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

PT'S GUIDE TO PELVIC FRACTURES

A pelvic fracture is a break in 1 or more bones in the pelvis. It is sometimes referred to as a "hip fracture" or "broken hip" because it occurs in the bones that make up the hip area. A pelvic fracture causes difficulty walking or standing. It can also cause abdominal pain, bleeding from pelvic cavities, and difficulty urinating. Pelvic fractures in the United States are relatively rare, making up 0.3% to 6% of all fractures. Pelvic fractures are most common in people 15-28 years of age. In people younger than 35, males suffer a higher incidence of pelvic fractures than females. In people older than 35, females suffer pelvic fractures more often than males.

What is a Pelvic Fracture (Hip Fracture)?

A pelvic fracture is a crack or break in one or more of the pelvic bones, which are located at the base of the spine. The pelvis is often referred to as part of the hip. (When you "put your hands on your hips," your hands are actually resting on your pelvic bones.)

A pelvic fracture can result from a low-impact or high-impact event.

Low-impact pelvic fractures most commonly occur in 2 age groups: adolescents and the elderly. Adolescents typically experience fractures of the tips of 1 of the pelvic bones, resulting from an athletic injury (football, hockey, skiing) or an activity such as jogging. Pelvic fractures also can occur after minor falls in people with osteoporosis or even occur spontaneously when bones are weak. The elderly frequently suffer fractures of the thicker part of the pelvic bones. These "pelvic ring fractures" result from falling onto the side of the hip. These falls can be caused by balance problems, vision problems, medication side effects, general frailty, or unintended obstacles such as pets underfoot, slippery floors, or rumpled rugs. Low-impact pelvic fractures often are mild fractures, and they may heal with several weeks of rest. Physical therapy is very helpful in restoring strength and balance in these cases.

High-impact pelvic fractures most commonly result from major incidents such as a motor vehicle accidents, a pedestrian being struck by a vehicle, or a fall from a high place. These pelvic fractures can be life-threatening, require emergency room care, surgery, and extensive physical therapy rehabilitation.

How Can a Physical Therapist Help?

Pelvic fracture recovery often involves surgery or long periods of bed rest. In the case of athletes, avoidance of sport activities is recommended until pain has resolved. During these periods of rest, which are usually weeks to months, a person often loses strength, flexibility, endurance, and balance abilities.

Physical therapists can help you recover from a pelvic fracture by improving your:

• Pain level
• Hip, spine, and leg motion
• Strength
• Flexibility
• Speed of healing
• Speed of return to activity and sport

When you are cleared by your physician to begin physical therapy, your physical therapist will design a specific treatment program to speed your recovery, including exercises and treatments you should do at home. This program will help you return to your normal life and activities and reach your recovery goals.

The First 24-48 Hours

Your physical therapist may help you learn to use crutches so you can move around your home without walking on the leg of the injured side. This will more commonly apply to low-impact pelvic fractures, as in athletes. More severe pelvic fractures will require a wheelchair, in which your physical therapist can instruct your safe usage.

Reduce Pain

Your physical therapist can use different types of treatments and technologies to control and reduce your pain, including ice, heat, ultrasound, electrical stimulation, taping, exercises, and special hands-on techniques called manual therapy that gently move your muscles and joints.

Your physical therapist will choose specific activities and treatments to help restore normal movement in the leg and hip. These might start with passive motions that he or she applies to your leg and hip joint, and progress to active exercises and stretches that you perform yourself. Treatment can involve hands-on manual therapy techniques called "trigger point release" and "soft tissue mobilization," as well as specific stretches to muscles that might be abnormally tight.

Improve Strength

Certain exercises will benefit your healing at each stage of recovery, and your physical therapist will choose and teach you an individualized exercise program that will restore your strength, power, and agility. These exercises may be performed using free weights, stretch bands, weight-lifting equipment, and cardio exercise machines such as treadmills and stationary bicycles. For pelvic fractures, muscles of the hip and core are often targeted by the strength exercises.

Improve Balance

The hip area contains many muscles that are vital for balance and steadiness when walking or performing any activity. Your physical therapist will teach you effective exercises to restore strength and endurance to these muscles so that you can regain your balance.

