Plagiocephaly: Early Intervention prevents, PT corrects the cause, Helmet improves shape

It is recommended to start physical therapy intervention as as soon as a parent or pediatrician detects a developing flat spot (plagiocephaly, brachycephaly).  It is equally important for pediatricians and OBGYN doctors to educate new moms that may have a newborn that is at risk for positional plagiocephaly.  Usually, pediatricians and OBGYN doctors refer these moms to a pediatric specialist for a consultation.

What are the risk factors?  Intra-uterine constraint (first pregnancy, multiple birth, breeched/ transverse positioning, intra-uterine fibroids, larger than average infant head or body size, > 40 weeks delivery) and traumatic birth history (infant head in birth canal for long period of time, use of vacuum/clamp, emergency c-section or premature delivery).

 ”It is completely possible to identify newborns who are at risk for positional plagiocephaly and help the families of these newborns at risk,  prevent the flattening from ever happening. ”  Dr Yvette Flores

We recommend a physical therapy evaluation within the first two months of life.  Physical therapy intervention could be as short as 2 visits: the first visit is to evaluate and educate the parents on what to do, the second visit is to follow up after a month or so to make sure the parents are doing a great job and the child’s head is looking good.

Physical therapy intervention has a high success rate at improving and restoring head shape symmetry when initiated between birth to 3 months of age.  In severe cases, however, helmet therapy is recommended.

Helmet therapy is most effective when done between 5 months to 8 months of age, in conjunction with physical therapy.  Helmet therapy eliminates the challenge parents have of sleeping their child ‘off’ the flat spot by offering an environment where nothing touches the flat spot 23 hours a day.  Depending on the severity of the flat spot and the child’s age, the helmet is used for 2 to 5 months.

We typically don’t recommend helmet therapy earlier than 5 months because:

1) Physical therapy alone usually can guide the families to normal restored head shape

2) Initiating helmet therapy too early can result in the need for another helmet shortly after the child grows out of the first.

3) Helmets are costly with no guarantee that health insurance will cover it.  On average, they are about $4000 depending on which center you go to.  If we can help families save four thousand dollars with just physical therapy alone, we are all for it.

4)  If the underlying ‘root cause’ of the plagiocephaly isn’t corrected by the time the helmet therapy is done, there is a chance of re-flattening. Here is an analogy: take a piece of play doh, putty or soft clay.  Make a round ball out of it and place it on a flat surface such as a table.  After a few minutes, you will see that the round ball begins to flatten where it is in contact with the table.  The same thing occurs with infant heads which is impressionable from birth to 12 months: repetitive pressure on the same spot can cause re-flattening.  If the child still has signs of positional ‘favoring’ (prefers sleeping with head turned or tilted to the left), it is likely that the original spot that was rounded out with the helmet can get dented in again over time.

Bottom line:  Positional plagiocephaly can be PREVENTED by :

1) Simply educating new parents on preventative techniques: if your pediatrician or OBGYN doctor does not refer new parents for a physical therapy early intervention session, parents can take the initiative to schedule this session directly with a pediatric physical therapist that specializes in head and neck challenges.  We recommend doing this within the first 2 months of life.

2) As a new parent, find out if your newborn is at risk by looking at the risk factors listed above and seeing how many (if any) pertain to your pregnancy and birth history.  If you identify with even 2 items on the list, it is imperative that you learn preventative techniques to start applying right away.  Schedule a session with a skilled pediatric therapist to learn what you can do that is safe and effective.

If your child has an obvious developing flat spot in the back of his/her head….

*Tell your baby’s pediatrician that you would like to schedule a consultation with a pediatric physical therapist.  It is a smart idea to get the opinion of a physical therapist who specializes in head & neck challenges on your baby’s developing flat spot, to learn techniques you can start doing right away to prevent it from getting flatter, and to determine if you child is a candidate for a physical therapy (and helmet therapy) program.

A referral or prescription for a physical therapy evaluation is not required in the state of California (and possibly other states). Should your child benefit from a course of physical therapy, the therapist can then get the prescription from your pediatrician.

