Tag Archives: children

PT & Me Clinics Give to Families in Need During the Holidays

December 20, 2017 Teresa Stockton - Blog, Events

During the holiday season we are thankful for what we have, but we understand some families might not be as fortunate due to hardships, unforeseen circumstances or health related issues. We at PT & Me try to instill compassion and kind-heartedness into all of our clinics that are a part of us. These are just a few ways of how our dedicated clinics are giving back to those in need within their communities this holiday season…

Madison Spine & Physical Therapy is organizing it’s 2017 Spread the Warmth Winter Clothing & Blanket Drive on December 22nd, 2017. If you live in the New York City or New Jersey area please support their charity campaign by donating today!

Items Needed Are:
• Jackets
• Blankets
• Boots
• Gloves
• Hats
• Scarves
• Sweatshirts
• Pants
• New Undergarments

Call (201) 982-3050 for donation pick up.

On December 22nd Madison Spine and their employees will drive into NYC with the donations and hand them out to those who could use a little warmth!
You donate, we deliver! Let’s all come together and make a difference!

For more information on Madison Spine and Physical Therapy click here.

Pinnacle Therapy Services is organizing Operation Breakthrough. They are collecting items throughout the month of December to donate in the Kansas City area. Operation Breakthrough is an organization that has been helping Kansas City families since 1971. They provide a safe, loving, and educational environment for children in poverty and empower their families through advocacy, emergency aid and education. If you are able, please help Pinnacle help local, underprivileged families. Items can be dropped off at any Pinnacle Therapy Services location.

DONATIONS NEEDED

Non-Perishable Foods:
• Cereal – Cold & Oatmeal
• Boxed Meals
• Canned Fruit
• Hearty Soups / Chili
• Crackers
• Hamburger/Tuna Helper
• Tuna
• Canned Chicken
• Mac & Cheese
• Canned Vegetables

Other Items:
• Diapers: Size 3 & Up & Wipes
• Toothpaste/Toothbrushes for Children & Adults
• Toilet Paper
• Deodorant
• Bath Soap
• Feminine Hygiene Products
• Laundry Detergent
• Cleaning Items
• Children’s Toys

For more information about Operation Breakthrough click here.
For more information about Pinnacle Therapy Services click here.

Thank you for your generosity! Happy holidays!

Treating Childhood Obesity With Activity

October 5, 2017 Teresa Stockton - Blog, Pediatrics

When talk focuses on childhood obesity in the United States, words like “critical” and “epidemic” are often used. The tried-and-true prescription of more exercise and better nutrition still holds true, but overweight children face unique challenges when it comes to weight loss.

Why Has Childhood Obesity Increased and What Are the Effects?
The statistics are disturbing. Not only are the overall obesity rates increasing, the heaviest kids are heavier than they were 30 years ago. Why is this happening? Experts who have studied childhood obesity attribute it to a change in lifestyle. The active lifestyle of the past—walking to school, playing outside, and engaging in after-school activities—has been replaced by a sedentary lifestyle of watching TV, playing video games, and using electronic devices like phones, computers, and tablets. Eating habits have changed noticeably, with convenience foods that are higher in fat and calories replacing fruits and vegetables.

The consequences of obesity are significant. A child who is obese may develop high blood pressure, high cholesterol, and type 2 diabetes. These conditions can increase the risk of cardiovascular disease such as a heart attack and stroke. In addition, older teens who are obese may have an increased risk of death during adulthood.

Obesity can also affect emotional health. A child who is obese may have emotional problems in school, and struggle with low self-esteem and depression.

What Is One of the Best Solutions?
Exercise is one of the main tools to fight childhood obesity. The US Department of Health and Human Services encourages children of all ages to be physically active. If your child is overweight, obese, or even of normal weight, recommendations to improve your child’s health include:

Encouraging your young child (aged 1-4 years old) to actively play daily in a safe environment
Encouraging your older child (aged 5 years and up) to participate in moderate to vigorous activity every day—Your child should aim for at least one hour per day of moderate to vigorous activity. At least 3 days out of the week should be vigorous activity.

Since children often engage in shorter bursts of activity throughout the day, it is okay to count these times as exercise.

Examples of different types of physical activity include:

Moderate-intensity: Brisk walking, hiking, skateboarding, baseball, rollerblading, and bike riding
Vigorous-intensity: Jumping rope, running, and playing sports like basketball, hockey or tennis

The main difference between moderate- and vigorous-intensity exercises is the demand on the body. Vigorous activities force the body to work harder. The heart beats faster and breathing becomes more rapid, but energy is used up faster.