Speed Recovery Time

Your physical therapist is trained and experienced in choosing the treatments and exercises to help you heal, get back to your normal life, and reach your goals faster than you might be able to on your own.

Return to Activities

Your physical therapist will collaborate with you to decide on your recovery goals, including return to work and sport. Your treatment program will be designed to help you reach these goals in the safest, fastest, and most effective way possible. Your physical therapist will use hands-on therapy and teach you exercises and work re-training activities. Athletes will be taught sport-specific techniques and drills to help achieve sports-specific goals.

Prevent Future Problems

Your physical therapist can recommend a home exercise program to strengthen and stretch the muscles around your hip, upper leg, and core to help prevent future problems, such as fatigue and walking difficulty. This program may include strength and flexibility exercises for the hip, thigh, and core muscles. Your physical therapist will also review with you and your family ways to prevent falls in your home. These fall-prevention strategies may include clearing the floors of loose obstacles (throw rugs, mats), using sticky mats or chairs in the shower, preventing pets from walking near your feet, and using non-slippery house shoes, as well as installing grab bars or rails for the shower, toilet, and stairs.

If Surgery Is Necessary

If surgery is required, your physical therapist will help you minimize pain, restore motion and strength, and return to normal activities in the speediest manner possible after surgery.

Can this Injury or Condition be Prevented?

Pelvic fracture can be prevented by:

• Warming up before starting any sport or heavy physical activity. Your warm-up should include stretches taught to you by your physical therapist, including stretches for the muscles on the front, side, and back of the hip.
• Increasing the intensity of an activity or sport gradually, not suddenly. Avoid pushing yourself too hard, too fast, too soon.
• Following a reasonable and safe nutritional plan. Nutritional factors can contribute to osteoporosis, which can put you at higher risk of pelvic fracture.
• Maintaining good balance skills. Balance problems can increase the risk of falling and thus increase the risk of incurring a pelvic fracture. Physical therapy can help maintain and improve balance ability, which can help prevent falls.
• Driving safely to avoid motor vehicle accidents.
• Clearing your house of obstacles that you could trip over, and eliminating slippery walking surfaces.

DOWN SYNDROME: LEARN MORE ABOUT THE ROLE OF PHYSICAL THERAPY

Down syndrome (DS) affects approximately 6,000 (1 in 700) babies born in the United States (US) each year. Most children with Down syndrome experience physical and developmental delays, and may have physical conditions requiring treatment. Individuals with Down syndrome experience cognitive (intellectual) delays, but the effect is usually mild to moderate and is not indicative of the many strengths that each individual possesses. Approximately 400,000 people living in the US and more than 6 million people worldwide have Down syndrome. Physical therapists work with individuals with Down syndrome from infancy through adulthood to help them function at their maximum potential and lead healthy, productive lives.

What is Down Syndrome?

Down syndrome, also called Trisomy 21, is a genetic disorder causing babies to be born with an extra copy of chromosome 21. Chromosomes determine how a baby grows in the mother's womb before birth and how the baby's body functions after birth; normally, a baby is born with 46 chromosomes. The extra copy of chromosome 21 in babies born with Down syndrome changes the typical development of the brain and the body, causing intellectual and physical challenges.

The current average life span of a person with Down syndrome living in the US and in other developed countries is approximately 60 years. Although DS continues throughout a person's life span, children and adults can improve their ability to perform movement activities and everyday tasks with the help of physical therapists and other health care professionals. Physical therapists working side-by-side with individuals with Down syndrome and their families can help prevent some of the complications of DS, such as developmental delay and obesity, and help boost and maintain their levels of heart and cardiovascular fitness.

Signs and Symptoms

Down syndrome may be detected during pregnancy by screening or diagnostic tests. If not detected before birth, Down syndrome usually is detectable at birth by the baby's physical characteristics. These physical characteristics include:

• Low muscle tone
• A single deep crease across the palm of the hand
• A slightly flattened facial profile, and an upward slant to the eyes

A chromosomal analysis of a newborn baby can be performed to confirm a diagnosis of DS.

Approximately 40% to 60% of babies born with DS will have some type of congenital heart disease, which may be noted at the time of birth or soon following birth. Motor development (movement) is often delayed because the baby may have low muscle tone, decreased strength, increased movement at the joints, postural and balance difficulties, feeding problems, or challenges with hand use. Children with Down syndrome also may experience some vision and hearing challenges, and develop and use language at a slower rate. They also often require increased time to learn complex movements, such as riding a tricycle.