Physical Therapy Programs & Wellness Programs: Solutions for New Parents wanting to be Pain-Free and Injury-Free

Parents of infants and toddlers are always lifting and carrying car seats, strollers, and especially their young ones various times during any given day.

Without proper counterbalance measures (specific exercises to reduce muscle cramping, muscle tightness, and tendonitis), all parents are at risk for developing some muscle soreness or even pain during the first 3 years of their child’s life.

At Physical Therapy Solutions, we created specialized physical therapy programs for those experiencing pain, injury or muscle weakness that haven’t gone away as expected. These programs are designed to quickly reduce the pain, quickly heal the injury and quickly increase muscle strength so that this doesn’t become a repetitive problem for the parent. We all know that parents have so much on their plate already that having to baby a shoulder, a low back or even a wrist that keeps getting irritated with use, is frustrating. Within 4 to 8 sessions of physical therapy, we can significantly get you to a better place, where you may even feel better or stronger than before your injury.

If your situation isn’t severe enough that you feel like you need to do physical therapy, we offer Wellness Programs designed to take you through ‘Counter-Balance’ exercises for the purpose of improving muscle balance, muscle flexibility and muscle strength. Our Wellness exercise programs teach you what you should be doing at home, to prevent pain, injury or weakness. Our Wellness treatment programs include myofacial release massages, use of Biofreeze gel and even treatment sessions with the 830 cold laser. 

We are in the process of finalizing the details of our ‘Mommy Wellness’ programs, to be available January 2012. These programs will include all of the above in addition to Body Composition tracking, nutritional advice over group breakfast sessions, and a SPA DAY at the end of the 12 week Wellness Program, to celebrate accomplishing your goals.

For more information, stop by our clinic today! Also ask to receive a FREE SAMPLE of Biofreeze: a practical solutions for reducing muscle aches/pains. 

                            For more information on Biofreeze, click the link below:

http://pt-solutions.blogspot.com/2011/11/biofreeze-works-to-reduce-muscle.html

12 Simple Ways to Fight Prediabetes

Happy Monday,

I am always reviewing articles and newsletters that come my way, especially the ones that focus on active prevention efforts.  This article is a great one for women who may be predisposed to diabetes.  I often think of new moms, families that have just begun, or even new grandmothers, and I realize the continued importance of choosing to stay healthy and choosing to be aware of all the things you can do for yourself to stay healthy.  These are one of those articles- simple, informative and shares a real story of a real person who succeeded.  Enjoy!

http://www.healthywomen.org/content/article/12-simple-ways-fight-prediabetes

Be Safe Trick or Treating on Halloween!

If you are planning on taking your children trick or treating this Monday evening, view this flyer for important safety tips and share this with other families.  Have a Happy and Safe Halloween!

Halloween Safety Tips: PDF version

Thank You to all the Mom’s of little ones we work with

Why We LOVE Moms:
On behalf of Physical Therapy Solutions, I just want to thank all the wonderful mommies that we’ve gotten to meet and grown to love over the years. We’ve had many moms share valuable tips, tricks, promotions, etc. We’ve also had moms donate no longer used toys, books wall decals, etc. We also had a Grandmother of a baby we worked with sew rice bag pillow cases, which have become such a hit at the clinic that parents have asked where can they buy them! Just yesterday, we had a Mom donate $500 to our children’s scholarship fund! This fund is used to help those undergoing financial hardship who need physical therapy or wellness services. Look out for an newsletter I will post spotlighting this incredibly generous Mom!! Lastly, Moms truly are what makes the world go round…. so many have referred other Moms and little ones to us and for this, we are utterly grateful.

Why We LOVE helping Moms & Families:
We love the unique work that we do: helping little ones achieve their potential, teaching parents how to guide their growth and development, and acknowledging parents on doing an amazing job with their child. We love that we are a family clinic- also taking care of Moms and Dads who have developed body aches and pains as they have devoted themselves to their child many a sleepless night and many a time where an arm would go numb from carrying their child. Trust me, your selfless acts do not go unnoticed!

