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What is Developmental Coordination Disorder (DCD)?

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What is Developmental Coordination Disorder?

Developmental Coordination Disorder (DCD) is a motor skill disorder that affects roughly 5-6% of school aged kids (5 years and up), with boys being affected at a 2:1 ratio to girls. DCD is commonly described as kids who show awkward, clumsy movements in their day to day.

Often parents or teachers will notice the child having a hard time keeping up with their peers, having difficulty doing tasks that involve one or more movements and/or are delayed in gross motor skills such as jumping, skipping and ball skills. Kiddos with DCD have difficulty planning out tasks, they know what they want to achieve, but they struggle to find the map to get there.  

Common tasks parents notice these children may find difficulty with are as follows:

  • Bike riding: some parents may notice that they can peddle on the bike once on, but they lack the planning to stop, and get off the bike smoothly. 
  • Skipping: arguably one of the most difficult tasks for kids to learn, they have a difficult time skipping as it takes coordination of the arms and legs at the same time.
  • Shuffling: these may be seen during activities such as team sports and warm ups, a difficult. 
  • Ball skills: kids may have difficulty catching and throwing balls with accuracy.

 

How can Paediatric Physiotherapists help with DCD?

We can help by giving REPETITIVE PRACTICE! As adults, we know we get better with practice, often these kids need blocked practice to improve a skill. We can help by identifying a specific goal, give them strategies on how to get there and work on each component of that skill. We give repetitive practice to allow these kids to build that road map from point A to point B. 

We can also perform a movement screening (The Movement ABC), to help determine if your child appears to have a coordination disorder. Book your assessment here.

Things that can help at home:

  • HEAVY PLAY! Fill up a toy shopping cart and push it, pulling a sibling on a bed sheet etc, these tasks help turn on muscles that are often limited. 
  • Give them a plan: If your kid forgets to put on their socks every time before they put on their boots- put a picture of a sock by their boots so they have a visual of what they need to do.
  • Encourage your little one to remain active, whether it’s individual sports, team sports or another activity they choose. These kids can often become discouraged if sports don’t look the same for them as they do for their peers, encourage them to stay active and have fun!

 

If you have any questions, or concerns that your child may have a coordination disorder, we can help! Click here to book your assessment.

Written By: Darrien Cantelo, Physiotherapist

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The Top 4 Figure Skating Injuries

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Figure Skating and Common Injuries

Figure skating is a demanding sport that requires flexibility, balance, strength, and artistry. It is a skill-based sport that requires many repetitions of complex movement patterns across all disciplines. With the demands of on-ice, off-ice, flexibility, and dance training, overlooked injuries can grow to more complex injuries.

The Top 4 Figure Skating Injuries:

  1. Ankle Sprains
  2. Knee Pain
  3. Back Injuries, from extreme positions or the impact on landings with a rigid boot
  4. Concussions, can be from falls with or without a direct hit to the head

How physiotherapy can help:

  1. Addressing an injury early can prevent the progression from an acute to a chronic injury. By identifying injuries early on, skaters are able to return to their regular training earlier without pain, allowing the skater to focus on their coach’s feedback.
  2. Pre-habilitation and injury prevention can decrease a skater’s risk of an injury during the season.
  3. Concussions happen in the sport. Recovering from a concussion can be tricky and your physiotherapist can guide your return to sport in a safe manner.

To book an assessment with National Figure Skater and Physiotherapist, Kai-Jing Leong, click here.

Written by: Kai-Jing Leong

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Toe Walking – Can You Treat It?

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Did you know that toe walking is something that can be treated at a paediatric physio clinic? 

When you bring your child in for an initial assessment at PlayWorks Physio, this is typically what you can expect:

  • Your physiotherapist will go over a detailed history of your child’s development (including pregnancy history, early development, toe walking habits as well as other medical history)
    • Why is a history important ?
      • If you know the root cause of the issue, then you’ll have more success in the treatment outcome. There are a few different reasons kids walk on their tip-toes:
      • 1) Neurological cause 
      • 2) Genetic cause 
      • 3) Sensory cause 
      • 4) Muscular cause  
      • Knowing the cause of the toe walking will help the physiotherapist create the most specific, and successful treatment approach for your child.
  • Watching your child move (and play)! It’s one of our best-kept, “not-so-secret” secrets. Kids are smart, when they hear “the physio is going to watch you walk,” they’ll change their pattern to walk to what they think is better. Your physio will encourage them to play around the treatment room, getting them to walk, run, skip, jump, squat, crawl, spin and bend. This will allow your physio to watch and analyze your child’s usual movement patterns.
  • Next, your physiotherapist will discuss the recommendations to fit your child’s (and family’s) individualized needs. This may include:
    • a plan for future physio sessions (if needed) 
    • exercises to work on at home 
    • orthotics (some kids need extra support to help your child achieve an appropriate walking pattern. Not all kids need this support, and the goal of these is typically a short-term solution to help achieve a normal walking pattern).
    • referral to any specialists if needed

Scroll down to see some examples of kids who are working on toe walking and some before/after pictures. Our goal is to get their heels to “strike” the floor when they take a step. In the examples below, you can see the progress made with coming to physio and following a home program!