Other challenges may include:

• Poor language development and use
• Vision and hearing problems
• Cognitive (ie, thinking, decision making) difficulties
• Obesity

In later childhood and adulthood, people with DS may develop other challenges, such as:

• Difficulty learning complex movement tasks
• Degenerative joint disease
• Poor cardiovascular health (ie, hypertension)
• Thyroid dysfunction
• Diabetes
• Skin disorders
• Lower bone density
• Digestive problems
• Leukemia
• Sleep apnea
• Depression (approximately 30% of cases)
• Early onset of dementia

Physical therapists will work with the individual, the family, and other health care providers to reduce the effect of these conditions, or even prevent them from developing.

Good medical care, strong educational environments that include physical therapy from preschool through high school and into adulthood, and support from families can help keep adults with DS living at their maximum potential. Many adolescents and adults with DS participate in family and community activities and lead happy, productive lives.

How Is It Diagnosed?

Three types of DS have been identified, and all types are diagnosed by a chromosomal analysis—frequently a blood test—ordered by a physician.

Type 1. The most common type of DS is called "Nondisjunction Trisomy 21." This type of DS occurs when 3 copies of chromosome 21 are present in the fertilized egg. Typically, 1 copy of chromosome 21 comes from the father and 1 copy comes from the mother. When 3 copies are present, the extra chromosome may come from either the mother or the father. As the baby develops, the extra chromosome is copied into every cell in the body.

Type 2. Translocation Trisomy 21 is seen in about 4% of all people with Down syndrome. In this type of DS, part of chromosome 21 breaks off during cell division of the fertilized egg and attaches to another chromosome. The total number of chromosomes in the cells is the usual 46, but the extra part of chromosome 21 causes the baby to have the characteristics of Down syndrome.

Type 3. Mosaic Trisomy 21 occurs in approximately 1% of persons with Down syndrome. This type of DS develops when a "nondisjunction" or error occurs in 1 of the cell divisions of the fertilized egg, but not all cell divisions are affected. Some of the baby's cells contain 46 chromosomes, which is typical, but other cells contain the extra chromosome 21 for a total of 47. People with Mosiac DS may have fewer characteristics of the syndrome.

How Can a Physical Therapist Help?

The physical therapist is an important partner in health care and fitness for anyone diagnosed with DS. Physical therapists help people with DS gain strength and movement skills in order to function at their best throughout all the stages of life.

Specifically, physical therapists work with children with DS to improve muscle strength, balance, coordination, and movement skills to improve independence with daily activities and quality of life. Early intervention by a physical therapist helps a child with DS develop to their maximum potential.

Your child's physical therapist will perform an evaluation that includes:

• Birth and developmental history. Your physical therapist will ask questions about your child's birth and developmental stages (the age he or she performed activities such as holding the head upright, rolling over, sitting up, crawling, walking, and running).
• General health questions. Your physical therapist may ask some of the following questions: Has your child been sick or hospitalized? When did your child last visit a physician or health care provider? Were any health concerns shared with you during that visit? Has your child had any surgeries?
• Parental concerns. Your physical therapist will ask about your chief concerns. What are your goals? What do you hope to accomplish first in physical therapy?
• Physical examination. The physical exam may include measuring your child's height and weight, observing movement patterns, and making a hands-on assessment of his or her muscle strength and tone, movement, flexibility, posture, balance, and coordination. Your child’s heart health and fitness may also be assessed, as well as his or her foot posture and potential need for orthotics.
• Motor skill acquisition. Your physical therapist will perform specific tests to determine your child's motor development such as sitting, crawling, kneeling, pulling up from sitting to standing, walking, and more advanced skills like running, jumping, or kicking and throwing a ball. Your therapist also may screen the child's hand use, vision, learning strategies, and other areas of development.
• Referrals. Your physical therapist may refer you to other health care professionals who can participate in a team effort to address your child's needs. The therapist may coordinate regularly with other consultants, such as a developmental pediatrician, a cardiologist, or a speech and language therapist, to schedule regular checkups.

