go to the dentist every 6 months.

 

Ideas to Target the Core

I don’t know about you, but I know my core muscles (abdominals, back extensors, shoulder girdle, and hips) can always stand to be stronger. This also goes for our kids, typically developing as well as kids with a neuromuscular challenge. While there are lots of ideas for targeting specific muscle groups, sometimes its good to do exercises that get a bigger bang for their buck. There are some exercises that can target multiple areas of the core at the same time. Here are a few:

• Planks – Planks are great for getting all areas of the core. Of course they are not easy, especially if you want to maintain good form. For those just starting out with a plank you can go on your hands and knees and bring your hips in a straight line with your trunk. To make it harder to you can move to your hands and toes (or forearms and toes) and keep your whole body in a straight line. To make it even easier, you can use a bench or a table and put your hands on there so you are at an incline. The goal is to be able to hold your body in a straight line without having your belly sag or your hips sticking up in the air. Find the level of difficulty that lets you maintain that straight body. And start small. If you can hold it for 15 seconds then do that. Slowly increase your time and then increase the difficulty!
• Wheelbarrow Walking – This also targets multiple areas, the hips don’t get as much work unless you are being supported by the ankles, but its still great for the shoulders and trunk. You can use a scooter board and sit on it and hold them by their trunk, or their hips, or their thighs, or their ankles (the further out you hold them, the harder it is). Use a hallway and have something fun like a book or a puzzle at the end that they get to do something with each time they get down there. You can also use a rolling stool. This changes the angle and makes it harder. Even harder is you just standing and walking while supporting them. Again, the goal is to hold the body straight so find the level of support that allows them to do this and gradually work your way out towards their ankles and up to you standing!
• Walk Outs – Use an exercise ball or a peanut ball or even a foam roller (the exercise ball will be the hardest because it can move in multiple directions). Place a puzzle and its pieces a little out of reach and have them lie on their stomach on the ball and then slowly walk out their hands as far as they can go while maintaining a straight trunk and hips. Then put a piece in the puzzle and walk their hands back. Keep repeating until all the pieces are done. You can also use beanbags, or other toys that involve multiple pieces.
• Bridging – This one really targets the hips but also works on the trunk. I’ve talked about ways to work on this in other posts. You can get creative with how to make it fun, such as balls or cars going underneath. You can also make it harder by putting one foot on an elevated surface and the other one on the floor, or both feet on an exercise ball or peanut (or other unstable surface). You could just do one leg and keep the other leg up in the air. You can do reps of up and down, or you can go up and hold it for longer and longer periods of time.

What are some of your favorite ways to work on the whole core?

Strong Outer Hips (aka abductors)

One of the muscles we focus on when we are working with kids, or young adult (or even ourselves if we’re being honest) is the hip abductor, or the outer hip muscle. This muscle may be on the smaller side but it is mighty!

When this muscle is strong it helps to stabilize your hips for every day activities like walking, standing, running, climbing stairs, crawling, and on and on and on. If you have a strong hip abductor and you pick up your foot to take a step it will hold your hips level so that you have a nice smooth walking pattern. If your hip abductor is weak, it will not be able to keep your hips level and when you take a step a few things could happen. Two of the most common things are:

1. when you pick your foot up, your hip on that side will drop down as compared to the hip on the other side, or
2. when you pick your foot up, you will lean your head and trunk away from that foot so that you are creating a counter balance to help keep you stable.

So why is this a problem? Here are a few reasons:

• For a little one first learning to walk, if they don’t have the stability at their hips it makes it harder to take those independent steps and they will want to hold on to support surfaces longer
• For a little one first learning to crawl, they may have finally mastered getting on to their hands and knees, but they don’t have the stability to lift one of their legs to bring it forward, and every time they try they collapse back down on to their belly
• For someone who may have spasticity or higher muscle tone in their inner hip muscles (adductors), they may scissor their legs when they walk (cross them in the middle rather than stepping straight in front). If their abductors are strong they can help to counteract the scissoring pull and make walking a bit more efficient.
• For anyone working on running, your hips will do the same thing as with walking if its weak, except you are putting more stress on your knee with every step you run. This can lead to overuse injuries and knee problems that can cause pain and lead to limited physical activity.

So what can you do? Here are a few ideas for exercises:

• Sidestepping – depending on the age and skill of the child, this can look like cruising back and forth at a support surface, or it can be walking sideways down a hallway, or even adding resistance tubing/banding while walking sideways (make sure to lead with each foot)
• Bridging – depending on the age and skill of the child, this can look like lying on their back with their knees bent and their feet flat on the floor and having them lift up their bottom (you can make it fun by driving cars under the ‘bridge’ or rolling balls under), or it can be holding the bridge position for longer periods of time, or while you are in the bridge position lifting one foot off the ground and then the other, or just doing one leg bridges, or even adding a resistance band around your thighs to push against while doing two leg bridges
• Climbing – depending on the age and skill of the child, this can look like crawling up and down stairs (or couches), climbing on ladders at the park, using a climbing wall (even better is to traverse side ways on a climbing wall or park climbing structure)

What are some ways you have worked on the abductors?