What we have created just for Moms:
Over the past month, my team and I have met regularly to put together services to offer just for Moms!!! We are so excited to be in the final stages of wrapping up the details for these special programs and will be promoting them soon. What we’ve done was take note on what Moms go through after birth and the changes their body goes through for the first 6 months after giving birth. Studies show that participating in a 12 week exercise program accelerates the body’s potential to return to a stable, strong and toned state AND reduces risk for post-partum depression. The programs we have created involve a 12 week exercise component, designed to be completed with other Moms in similar situations, and includes incredible perks: massages, breakfasts and at the very end of the program, a trip to an amazing spa! During the 12 week program, we will track your progress via pre and post body measurements to ensure successful weight loss, core strength, pelvic strength and body strength. After the program, you will be independent with a home exercise program, have the body strength to care for your baby without having any body aches and pains of your own, and be empowered to continue caring for yourself without compromising caring for your child.

Does this sound awesome or what?!!

I would love feedback from all the Moms with newborns and toddlers.
I would like to know what other perks and indulgences you would like to see included in a program like ours. Your opinion is valuable and will be considered. Please email your thoughts and ideas to me at yvette@ptsolutionsla.com.

Twin baby success with PT for motor delays and torticollis

http://youtu.be/MhG6aCaAu9w

Learning to Crawl w/ ‘Rocky Rocky’ – video

A couple months back, I wrote an article on the impact ‘Rocky Rocky’ has on helping little ones learn how to crawl. For details on this safe and effective exercise technique, please review the article.

I’ve since received a video that a Mom took of ‘Rocky Rocky’ in action and Mom was happy to have me share this with you.

Remember, crawling is a significant milestone that promotes greater core strength, greater spine stability and better coordination between arms and legs. I always get the question, ” Is it OK if my child skips crawling and goes right into walking?” My answer has always been that there are many young ones that skip crawling for one reason or another, but if parents can guide their child toward NOT skipping crawling, their child will derive the benefits of this significant milestone.

Enjoy the video and know that we are here to help!

Dr. Flores

I sang with an 11 month old today!

I have to share this amazing experience I had today with an 11 month old patient of mine. Today we sang a song together while I was working with her doing physical therapy. This 11 month old does not say words but has proven to be able to create song. A few sessions back, I noticed that she would vocalize a unique tune over and over again to the point where her mom and I would join in and sing along. I didn’t think how significant this ability of hers is until today. Today she wasn’t participating well with the traditional nursery rhymes that I usually sing to engage participation. I then decided to sing ‘her’ tune and when I did, I was extremely surprised at her reaction. It was obvious that she recognized “her song” as she started smiling, singing along and participating better with her therapy. How amazing! It was a blessing for me to experience this today because I grew up singing and singing is a deep passion of mine.

How cool to see this unique gift develop so early even before the development of speech…… I was truly blown away and wanted to share my experience. I love that I can be inspired by experiences and moments I have with my pediatric patients….

FYI: 7 Tips for Saving Money Once the New Baby Arrives

I thought this article from The Stir was great for new parents as there are some good pointers to consider. Enjoy! And if you are new parents, congratulations!!!

Money should not be the reason to avoid a baby

Read More from This Author »
For many parents, having a new baby is a scary prospect, indeed. There are sleepless nights, tons of responsibility, and for many, the possibility of going deep into a financial hole.
Yes, babies are expensive, toddlers are even more so, and then preschoolers take it all. And let’s just forget about school-age children and teenagers. Denial is the only way to get ready for that mess.

Still, there is no reason to skip a baby for financial reasons. If we did, no one would ever procreate! The Stir talked to financial expert and BabyCenter.com contributor Jean Chatzky who offered the following piece of advice: “As long as you are not sinking into a financial hole, you can go ahead and have a baby.” Here are her 7 Tips for Saving Money Once Baby Arrives:

1. Embrace hand-me-downs: “The first thing you have to understand is that new is not best,” says Chatzky. Between friends who have had children and Craigslist, many items for baby can be purchased used. The fact is, babies only “use” anything for a very short period of time, so even “used” items are often in great shape.

2. Every child needs to know the rule of 10 percent: If you can save 10 percent no matter what, then you will be in good shape for any hardships that may come.