The physical therapist will design an individualized treatment program that may include:

• Improving strength. Your physical therapist may teach you and your child exercises to increase muscle strength. The therapist will identify games and fun tasks that improve strength, and adjust them as the child grows, identifying new fitness activities to reduce the risk of obesity and increase and maintain heart health.
• Improving developmental skills. Your physical therapist will help your child learn to master motor skills such as crawling, pulling up from sitting to standing, and walking. Research has shown that infants with DS can benefit from activities like walking on a treadmill. Physical therapists can help caregivers support their child's movement development by providing hands-on training for positioning, movement, feeding, and play. Your physical therapist also may suggest changes at home to encourage movement development, communication, hearing, vision, and play skills.
• Improving balance, coordination, and postural control. Your physical therapist may use equipment such as a firm, round pillow or an exercise ball to improve your child's ability to hold the head erect or to maintain a sitting position. Other skills such as jumping, skipping, and dribbling a ball may be incorporated into a fun physical therapy regimen.
• Improving physical fitness. Your physical therapist will help determine the specific exercises, diet, and community involvement that can promote healthy living choices for your child, and prevent complications of DS, such as activity limitations and decreased participation with siblings or peers.

Physical therapy may be provided in the home or at another location like a community center, school, or a physical therapy outpatient clinic. Physical therapists work with other health care professionals to address the needs of individuals with DS, as treatment priorities shift throughout their lifespans.

How Often Does This Occur?

The exact cause of the chromosomal changes that result in DS is not known, but the disorder is associated with increasing age in mothers. Women older than 35 years at the time of childbirth have an increased incidence of having a baby with Down syndrome. Mothers at age 20 have an incidence of having a baby with DS at 1 in 2,000 births; at age 40, incidence increases to 1 in every 100 births. However, due to the fact that younger women have a much greater childbirth rate, the overall majority of babies with DS are born to women younger than 35 years of age.

Excellent prenatal care is important for all pregnant women. Once a child is diagnosed with DS, the physical therapist and other health care professionals can prevent or reduce additional complications that might occur following birth.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat a variety of conditions or injuries. You may want to consider:

• A physical therapist who is experienced in pediatrics and developmental disorders. Some physical therapists have a pediatric practice and will work with you and your child in the clinic, home, school, and community environment.
• A physical therapist who is a board-certified clinical specialist or who has completed a residency or fellowship in pediatric physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to developmental conditions such as DS.
• Experienced pediatric physical therapists who also understand the importance of working with other health care professionals as needed to maximize outcomes for people with DS.
• A physical therapist who specializes in neurological conditions, musculoskeletal impairments, or pain management for an adult with DS, depending on that individual’s needs. Your physician or physical therapist can direct you to the appropriate specialist.
• Early-intervention physical therapy from birth to 3. Each State in the US is responsible for providing early intervention programs for infants and toddlers. Services for children are provided at the local level, under state supervision. Find out the agency for your state at the ECTA Center, or contact your pediatrician or family physician.

 You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family and friends or from other health care providers.
• When you contact a physical therapy clinic or home health agency for an appointment, ask about the physical therapists' experience in helping children with Down syndrome or other developmental disorders.
• During your first visit with the physical therapist, be prepared to describe your child's symptoms and motor skills in as much detail as possible.
  
  For more information, visit www.apta.org

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.

FLAT FEET AND FALLEN ARCHES IN CHILDREN

Babies are often born with flat feet, which may persist well into their childhood. This occurs because children’s bones and joints are flexible, causing their feet to flatten when they stand. Young babies also have a fat pad on the inner border of their feet that hides the arch. You still can see the arch if you lift your baby up on the tips of the toes, but it disappears when he’s standing normally. The foot may also turn out, increasing the weight on the inner side and making it appear even more flat. 

Normally, flat feet disappear by age six as the feet become less flexible and the arches develop. Only about 1 or 2 out of every 10 children will continue to have flat feet into adulthood. For children who do not develop an arch, treatment is not recommended unless the foot is stiff or painful. Shoe inserts won’t help your child develop an arch, and may cause more problems than the flat feet themselves. 

