PIGEON TOES IN YOUR TOT

Pigeon Toes (Intoeing)

Children who walk with their feet turned in are described as being “pigeon-toed” or having “intoeing.” This is a very common condition that may involve one or both feet, and it occurs for a variety of reasons. 

Intoeing During Infancy 

Infants are sometimes born with their feet turning in. This turning occurs from the front part of their foot, and is called metatarsus adductus. It most commonly is due to being positioned in a crowded space inside the uterus before the baby is born. 

You can suspect that metatarsus adductus may be present if: 

• The front portion of your infant’s foot at rest turns inward. 
• The outer side of the child’s foot is curved like a half- moon. This condition is usually mild and will resolve before your infant’s first birthday. Sometimes it is more severe, or is accompanied by other foot deformities that result in a problem called clubfoot. 

This condition requires a consultation with a pediatric orthopedist and treatment with early casting or splinting. 

Intoeing In Later Childhood 

When a child is intoeing during her second year, this is most likely due to inward twisting of the shinbone (tibia). This condition is called internal tibial torsion. When a child between ages three and ten has intoeing, it is probably due to an inward turning of the thighbone (femur), a condition called medial femoral torsion. Both of these conditions tend to run in families. 

Treatment 

Some experts feel no treatment is necessary for intoeing in an infant under six months of age. For severe metatarsus adductus in infancy, early casting may be useful. 

Studies show that most infants who have metatarsus adductus in early infancy will outgrow it with no treatment necessary. If your baby’s intoeing persists after six months, or if it is rigid and difficult to straighten out, your doctor may refer you to a pediatric orthopedist who may recommend a series of casts applied over a period of three to six weeks. The main goal is to correct the condition before your child starts walking. 

Intoeing in early childhood often corrects itself over time, and usually requires no treatment. But if your child has trouble walking, discuss the condition with your pediatrician who may refer you to an orthopedist. A night brace (special shoes with connecting bars) was used in the past for this problem, but it hasn’t proven to be an effective treatment. Because intoeing often corrects itself over time, it is very important to avoid nonprescribed “treatments” such as corrective shoes, twister cables, daytime bracing, exercises, shoe inserts, or back manipulations. These do not correct the problem and may be harmful because they interfere with normal play or walking. Furthermore, a child wearing these braces may face unnecessary emotional strain from her peers. 

Nevertheless, if a child’s intoeing remains by the age of nine or ten years old, surgery may be required to correct it.

Source - 11/21/2015

Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

PT FOR ATHLETES

If you’re an athlete, you know that long periods of training followed by performing at peak levels can take a toll on your body. Whether you’ve experienced an acute injury or have become hurt as a result of overuse, the professional physical therapists from Champion Performance and Physical Therapy in Prairie Village, Kansas can help you get back in the game with their effective sports physical therapy programs.

If you’re an athlete considering sports physical therapy, take a look at some of the ways in which you could benefit from treatment at Champion:

• Less Downtime: Sports physical therapy helps athletes regain muscle strength without damaging the injured area further. This will help you proactively work to repair injured tissue and get back to your training or active recovery period faster and with less downtime.
• Better Odds For A Full Recovery: Instead of letting an injury “ride its course,” physical therapy takes a proactive approach to healing and thus increases your odds of making a complete recovery. Under the care of a physical therapist, you’ll also know exactly when you can resume your normal activity levels again, whereas athletes who don’t seek physical therapy often try to do too much too soon and risk re-injuring themselves.
• You’ll Receive Tailored Treatment: Some athletes make the mistake of trying to rehabilitate their injured body part on their own, but this approach overlooks the fact that each body and injury is unique. The professionals at Therapy Works utilize a number of different treatment methods and have the skills, knowledge, and experience to tailor their sports physical therapy program to the unique needs of each patient.

Click on the contact information tab on our website menu for a full list of contact options. 

www.kcchampionperformance.com

WHAT EXACTLY IS A PHYSICAL THERAPIST?

As described by the American Physical Therapy Association

Physical therapists (PTs) are health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives.

PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

Physical therapists provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a physical therapist practices.

The Physical Therapy Profession

Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists:

• Diagnose and manage movement dysfunction and enhance physical and functional abilities.
• Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health. 
• Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.

The terms "physical therapy" and "physiotherapy," and the terms "physical therapist" and "physiotherapist," are synonymous.

As essential participants in the health care delivery system, physical therapists assume leadership roles in rehabilitation; in prevention, health maintenance, and programs that promote health, wellness, and fitness; and in professional and community organizations. Physical therapists also play important roles both in developing standards for physical therapist practice and in developing health care policy to ensure availability, accessibility, and optimal delivery of health care services. Physical therapy is covered by federal, state, and private insurance plans. Physical therapists' services have a positive impact on health-related quality of life.