Rollerblading
Learning karate
Playing organized sports (field hockey, soccer, football)
Swimming
Gymnastics
Strength training with weights
Rock climbing
Cross-country skiing

Before your child jumps into a new fitness routine, it is important that you work with your child’s doctor. Being obese can put a strain on muscles and bones, possibly causing back pain and foot or ankle problems. The doctor can assess your child’s overall health and recommend safe exercises.

What Else Can Be Done to Encourage Activity?
Another important piece to the puzzle is to focus on screen time. Screen time refers to how many hours per day your child spends in front of a screen—whether it be watching TV, playing video games, or using electronic devices. These are sedentary activities that contribute to obesity. The NHLBI recommends that screen time should be limited to less than 2 hours per day, which leaves more time for exercise. You can further encourage your child to be active by planning family outings, like going on a hike, riding bikes, or playing flag football. That way, the whole family can become healthier together.

by Patricia Kellicker, BSN and Rebecca J. Stahl, MA

RESOURCES:
American Council on Exercise
http://www.acefitness.org

Shape Up America
http://www.shapeupus.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Healthy Alberta
http://www.healthyalberta.com

REFERENCES:
Aerobic, muscle, and bone-strengthening: What counts? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/basics/children/what_counts.htm. Updated June 5, 2015. Accessed March 2, 2016.

Chapter 3: Active children and adolescents. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/chapter3.aspx. Accessed March 2, 2016.

How much physical activity do children need? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/basics/children/index.htm. Updated June 4, 2015. Accessed March 2, 2016.

Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Musculoskeletal problems in overweight and obese children. Ann Fam Med. 2009;7(4):352-356.

NCHBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 12, 2013. Accessed March 2, 2016.

Obesity in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 10, 2016. Accessed March 2, 2016.

Last reviewed March 2016 by Michael Woods, MD Last Updated: 3/2/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Baby Mechanics

May 17, 2017 Teresa Stockton - Blog, Women's Health

Proper lifting mechanics is important for everyone, especially for a new mom. Caring for a young child/infant significantly increases the strain to one’s low back. Luckily, there are steps that one can make to decrease that strain and reduce the risk of injury.

Always remember to: lift the child/infant close to you and bend through your legs versus your back.

As your baby begins to gain more independence and mobility, lower the height of his mattress to keep him safe. Be aware that the lower mattress height can increase strain on your back, so lower the mattress height as gradually as possible. When lifting your baby in or out of the crib, keep baby as close to your body as possible while keeping your back straight and bending through your legs. For older babies, help him get into a sitting position before lifting him out of the crib. Once baby can stand, lift him out of the crib from a standing position.

Just like lifting baby out of the crib, keep her as close to you as possible, bend through your legs and keep your back straight. Keep your abdominal muscles tight as you lift her up. If possible, get into a deep squat position to lower your center of gravity before picking up baby.

Avoid the “hip shift” position with baby propped on one hip while shifting your body to that side. Instead hold baby in front of you with his legs out on either side of you. If you are going to be holding baby for an extended period of time, use a baby carrier to keep your baby supported in a neutral alignment.

Tummy time isn’t just good for babies! During tummy time, get down on your stomach too. Stretching out on your stomach is good for you, and it also allows you to better interact with your baby.

During story time, be aware of your posture and always sit up straight. Place a pillow behind your back for extra support.

Use a nursing pillow under baby to help prop her up closer to you. Bring baby to you instead of leaning forward towards her to avoid strain. Placing a pillow behind your back can provide extra support and help you maintain the proper posture. If you are bottle feeding or for older babies, place a pillow under the arm that is supporting baby’s head to decrease the strain on your shoulder and neck. Although making eye contact with baby during a feeding can help strengthen your relationship with baby, it can cause strain on your neck. Be sure to bring your head to a neutral position throughout the feeding to decrease the tension on your neck.

When lifting a car seat, be sure to keep the car seat as close to your body as possible. Bend through your legs and keep your abdominal muscles tight as you pick up the car seat. Instead of carrying the car seat in one hand at your side, use both hands to hold and carry the car seat in front of you whenever possible.

Getting the car seat in and out of the car can be tricky. Remember to keep the car seat as close to your body as possible, keep your abdominal muscles tight and your back straight. If your car seat is placed in the middle position in your car, put one leg up into the car to protect your back while keeping the car seat close to your body.

This information was written by Metro Spine & Sports Rehabilitation, an outpatient physical therapy group with locations in the Chicago Loop and Lakeview areas. At Metro Spine & Sports Rehabilitation, their number one priority is the patient. For more information click here.