However, certain forms of flat feet may need to be treated differently. For instance, a child may have tightness of the heel cord (Achilles tendon) that limits the motion of his foot. This tightness can result in a flat foot, but it usually can be treated with special stretching exercises to lengthen the heel cord. Rarely, a child will have truly rigid flat feet, a condition that can cause problems. These children have difficulty moving the foot up and down or side to side at the ankle. The rigid foot can cause pain and, if left untreated, can lead to arthritis. This rigid type of flat foot is seldom seen in an infant or very young child. (More often, rigid flat feet develop during the teen years and should be evaluated by your child’s pediatrician.) 

Symptoms that should be checked by a pediatrician include foot pain, sores or pressure areas on the inner side of the foot, a stiff foot, limited side-to-side foot motion, or limited up-and-down ankle motion. For further treatment you should see a pediatric orthopedic surgeon or podiatrist experienced in childhood foot conditions.

INFANT BRACHIAL PLEXUS INJURIES

The brachial plexus is a network (bundle) of nerves in the shoulder and under the arm. The network is composed of the nerves that carry signals from the spinal cord to the shoulder, arm, hand, and fingers. These signals transmit information between the brain, the spinal cord, and the arm and hand and are required for typical movement and feeling (sensation). If nerves in the upper part of the brachial plexus bundle are damaged, the injury is called Erb’s (or Erb-Duchenne) Palsy. If the nerves in the lower part of the brachial plexus are damaged, the injury is called Klumpke’s (or Dejerine-Klumpke) Palsy. In some instances, all the nerves may be damaged, resulting in "global" palsy.

Injuries to the brachial plexus result in movement and sensation difficulties in the arm, which may be mild or severe, and temporary or prolonged. Brachial plexus injury occurs in approximately 1.5 of every 1,000 infants born; the rate of injury is lower in smaller infants (under 6 pounds) and increases as the size of the infant increases, especially in babies who weigh 9 pounds or more.

What is a Brachial Plexus Injury?

The brachial plexus is a bundle of nerves that runs from the neck through the shoulder to the arm. Although injury can happen anytime, most brachial plexus injuries occur during birth when the infant's shoulder becomes wedged in the birth canal. This event, called shoulder dystocia, can stretch the brachial plexus, damaging the nerves. The delivery becomes an emergency situation, and additional maneuvers are required to deliver the infant. Injury also may occur without shoulder dystocia if the labor is long, the infant is large, the mother develops gestational diabetes, the delivery requires external assistance (such as forceps), or if a breech birth (buttocks- or feet-first rather than head-first) occurs.

Possible Causes

Erb's or Klumpke's Palsies result from 4 types of brachial plexus injuries:

• Neuropraxia occurs when 1 or more of the nerves are stretched and damaged, but not torn. It is the most common type of injury to the nerves of the brachial plexus, and may heal spontaneously.
• Neuroma results from a torn nerve that heals, but scar tissue develops. The scar tissue puts pressure on the injured nerve and prevents signals from being transmitted between nerves and muscles. Neuroma injuries require treatment to heal.
• Rupture describes a torn nerve, but the tear is not at the site where the nerve attaches to the spine. Surgery will be required, and the muscles may continue to weaken if physical therapy treatment does not occur following surgery.
• Avulsion is the most severe type of injury, in which the nerve is torn from the spine. The size and growth of the arm or hand may be affected, and damage may be present for life.

Signs and Symptoms

The signs and symptoms of brachial plexus injury vary, depending upon which nerves are damaged and the extent of the damage. Major damage may result in a limp or paralyzed arm. The arm muscles are weak and lack feeling or sensation.

In Erb's Palsy, the signs may be a stiff arm that is rotated inward with the wrist fully bent and fingers extended. This position is often called the "waiter's tip" because it resembles a food server holding the hand discreetly for a tip.

If other nerves are damaged, as in Klumpke's Palsy, the posture of the arm will be different. Sometimes the fingers and hand can move even when the arm has limited movement. The amount of pain that is present also is dependent upon the extent of the nerve damage.

How Is It Diagnosed?

Brachial plexus injuries are often apparent at birth because the infant's arm is limp or unusually stiff. Diagnosis of the injury requires a careful neurological examination by a specialist to determine which nerves have been affected, and the severity of the injury. Usually, the examination will include physical observation of the arm as well as some special tests, such as an electromyogram (EMG) that reveals the extent of muscle damage caused by the nerve injury. A nerve conduction study (NCS) may be used to determine how far signals are transmitted along the nerves. Other scans may be required to assess the damage to the nerves.