As clinicians, physical therapists engage in an examination process that includes:

• taking the patient/client history,
• conducting a systems review, and 
• performing tests and measures to identify potential and existing problems.

To establish diagnoses, prognoses, and plans of care, physical therapists perform evaluations, synthesizing the examination data and determining whether the problems to be addressed are within the scope of physical therapist practice. Based on their judgments about diagnoses and prognoses and based on patient/client goals, physical therapists:

• provide interventions (the interactions and procedures used in managing and instructing patients/clients),
• conduct re-examinations,
• modify interventions as necessary to achieve anticipated goals and expected outcomes, and
• develop and implement discharge plans.

Physical therapy can be provided only by qualified physical therapists (PTs) or by physical therapist assistants (PTAs) working under the supervision of a physical therapist.

PELVIC PAIN AND WHAT TO DO ABOUT IT

Pelvic pain is pain felt in the lower abdomen, pelvis, or perineum. It has many possible causes and affects up to 20% of the population in the United States, including women and men. Pelvic pain is considered "chronic" when it lasts for more than 6 months. Physical therapists help people experiencing pelvic pain restore strength and flexibility to the muscles and joints in the pelvic region, and reduce their pain.

What Is Pelvic Pain?

Pelvic pain can be caused by:

• Pregnancy and childbirth, which affect pelvic muscles and cause changes to pelvic joints
• Pelvic joint problems from causes other than pregnancy and childbirth
• Muscle weakness or imbalance within the muscles of the pelvic floor, trunk, or pelvis
• Changes in the muscles that control the bowel and bladder
• Tender points in the muscles around the pelvis, abdomen, low back, or groin areas
• Pressure on 1 or more nerves in the pelvis
• Weakness in the muscles of the pelvis and pelvic floor
• Scar tissue after abdominal or pelvic surgery
• Disease
• A shift in the position of the pelvic organs, sometimes known as prolapse

How Does it Feel?

The pain in your lower abdomen and pelvis may vary; some people say it feels like an aching pain; others describe it as a burning, sharp, or stabbing pain, or even pins and needles. In addition, you may have:

• Pain in the hip or buttock.
• Pain in the tailbone or pubic bone.
• Pain in the joints of the pelvis.
• Tender points in the muscles of the abdomen, low back, or buttock region.
• A sensation of heaviness in the pelvic region or even a sensation as if you are sitting on something hard, like a golf ball.

Signs and Symptoms

• Inability to sit for normal periods of time.
• Reduced ability to move your hips or low back.
• Difficulty walking, sleeping, or performing daily activities.
• Pain or numbness in the pelvic region with exercise or recreational activities, such as riding a bike or running.
• Pain during sexual activity.
• Urinary frequency, urgency, or incontinence, or pain during urination.
• Constipation or straining with bowel movements, or pain during bowel movements.
• Difficulty using tampons.
• Imbalance when walking.

How Is It Diagnosed?

Your physical therapist will complete a thorough review of your medical history, and perform a physical examination to identify the causes of your pelvic pain and any joint issues, muscle tightness or weakness, or nerve involvement. The exam may include:

• Pelvic girdle screening.
• Soft tissue assessment.
• Visual inspection of the tissues.
• Reflex testing.
• Sensation testing.
• Internal assessment of pelvic floor muscles.

Your physical therapist also will determine whether you should be referred to a physician to assist in your interdisciplinary plan of care.

How Can a Physical Therapist Help?

Based on the examination results, your physical therapist will design an individualized treatment program to meet your specific needs and goals. Your physical therapist may:

• Show you how to identify the appropriate muscles, such as the pelvic floor, deep abdominals, and diaphragm.
• Educate you on how to use these muscles correctly for activities like exercise, posture correction, getting up from a chair, or squatting to pick up a child or pick something up from the floor.
• Teach you exercises to stretch and strengthen the affected muscles and retrain them, so they work together normally.
• Teach you techniques to improve blood flow and tissue function in the pelvic area.
• Teach you appropriate pelvic floor muscle exercises.

 Depending on your symptoms and level of discomfort, your physical therapist may decide to use biofeedback to help make you aware of how your pelvic floor muscles work, and how you can control them better. Your physical therapist may attach electrodes to the area to measure your muscle activity as it displays on a monitor, and will work with you to help you understand and change those readings. Your physical therapist also may use gentle electrical stimulation to improve your awareness of your muscles.

ALMOST 1/2 OF BABIES HAVE FLAT SPOTS

Putting babies to sleep on their backs is preventing sudden infant death syndrome (SIDS), but too much time on their backs it might also be leading to an increase in flat spots on babies' heads.

As reported by NBC News (Nearly half of babies have flat spots, study finds - July 8, 2013), a recent study found that 46.6% of babies had some form of plagiocephaly ("oblique head").