Winter Safety Tips for Children

January 3, 2017 Teresa Stockton - Blog, Pediatrics

When the temperature drops and snow is on the ground, your children can still benefit from some outdoor physical activity. All it takes is a little extra planning to stay safe.

Layer Up!
Infants and children lose heat more quickly due to their size. As a result, they are more likely to suffer from low body temperature, also known as hypothermia. Dressing in layers is a good way to provide your child with added warmth during the winter months. Your child should wear 1 more layer than an adult would wear. Choose fabrics that wick moisture to help pull sweat away from your child’s skin and keep them warm.

Here are some other winter stafety tips to help keep your child safe in the cold:
• Mittens are warmer, but gloves allow your child to use their fingers more. Consider having your child wear mittens over a pair of light gloves.
• Keep your child’s feet warm and dry with 2 pairs of socks.
• Avoid long scarves and drawstrings or ties, which could become a choking hazard. Consider neck warmers or turtleneck garments.
• Choose hats and hoods that do not obstruct your child’s vision.
• Keep a dry set of clothing at school in the event your child’s clothes become wet.

Winter Sport Safety
Winter safety tips for sports such as skiing, skating, snowboarding, and sledding require adult supervision and added safety measures. To help keep your child safe:
• Make sure your child wears a helmet and other protective gear such as wrist guards for snowboarding and a mouth guard for ice hockey.
• Teach your child to be aware of and avoid hazards when sledding such as cars, trees, and ponds.
• Do not allow your child to skate on surfaces until you are sure the water is frozen solid.
• Do not allow your child to wear headphones while playing. Headphones will block traffic or grooming machine sounds.
• Encourage your child to keep moving when outdoors to help generate body heat.

Bring your child inside at the first sign of frostnip—skin that is red, numb, and tingly. Soak your child’s skin in warm water until the symptoms go away. Do not rub the skin. If symptoms do not improve, call your child’s doctor. If your child’s skin becomes white, hard, and swollen, your child may have frostbite. The skin may also burn, tingle, or become numb. If you think your child has frostbite, bring your child inside and put your child in dry clothes. Do not rub the skin, rubbing can cause more damage. Call for medical help right away.

Don’t Skip the Sunscreen
It is possible for your child to get a sunburn in the winter since sunlight reflects off of the snow and ice. Your child should use a sunscreen with an SPF of at least 30. Apply it to your child 20 minutes before going outside and reapply it every 2 hours.

Fuel Up for Fun
Dehydration can contribute to hypothermia. Encourage your child to drink plenty of fluids, especially during vigorous physical activities. Your child will also need to fuel up to generate body heat needed for outdoor play. Provide your child with plenty of healthy snacks such as trail mix, fruit and bread.

When to Play
Freezing temperatures and wind are risk factors for hypothermia and frostbite. Avoid severe cold. Keep an eye on weather forecasts and plan outdoor activities for warmer days without snow or rain.

Following these winter safety tips will allow you and your child to safely enjoy the beauty of winter.

by Cynthia M. Johnson, MA

RESOURCES:
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES:
Canadian Paediatric Society
http://www.cps.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

Chillin’ with winter safety. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Chillin-With-Winter-Safety.aspx. Updated January 19, 2016. Accessed February 11, 2016.

Frostbite in children. Lucile Packard Children’s Hospital Stanford website. Available at: http://www.stanfordchildrens.org/en/topic/default?id=frostbite-in-children-90-P02820. Accessed February 11, 2016.

Keeping kids safe in the cold. American Academy of Pediatrics website. Available at: http://www2.aap.org/sections/schoolhealth/ECarchivenovember11.html. Accessed February 11, 2016.

Sunscreen FAQs. American Academy of Dermatology website. Available at: https://www.aad.org/media-resources/stats-and-facts/prevention-and-care/sunscreens. Accessed February 11, 2016.

Last reviewed February 2016 by Michael Woods, MD Last Updated:10/20/2014

For more winter safety tips to keep you out of harm’s way this season check the articles below!

Backpack Safety 101

August 4, 2016 Teresa Stockton - Back, Blog, Pediatrics

It’s that time of the year again when the kids are heading back to school. Learn the proper guidelines and precautions about backpack safety in this week’s PTandMe blog post.