Some children's hospitals offer a team approach in diagnosing and treating children with brachial plexus injuries. The specialists on the team might include physicians, orthopedic surgeons, and physical therapists. Surgery may be necessary if the nerve damage is too extensive for recovery with therapy alone. Physical therapy will likely be a part of the treatment plan, whether or not the child has surgery. Sensory re-education may be included if the brain forgets how the arm and hand should function during the time the nerve is regrowing or healing. Seeking treatment as early as possible, and seeking care by experts in brachial plexus injury can make a big difference in helping a child gain full use of their arm.

How Can a Physical Therapist Help?

A physical therapist is an important family treatment partner for any child diagnosed with a brachial plexus injury. Physical therapy should begin as soon as possible after diagnosis or surgery, and before joint or muscle tightness has developed. Physical therapists will:

• Identify muscle weakness and work with each child to keep muscles flexible and strong.
• Help reduce or prevent muscle or joint contractures (tightening) and deformities.
• Encourage movement and function.

Even when surgery is not required, therapy may need to continue for weeks and months as the nerves grow again or recover from damage. Children with Erb's Palsy will usually recover by 6 months of age, but other palsies may require longer treatment. Each treatment plan is designed to meet the child's needs using a family-centered approach to care.

Evaluation. Your child's physical therapist will perform an evaluation that includes a detailed birth and developmental history. Your child’s physical therapist will perform specific tests to determine arm function, such as getting the child to bring the hands together, grasp a toy, or use the arm for support or for crawling. The physical therapist will test arm sensation to determine whether some or all feeling has been lost, and educate the family about protecting the child from injuries when the child may not be able to feel pain. Physical therapists know the importance of addressing the child’s needs with a team approach, review all health care assessments, and send the child for further evaluation, if needed.

Treatment. Physical therapists work with children with brachial plexus injury to prevent or reduce joint contractures, maintain or improve muscle strength, adapt toys or activities to promote movement and play, and increase daily activities to encourage participation—first in the family, and later, in the community. Treatments may include:

• Education on holding, carrying, and playing with the baby. Your physical therapist will make suggestions for positioning, so that your baby's arm will not be left hanging when the baby is being held or carried. Your physical therapist will provide ideas for positioning the baby on the back or stomach for play without injury to the arm.
• Prevention of injury. Your physical therapist will explain the possible injuries that could occur without the baby crying, since the baby cannot perceive pain if sensation is limited in the arm.
• Passive and active stretching. Your physical therapist will assist you and your child in performing gentle stretches to increase joint flexibility (range of motion), and prevent or delay contractures (tightening) in the arm.
• Improving strength. Your physical therapist will teach you and your child exercises and play activities to maintain or increase arm strength. Your physical therapist will identify games and fun tasks that promote strength without asking the baby to work too hard. As your child improves and grows, your physical therapist will identify new games and activities that will continue to strengthen the arm and hand.
• Use of modalities. Your physical therapist might use a variety of intervention techniques (modalities) to improve muscle function and movement. Electrical stimulation can be applied to gently simulate the nerve signal to the muscle and keep the muscle tissue functional. Flexible tape can be applied over specific muscle areas to ease muscle contraction. Constraint-induced movement therapy (CIMT) may be applied to the nonaffected arm to encourage use of the affected arm. Repetitive training of the affected arm is encouraged, using age-appropriate tasks, such as finger painting, building a tower, or picking up and eating small bites of food. Your physical therapist will collaborate with other health professionals to recommend the best treatment techniques for your child.
• Improving developmental skills. Your physical therapist will help your child learn to master motor skills, like putting the child’s weight on the injured arm, sitting up with arm support, and crawling. Your physical therapist will provide an individualized plan of care that is appropriate based on your child’s needs.
• Fostering physical fitness. Your physical therapist will help you determine the exercises, diet, and community involvement that will promote good health throughout childhood. Your physical therapist will continue to work with you and your child to determine any adaptations that may be needed, so that your child can participate fully in family life and in society.