The solution includes varying the side of the head that is placed down when the baby goes to sleep, and also increased "tummy time." Tummy time, even when infants are still very young, is so important. Babies come out flexed up into a ball, and as their muscles begin to relax and their bodies straighten out, tummy time helps the muscles in their neck become active. Babies can typically begin to lift their heads and clear their mouth/nose as early as 10 days after they're born! Within the 1st month, they should begin to get a little bit of clearance, within the 2nd month they should be able to lift their whole head off the ground, and by the 3rd month your baby should be able to hold their heads up and support themselves on their elbows. Once your baby can support their upper body on their elbows, they're typically within ~6 months of crawling! 

Download Tummy Time Tools from the APTA's website for quick tips on how to position, carry, hold, and play with your baby to promote muscle development in the child's neck and shoulders and avoid the development of flat areas on the back of the baby's head.

CHEERLEADING INJURY PREVENTION

Legend has it that cheerleading started with a University of Minnesota student standing up in the stands and leading his fellow students in "cheering" for their team during a football game. Cheerleading has morphed drastically since then. Today, it's considered an athletic activity that incorporates elements of dance and gymnastics along with stunts and pyramid formations. In 2002, an estimated 3.5 million people in the United States participated as cheerleaders, from six-year-olds to adults who cheerlead for professional athletic teams. While cheerleading is meant to support an athletic team, its intense competitions at the high school and collegiate levels have created a whole new dynamic, including increased risk for injury.

WHAT TYPES OF INJURIES ARE MOST COMMON IN CHEERLEADING?

The U.S. Consumer Product Safety Commission (CPSC) estimates that cheerleading led to 16,000 emergency room visits in 2002 (the latest year for data). While not as frequent as injuries in other sports, cheerleading injuries tend to be more severe, making up more than half of the catastrophic injuries in female athletes. Cheerleading injuries affect all areas of the body — most commonly the wrists, shoulders, ankles, head, and neck.
 

HOW CAN INJURIES BE PREVENTED?

Stunt Restrictions

In an attempt to curb the amount of catastrophic injuries in cheerleading, restrictions have been placed on stunts. They range from height restrictions in human pyramids, to the thrower-flyer ratio, to the number of spotters that must be present for each person lifted above shoulder level.

For example, the limit for pyramids is two body lengths for the high school level and 2.5 body lengths for the college level, with the base cheerleader in direct contact with the performing surface. Base supporters must remain stationary and the suspended person is not allowed to be inverted or rotate on dismount.

Basket toss stunts in which a cheerleader is thrown into the air (sometimes as high as 20 feet) are only allowed to have four throwers. The person being tossed (flyer) is not allowed to drop the head below a horizontal plane with the torso. One of the throwers must remain behind the flyer at all times during the toss.

Mats should be used during practice sessions and as much as possible during competitions. Cheerleaders should not attempt a stunt if they are tired, injured, or ill, as this may disrupt their focus and cause the stunt to be performed in an unsafe manner.
 

Training

The importance of a qualified coach is also critical. Coaching certification is encouraged. Precautions should always be taken during inclement weather for all stunts. Also, a stunt should not be attempted without proper training, and not until the cheerleader is confident and comfortable with performing the stunt.  Supervision should be provided at all times during stunt routines.

As with any sport, proper conditioning and training are important to minimize injury, including:

• Resistance exercises to gain strength in the lower back, stomach, and shoulders
• Regular stretching, yoga, or pilates instruction to improve flexibility
• Speaking with a sports medicine professional or athletic trainer if you have any concerns about injuries or cheerleading injury prevention strategies
• Returning to play only when clearance is granted by a healthcare professional
   

HOW ARE CHEERLEADING INJURIES TREATED?

One of the most common injuries cheerleaders suffer is an ankle or wrist sprain or strain. For treatment of a sprain or strain, remember RICE:

•  Rest the injured site for at least 24 hours
•  Ice the injury at least every hour for 10-20 minutes during the initial four hours after injury. Icing then can be done 10-20 minutes four times a day for two days
•  Compress the injured site with a snug, elastic bandage for 48 hours
•  Elevate the injured limb for at least 24 hours Immediate medical attention is required for any cheerleader with a suspected head or neck injury.
   

REFERENCES AND ADDITIONAL RESOURCES

Campbell, John D, and Barry P. Boden. Cheerleading Injuries. Sports Medicine Update. September/October 2008.

Boden BP, R Tacchetti, FO Mueller. Catastrophic cheerleading injuries. Am Journal of Sports Med. 31:881-888, 2003.

Shields BJ, GA Smith. Cheerleading related injuries to children 5 to 18 years of age: United States, 1990- 2002. Pediatrics. 117:122-129, 2006.

The following expert consultants contributed to the tip sheet:
John D Campbell, MD
Barry P. Boden, MD