Size
• Should Not Extend Above Shoulders
• Should Rest In Contour Of Low Back (Not Sag Down Toward Buttocks)
• Should Sit Evenly In Middle Of Back

Fit
• Shoulder Straps Should Rest Comfortably On Shoulders And Underarms, With Arms Free To Move – Tighten Shoulder Straps To Achieve This Fit
• Tighten Hip And Waist Straps To Hold Pack Near Body
• Padded Straps Help Even Pressure Over The Shoulders

Weight Of Pack
• Should Never Exceed 15% Of The Child’s Weight To Avoid Excess Loads On The Spine

Lifting Of Pack
• Proper Lifting Is Done By Bending The Knees, Squatting To Pack Level, And Keeping Pack Close To Body To Lift First To Waist Level And Then Up To Shoulders

Carrying The Pack
• Keep Both Shoulder Straps In Place And Pack Centered
• Spinal Forces Increase With Distance From The Body’s Center

Posture
• Uneven Stresses On The Spine Can Cause Muscle Imbalances. This Can Lead To Pain And Possibly Functional Scoliosis.

Juvenile Rheumatoid Arthritis

July 19, 2016 Teresa Stockton - Blog, Pediatrics

Definition

Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis, is a disease of the joints in children. It can affect a child over a long period of time. JRA often starts before the child is 16 years old.

In Juvenile rheumatoid arthritis, the joint becomes swollen. It will make the joint painful and difficult to move. JRA can also lead to long term damage to the joint. For some, JRA can interfere with the child’s growth and development.

There are 5 major types of juvenile rheumatoid arthritis:
• Pauciarticular JRA—4 or less joints are affected in the first 6 months of illness
• Polyarticular JRA—5 or more joints are affected in the first 6 months of illness
• Enthesitis associated arthritis—swelling of the tendon at the bone
• Psoriatic arthritis—associated with a skin disease called psoriasis
• Systemic onset JRA (also called Stills disease)—affects the entire body, least common type of JRA

Causes

Juvenile rheumatoid arthritis is caused by a problem of the immune system. The normal job of the immune system is to find and destroy items that should not be in the body, like viruses. With JRA, the immune system attacks the healthy tissue in the joint. It is not clear why this happens. The immune system problems may be caused by genetics and/or factors in the environment.

People of Hispanic American, Asian American, Pacific Islander, Native American, or African American descent are at higher risk.
Having prediabetes means that you are at high risk for developing diabetes and may already be experiencing adverse effects of elevated blood sugar levels.

Risk Factors

Girls are more likely to get JRA than boys.

There are no clear risk factors for JRA. Factors that may be associated with some types of JRA include:
• Family history of:
• Anterior uveitis with eye pain
• Inflammatory back arthritis (ankylosing spondylitis)
• Inflammatory bowel disease

Symptoms

• Symptoms may include:
• Joint stiffness, especially in the morning or after periods of rest
• Pain, swelling, tenderness, or weakness in the joints
• Fever
• Weight loss
• Fatigue or irritability
• Swelling in the eye—especially associated with eye pain, redness, or sensitivity to light
• Swollen lymph nodes
• Growth problems, such as:
• Growth that is too fast or too slow in one joint (may cause one leg or arm to be longer than the other)
• Joints grow unevenly, off to one side
• Overall growth may be slowed

Some symptoms are specific to each type of juvenile rheumatoid arthritis . For example:
• Symptoms common with pauciarticular JRA include:
• Problems most often found in large joints. These joints include knees, ankles, wrists, and elbows.
• If the left-side joint is affected, then the right-side similar joint will not be affected. For example, if the right knee is affected, then the left knee will be healthy.
• May also have swelling and pain at on the tendons and ligaments attached to the bone

• Symptoms common with polyarticular JRA include:
• Problems found most often in small joints of the fingers and hands. May also affect weight-bearing joints like the knees, hips, ankles, and feet.
• Joints on both sides of the body are affected. For example, if the left hand is affected, then the right hand will also be affected.
• May also have a blood disorder called anemia. This is an abnormally low number of red blood cells.
• One type of polyarticular JRA may occur with:
• A low-grade fever
• Nodules—bumps on parts of body that receive a lot of pressure such as elbows

• Symptoms common with systemic onset JRA include:
• Some of the first signs may be a high fever, chills, and a rash on the thighs and chest. May appear on and off for weeks or months
• May have swelling in the heart, lungs, and surrounding tissues
• The lymph nodes, liver and/or spleen may become enlarged
• Children with enthesitis arthritis often have tenderness over the joint where the pelvis and spine meet.
• Children with psoriatic arthritis often have finger or toe swelling. There may also be damage on fingernails.

Often, there are remissions and flare-ups. Remission is a time when the symptoms improve or disappear. Flare-ups are times when symptoms become worse.