Therapy may be provided in the home or at another location, such as a hospital, community center, school, or a physical therapy outpatient clinic. Depending upon the severity of the brachial plexus injury, the child's needs may continue and vary greatly as the child ages. Your physical therapist will work with other health care professionals, eg, occupational therapists and physicians, to address all your child's needs as treatment priorities shift.

POOL SEASON IS RIGHT AROUND THE CORNER

Pool (aquatic) exercise provides many benefits, including an ideal environment to exercise throughout the year. The buoyancy of the water supports a portion of your body weight making it easier to move in the water and improve your flexibility. The water also provides resistance to movements, which helps to strengthen muscles. Pool exercises can also improve agility, balance, and cardiovascular fitness. Many types of conditions greatly benefit from pool exercise, including arthritis, fibromyalgia, back pain, joint replacements, neurological, and balance conditions. The pool environment also reduces the risk of falls when compared to exercise on land. Below are some tips and tricks provided by the APTA as suggestions to get you started in the right direction.

Preparing for the Pool

Before starting any pool exercise program, always check with your physical therapist or physician to make sure pool exercises are right for you. A wonderful option is asking your physical therapist to take your home exercise program and adapt it so that it's possible to do in the water. Here are some tips to get you started:

• Water shoes will help to provide traction on the pool floor.
• Water level can be waist or chest high.
• Use a Styrofoam noodle or floatation belt/vest to keep you afloat in deeper water.
• Slower movements in the water will provide less resistance than faster movements.
• You can use webbed water gloves, Styrofoam weights, inflated balls, or kickboards for increased resistance.
• Never push your body through pain during any exercise.
• Although you will not sweat with pool exercises, it is still important to drink plenty of water.

10 Excellent Exercises for the Pool

1. Water walking or jogging: Start with forward and backward walking in chest or waist high water. Walk about 10-20 steps forward, and then walk backward. Increase speed to make it more difficult. Also, increase intensity by jogging gently in place. Alternate jogging for 30 seconds with walking in place for 30 seconds. Continue for 5 minutes.

2. Forward and side lunges: Standing near a pool wall for support, if necessary, take an oversized lunge step in a forward direction. Do not let the forward knee advance past the toes. Return to the starting position and repeat with the other leg. For a side lunge, face the pool wall and take an oversized step to the side. Keep toes facing forward. Repeat on the other side. Try 3 sets of 10 lunge steps. For variation, lunge walk in a forward or sideways direction instead of staying in place.

3. One leg balance: Stand on 1 leg while raising the other knee to hip level. Place a pool noodle under the raised leg, so the noodle forms a “U” with your foot in the center of the U. Hold as long as you can up to 30 seconds and switch legs. Try 1-2 sets of 5 on each leg.

4. Sidestepping Face the pool wall. Take sideways steps with your body and toes facing the wall. Take 10-20 steps in 1 direction and then return. Repeat twice in each direction.

5. Hip kickers at pool wall: Stand with the pool wall to one side of your body for support. Move 1 leg in a forward direction with the knee straight, like you are kicking. Return to start. Then move the same leg to the side, and return to the start position. Lastly, move that same leg behind you. Repeat 3 sets of 10 and switch the kicking leg.

6. Pool planks: Hold the noodle in front of you. Lean forward into a plank position. The noodle will be submerged under the water, and your elbows should be straight downward toward the pool floor. Your feet should still be on the pool floor. Hold as long as comfortable, 15-60 seconds depending on your core strength. Repeat 3-5 times.

7. Deep water bicycle: In deeper water, loop 1-2 noodles around the back of your body and rest your arms on top of the noodle for support in the water. Move your legs as if you are riding a bicycle. Continue for 3-5 minutes.

8. Arm raises: Using arm paddles or webbed gloves for added resistance, hold arms at your sides. Bend your elbows to 90 degrees. Raise and lower elbows and arms toward the water surface, while the elbows remain bent to 90 degrees. Repeat for 3 sets of 10.

9. Push ups: While standing in the pool by the pool side, place arms shoulder width apart on pool edge. Press weight through your hands and raise your body up and half way out of the water, keeping elbows slightly bent. Hold 3 seconds and slowly lower back into pool. (Easier variation: Wall push up on side of pool: place hands on edge of pool shoulder width apart, bend elbows, and lean chest toward the pool wall.)

