Rehab for Children

April 28, 2015 | By | Reply

– Dr. Urvashi Chhabria

Issues faced by children these days:

For all functional activities like sitting, standing, walking, running, stair climbing, bending, squatting etc a healthy musculoskeletal, neuro-muscular, cardiovascular and respiratory system is vital. These systems are made up of bone, joints, muscles, heart, lung, nerves, brain. Healthy body systems during the growing years i.e. from birth to 18 years is crucial to a child’s growth and development. With the advancement in science and technology, the amount of children suffering from body system issues can be easily identified and treated.

Each year thousands of children and adolescents suffer from body system problems. Dr Anjana Laungani, Consultant physiotherapist at PhysioRehab states that the population of children and adolescents suffering from these issues requiring physical therapy has increased tremendously over the past few years. She also states that early identification and management of these conditions will not only affect the child now but also lay the foundation for their adulthood .

Common causes of problems in children:

Heavy School bags: There is ongoing concern regarding the weight of children’s schoolbags and the negative consequences of such heavy loads on the developing spine. “School bags represent a considerable daily ‘occupational load’ on school going children. The result of this excessive load leads to upper and lower back problems in children.” Carrying a school bag on one shoulder can also result in a condition called Scoliosis. It refers to a curvature in the spine resulting in muscular imbalances.

The following measures can be taken in the management of the above issue:

  • It is recommended that school bags should not exceed 10% of the bodyweight of the child.
  • The child should be encouraged to carry the school bag on both his shoulders.
  • When fitted correctly the backpack should follow the shape of the child’s back instead of hanging on their shoulders.
  • Train children to keep their back healthy. Your physical therapist can teach you core strengthening exercises and give you tips on posture management to ensure good back health.
  • Your physiotherapist can also identify children at risk of developing back pain by a detailed analysis of their posture and muscular imbalances, thus aiding in preventing future back problems.
  • Schools too should take measures to lighten up the backpack load.

Gadget use:
The use of gadgets has reached an all-time high in the recent years. Everywhere you go one would notice how young children are glued to this technology. While a variety of them use it for educational purposes a large section of these children are misusing them. Repetitive use of gadgets can result in a continuous strain on the muscles of your neck and upper back resulting in postural abnormalities. Besides affecting the spine it can also cause arm wrist and finger injuries due to the repetitive stress on these structures.

What can one do about this?

  • Parents should ensure that kids take regular breaks from their gadgets. e.g. Every 30 minutes, during which they should be encouraged to move and stretch around.
  • Parents should limit the daily allowance on gadget use.
  • Children should be encouraged to adopt better posture while using these gadgets. This can be achieved with the aid of a physical therapist who can identify the child’s postural abnormality and aid in correcting it.
  • Children with ongoing issues should be encouraged to seek help of a physiotherapist who will help them identify the cause of the problem and help correct the muscular imbalances that occur due to repetitive use of these gadgets.
  • The importance of outdoor activity should be emphasized and parents must encourage children to increase their physical activity thus decreasing their sedentary time.

Biomechanical causes:
The bones of young children are growing and soft thus prone to strains due to alignment issues. The feet, hip, knees and lower back can be affected due to these alignment issues causing pain and affecting the normal growth of the child. Common causes of these include: Flat feet, Pronated feet (feet rolling in too far), Supinated feet (Feet rolling out to far or a high arch), Knocks knees (knees touching each other) etc.

Flat feet Knock knees

These mal-alignments can result in early wear and tear of joint surfaces and overload soft tissue structures resulting in a wide variety of problems. Appropriate orthotics along with a muscle strengthening and stretching programme advised by your physiotherapist can improve the child’s foot and other alignment issues creating a stable base for a well aligned muscular and skeletal system.Other major biomechanical causes of problems include leg length discrepancy & scoliosis.

Leg length discrepancy refers to a condition in which the paired lower extremities have a noticeably unequal length. This can occur due to 2 reasons, one being due to an inequality within the bony structure & the other due to problems in the back or lower extremity musculature resulting in an apparent shortening of the limb. The human body is designed in such a way that it will compensate for any postural imbalance that occur. The amount of compensation can vary and it is this compensation that can result in a wide variety of hip knee and back problems.

Scoliosis refers to a sideward curvature of the spine which results in the spine looking like a ‘S’ or ‘C’. The curvature in the spine causes muscular imbalances which can lead to back and lower body problems including leg length differences. The condition usually does not produce any symptoms thus is missed most of the time. Early identification in the form of screening the child by a physiotherapist followed by a closely supervised tailor made rehabilitation programme can prevent the curve from growing along with aiding in re alignment of the spine.

Increasing rates of obesity & overweight among children & adolescents has become a worldwide health issue in the recent years. Not only does obesity serve as physical problem but can result in a wide variety of social and emotional problems in children such as stigmatization and poor self-esteem. The leading cause of obesity among children of today is lack of physical activity and unhealthy eating habits compared to the past says Dr Laungani. The lack of physical activity and improper eating habits results in decreased utilization of energy stores resulting in excess energy being stored as fat. Overweight and obesity are significant issues for children. If you help children deal with these issues during childhood, they’re less likely to have problems with overweight and obesity later in life.

Some of the following measures to be taken to aid in the reduction of this problem:

  • Give your child a range of healthy nutritious food. Healthy nutritious foods include vegetables, fruits, grains, reduced fat- dairy products, lean meat, legumes, egg whites, etc.
  • Avoid processed, canned foods & food with increased fat content: like burgers, pizzas.
  • Change family habits: Your child is more likely to choose healthy food habits if he/she sees you eating healthy.
  • Increase physical activity: Encourage your child to spend more time outdoors engaging in physical activity with peers.
  • Exercise: Look for ways to incorporate exercise into your child`s routine. Your physical therapist can help develop an exercise plan for your child based on his capacity thus preventing the chances of injury.

Sports injuries:
Although participation in sports provides numerous physical and social benefits for children it has a down side: the risk of sport related injuries. Kids can be particularly susceptible to sport injuries for a variety of reasons. Young children especially below the age of 8 have slower reaction times and are less co-ordinated compared to adults. In addition, kids mature at different rates. Often there’s a substantial difference in height and weight between kids of the same age. And when kids of varying sizes play sports together, there may be an increased risk of injury.

Steps to prevent & treat sport related injuries can be done at various levels. These include:

  1. Screening a child by a sports physiotherapist can help identify the musculoskeletal issues relevant to the particular sport. These if addressed early can help prevent or decrease the risk of future injuries.
  2. Accurate diagnosis and management is a key to successful rehabilitation & return to sport. At PhysioRehab, each child is assessed by a sport specific assessment and a treatment regime is then tailor made to the child`s sport to provide accurate and speedy recovery.
  3. Even if the child does not suffer from any ongoing issues a physical therapist can help identify key areas the child can work on to improve or enhance his sport performance.

By knowing the causes of sports injuries and how to prevent them, one can help make athletics a positive experience for your child. All of the issues noted above can have a deleterious effect on a child’s development and childhood experiences. Early identification can not only aid in improving the child’s health but also help them attain a better and pain free future.

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