Diagnosis

You will be asked about your child’s symptoms. You will also be asked about your family medical history. A physical exam will be done. An eye examination may also be done to check for swelling in the eye. Your child may be referred to a specialist if JRA is suspected. The specialist is a doctor that focuses on diseases of the joints.

Images may be taken of your child’s bodily structures. This can be done with x-rays.

Your child’s bodily fluids may be tested. This can be done with:
• Blood tests
• Urine tests
• Tests of joint fluid

Treatment

Talk with your doctor about the best plan for your child. The plan will work to control swelling, relieve pain, and control joint damage. The goal is to keep a high level of physical and social function. This will help keep a good quality of life. Treatment options include the following:

Medication

There are several types of medication that may be used:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)—to help swelling and pain
• Disease-modifying antirheumatic drugs (DMARDs)—to slow the progression of the disease
• Tumor necrosis factor (TNF) blockers—to decrease swelling, pain, and joint stiffness
• Interleukin inhibitors—to reduces disease activity
• Corticosteroids through IV or by mouth—for swelling
• Steroid injections into the joint—may help relieve swelling and pain in some children

Polyarticular JRA may become inactive in children who begin medications within 2 years of onset.

Physical Therapy

Exercise is done to strengthen muscles and to help manage pain. Strong nearby muscles will support the joint. It also helps to recover the range of motion of the joints. Normal daily activities are encouraged. Non-contact sports and recreational activities may be good options. Physical activities can also help boost a child’s confidence in their physical abilities.

Physical therapy may be needed. This will help to make the muscles strong and keep the joints moving well.

Maintenance Devices

Splints and other devices may be recommended. They may be worn to keep bone and joint growth normal. Some joints may get stuck in a bent position. These devices can help prevent this.

Prevention

There is no known way to prevent JRA.

by Jacquelyn Rudis

RESOURCES:
American College of Rheumatology
http://www.rheumatology.org

Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES:
The Arthritis Society
http://www.arthritis.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

Hofer MF, Mouy R, et al. Juvenile idiopathic arthritides evaluated prospectively in a single center according to the Durban criteria. J Rheumatol. 2001. 28:1083.

Juvenile idiopathic arthritis (JIA) enthesitis related. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

Juvenile idiopathic arthritis (JIA) oligoarticular. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

Juvenile idiopathic arthritis (JIA) polyarticular. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

Juvenile idiopathic arthritis (JIA) systemic-onset. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 16, 2015. Accessed December 21, 2015.

JAMA Patient Page. Juvenile idiopathic arthritis. JAMA. 2005;294:1722.

Petty RE, Southwood TR, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol.1998; 25:1991.

2/5/2013 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: De Benedetti F, Brunner HI, Ruperto N, et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. N Eng J Med. 2012;367(25):2385-95.

2/24/2014 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Limenis E, Grosbein HA, et al. The relationship between physical activity levels and pain in children with juvenile idiopathic arthritis. J Rheumatol. 2014 Feb;41(2):345-351.

9/2/2014 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Guzman J, Oen K, et al. The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort. Ann Rheum Dis. 2014 May 19.

Last reviewed December 2015 by Kari Kassir, MD Last Updated: 12/20/2014

Can Physical Therapy Help Kids with Arthritis?

May 26, 2016 Teresa Stockton - Blog, Pediatrics

Did you know that physical therapy can help kids with arthritis? Juvenile Rheumatoid Arthritis (JRA), also called Stills disease, is the most common form of arthritis seen in children and young adults.Children commonly complain of joint pain and stiffness, along with an occasional fever.

JRA can impact fine movements and overall mobility if left untreated. While medical therapy is the mainstay of treatment, physical therapy and rehabilitation are essential to restoring full movement and quality of life.

How does physical therapy help?
Physical therapists are trained experts at delivering a variety of treatments to help reduce pain and improve joint movement. A child experiencing pain and dysfunction can feel isolated and left out, unable to participate in group activities with other children. A physical therapist can help the child to improve muscle tone, strength and reduce joint inflammation. This helps children regain the quality of life they deserve; allowing them to live with less pain and enjoy the benefits of unrestricted movement.

This information was written by Oregon Spine and Physical Therapy, a physical therapy group located in Eugene, Oregon. At Oregon Spine & Physical Therapy, your care begins with a comprehensive evaluation of your condition by your physical therapist. This initial assessment will allow the physical therapist to accurately reach a diagnosis and then prepare your appropriate, personal treatment plan. For more information click here.