3. Needs and wants are two different things: Chatzky says there is one important question to ask oneself any time you want to buy something: “What happens if I don’t have this?” If the answer is nothing, then you probably don’t need it.

4. Times when we feel flush and times we don’t: We all experience times where we feel we have plenty of excess cash and times where we feel like we have none. When you feel “flush,” save it. That will make the “lean” times easier to take.

5. Saving money is great for your marriage and accumulating debt is bad: Credit card debt is particularly bad for your love life. “The more frequently couples fight about money, the more likely they are to divorce,” Chatzky says. So get rid of debt if at all possible.

6. Look at your benefits: It may make sense for each parent to use their work benefits and have only one add the children. It all depends. Different jobs have different benefits, so use them to your advantage and see what you can get.

7. Get responsible about making a will: It’s a huge financial mistake not to have a will. Name a person, not a couple as guardians for your children, Chatzky says, because the couple can get divorced and it will get ugly. Life insurance on both parents is a must.
These are just a few tips, but they will make the financial burden easier to shoulder.

‘Rocky Rocky Rocky’: this play position’s effective role in learning how to crawl

Babies typically learn how to crawl anywhere between 9 to 11 months of age. There are a multitude of factors that can result in an early crawler versus a late crawler. Body size/weight, muscle tone, and even personality contribute to achievement of this significant milestone.
Body size & weight: if a baby is larger than average body or head size, it is harder for him/her to pick up that weight against gravity. When positioned on hands and knees, gravity makes it challenging to pick up the head and hold it up. In addition, gravity challenges the center trunk muscles, requiring one to be able to lift the mid-spine and abdominals up against gravity. We typically see drooping of the midsection in babies learning to maintain the ‘rocky rocky’ (hands & knees) position. Lastly, a certain amount of shoulder and hip stability needs to be present in order for one to maintain being on his/her hands and knees for any length of time.
Muscle tone: Some babies are born with a little less or a little more muscle tone than what we consider to be normal. In babies with high muscle tone, they feel stiff when you pick them up or handle them. They usually prefer keeping their arms and legs straight with not much bend, or they prefer keeping their arms and legs in one position, making it difficult for you to bend or extend their limbs. In babies with low muscle tone, they feel like putty when you pick them up or handle them. Sometimes, its difficult to pick them up under their arms because they don’t keep their arms down as you lift them. Also, if you sit them, they slouch and if you place them in the rocky rocky position, their mid-section slouches down. In babies with low muscle tone, crawling is typically delayed as they need more time and development to build up muscle strength and muscle tone.
Personality: All babies demonstrate preferences at an early age. Some are very easy going, kicked back and do not complain much. Other babies are sensitive. Other babies are eager to explore their environment. Babies that are easy going may become delayed crawlers if they don’t show interest in exploring their environment in the tummy time position. They may need encouragement engaging in tummy time and rocky rocky activities. Babies that are sensitive may cry every time you place them on their belly or in the crawl position. If this is the case, it makes it difficult for parents to engage them in daily activities that result in good strengthening and body stability required for crawling. Babies that are eager to explore their environment will usually disregard the strength difficulties of being in the face down position and by default will get stronger earlier than their peers. They typically are the ones that crawl sooner than later.

Placing your baby in the ‘rocky rocky’ position for the first time will tell you alot. First of all, if your baby resists being in this position, they may not be ready for it. If your baby allows you to hold them as they weight bear through their hands and knees, they are ready to explore this new position with you. ‘Rocky rocky rocky’ essentially is the forward to backward weight shifting of your baby’s weight over their hands and then their knees while being supported. We often sing ‘rocky rocky rocky’ as we help one move their body forward and backward while in this position.

This play position is highly effective in doing several things: 1. It provides a positive experience for one that will eventually take to the position and movement pattern and start doing it on their own. 2. It is an opportunity to strengthen the core muscles, the shoulder and hip stabilizers and develop good neck strength. 3. It boasts confidence, thereby enabling one to start reaching forward with one hand, and eventually crawling on their own.

If your baby is not crawling by 11 months and you would like to learn this technique, we are here to help!