10. Standing knee lift: Stand against the pool wall with both feet on the floor. Lift 1 knee up like you are marching in place. While the knee is lifted even with your hip, straighten your knee. Continue to bend and straighten your knee 10 times, and then repeat on the other leg. Complete 3 sets of 10 on each leg. For more of a challenge, try this exercise without standing against the pool wall.

PREVENTING LOW BACK PAIN DURING PREGNANCY

http://www.moveforwardpt.com/PatientResources/VideoLibrary/detail/back-preventing-low-pain-in-pregnancy

Attached above is a wonderful link provided by the APTA, or the American Physical Therapy Association, for women just like you to help prevent/manage back pain during pregnancy! Let us know what you think! 

When CHAMPION posts something about pregnancy, you know something is up...

YOU GUESSED IT! 

Our very own Kaitlin Way, PTA is PREGNANT! Kaitlin and her husband, Drew, are excited to announce to all of our CHAMPION family that they are expecting their first child! YAY KAITLIN!!!!

Kaitlin is somewhere in her 2nd trimester, they do not know the sex yet but the heart beat is healthy and strong :) 

Gender news to follow! 

Ensure that your body is ready to carry a baby by addressing before pregnancy any pain or problems associated with posture or weakness. Here are some physical therapist tips for helping to prepare your body for pregnancy and to guard against musculoskeletal pain and dysfunction during and after it.

1. Strengthen your pelvic muscles. To strengthen your muscles, use pelvic floor contractions (commonly referred to as Kegels), which involve gently squeezing the sphincter muscles (rather than the buttocks and thighs). These tightening exercises help prevent leakage when a woman sneezes, coughs, etc, and also can help reduce pelvic pain during pregnancy. However, many women do Kegels incorrectly (perhaps because muscles are too tight and need to be relaxed before strengthening). Doing Kegels incorrectly can worsen conditions such as incontinence, pelvic pain, and even low back pain. This is why it is important to consult a women’s health physical therapist before beginning an exercise program. Physical therapists who specialize in women’s health can instruct women in how to perform these exercises safely and correctly.

2. Prepare for "baby belly" by focusing on your core. Core exercises can help prevent diastasis recti —abdominal muscle separation. As your belly grows, the abdominal muscles that run vertically along either side of the belly button can be forced apart, like a zipper opening. If these abdominal muscles separate from each other too much, the result can be low back pain, pelvic pain, or other injuries as your body tries to compensate for its weaker core. This also can result in the postpregnancy "pooch" many women find undesirable.

Some exercises, such as sit ups, increase the likelihood of developing diastasis recti, incontinence, and back pain during and after pregnancy. It is important, therefore, to work with your physical therapist on the right exercise strategy for establishing a strong core.

3. Take a breath! Learning proper breathing and relaxation techniques from your physical therapist will help prepare your body and mind for a healthy pregnancy. It is important to learn to properly exhale before performing any exercise. With proper technique, your core and pelvic floor muscles will contract automatically, and this will lead to optimal stability and injury protection.

4. Begin a regular fitness routine. Exercise will help reduce the amount of cortisol (stress hormone) in your body and will boost your muscle and cardiovascular strength—strength you'll need to carry that extra baby weight. Once you become pregnant, consider engaging in relatively low-impact activities, such as swimming, walking on even surfaces, biking, or using an elliptical machine. Runners should be aware that loosening of their ligaments may make them more susceptible to knee and ankle injuries. Also, when the muscles and ligaments that support a woman's pelvic organs weaken, the repetitive jarring of running can cause these organs to descend. This is known as pelvic organ prolapse. Physical therapists strongly recommend that, to prevent this condition, women wear undergarments that offer pelvic floor support, or compression shorts that support the pelvic floor, both during and after pregnancy.

5. Practice good posture. Poor posture can have a major effect on every part of your body, particularly with regard to pain during pregnancy. A physical therapist can evaluate your posture and suggest muscle-strengthening exercises and lifestyle education (such as not sitting at a desk for long periods, and carrying grocery bags properly). Establishing healthy posture habits—pre-baby—will better prepare your body for the extra weight of pregnancy and lessen your chances of low back and pelvic pain.