Example A:

  • This kiddo has been coming to physio since January 2020 (even virtually through the pandemic!) and his treatment plan includes weekly physio, custom orthotics, and a gait-retraining program. He’s very close to being completely discharged from physio. This family was extremely dedicated and were gold star patients in following the plan. As a result he’s had a change of 16 degrees of ankle range, and we’re not stopping yet!

Before

After

Example B:

  • Kiddo B has been intermittently coming to physio, and her physio plan includes exercises to do at home, and shoe recommendations. The before/after picture was taken in the same session! 

Before

After

Example C:

  • Kiddo C has been coming to physio once a month to work on her goals. Her plan also includes home exercises and custom orthotics. 

Before

After

If you’re interested in what we can do for your kiddo’s toe-walking habits, email us at: [email protected] or book your assessment here.

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What is Torticollis?

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What is Torticollis ? 

Torticollis is the term used to describe the tightening of a muscle in baby’s neck. It is the shortening of one of the neck muscles, the sternocleidomastoid (SCM), which results in the baby’s head tilting slightly to the side and rotating in the opposite direction. 

What are some causes of torticollis?

  • Position of baby in utero (higher risk with twins or pregnancies with growth restrictions)
  • A long/difficult labour and delivery which can cause muscle spasms in baby’s neck
  • A preference of looking one direction over the other, eventually leading to the muscle shortening
  • Having a flat spot on the head may cause the baby to always rest in this position and over time, tightens the muscle

These are some conditions that appear like torticollis and are important to rule out: 

  • Vision difficulties
  • Hearing difficulties 
  • Reflux or GERD 
  • Viral infections 
  • Improper alignment of the spine 

How will torticollis impact my child?

Imagine your baby trying to develop their gross-motor milestones while their head is always tilted and looking one way. They will have difficulty with the following:

  • Learning to roll both directions
  • Learning how to sit independently
  • Discovering where the center of their body is (discovering midline)

Furthermore, torticollis can often lead to plagiocephaly – a flat spot on baby’s head, because of a preference to always rest in one position. See our plagiocephaly post here: Help! My baby has a flat head!

The neat thing about torticollis and plagiocephaly is it can be corrected quite easily, especially from a young age. EARLY INTERVENTION is key, and easiest to treat. 

What to expect during an assessment with your paediatric physiotherapist:

  • We will see how your baby’s neck moves to determine if there are any restrictions
  • Rule out the more complicated causes of torticollis
  • Provide tips to help to correct this and if warranted, give you stretches and strengthening exercises appropriate for the stage of your baby’s development
  • Depending on baby’s age and severity of the torticollis, we may also track your baby’s head shape to ensure they’re not developing a flat spot

Remember, the EARLIER the BETTER. It’s much easier to work on positioning and stretching exercises with younger babies, and that can allow us to introduce strength exercises at the optimal time. 

If you have any questions, please contact us at [email protected]! We’re able to provide assessments over video call until we get over the COVID-19 hurdle. You do not need a referral for physiotherapy.

Written by: Karly Dagys, Physiotherapist

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Help! My baby has a flat head!

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My baby has a flat head…

Is this a common issue?

YES, this is a very common issue with babies. Flattening can be caused by the following:

  • Your baby has a preference of looking in one direction, resulting from tight neck muscles
  • Your baby prefers looking in a certain direction but there are no neck restrictions
  • Your baby is a good sleeper and doesn’t move much when sleeping

 3 Types of Flattening

Plagiocephaly is flattening on one side of the head from your baby preferring to look left or right. It is often associated with tight neck muscles (torticollis). Things you may notice:

  • Flattening on the back when washing your baby’s hair
  • One cheek appears larger
  • One side of your baby’s forehead is more prominent than the other
  • One eye is slightly larger than the other

Brachycephaly is flattening directly on the back of your baby’s head and is often seen with babies who sleep for long stretches without turning their head to either side. It causes baby’s head to be wider than average.

Scaphycephaly is the rarest type of head shape issues we see and is when the head is more narrow than average. It is most commonly seen in babies who spent long periods of time in the NICU because their heads are being turned from one side to the other.

How will a flat head impact my child?

  • Depending on the severity of flattening, your child may have difficulty fitting helmets, because these are made for the average shaped head.
  • Plagiocephaly can result in a forward shift of the facial bones, which can be purely aesthetic or in severe cases can lead to jaw issues.

What can we do?

  • A paediatric physiotherapist can measure your baby’s head to determine if there are any concerns and provide you with education to best manage your baby’s head shape.
  • When recommended, we can refer you and your baby to an orthoptist for helmeting. This is dependent on your baby’s age and the severity of flattening.

When is it best to seek help?

  • The earlier the better! This provides more time to track your baby’s head growth and improvements in flattening. The earlier you come in the more likely we can address the flattening conservatively (with positioning, education and stretches if needed).
  • If a helmet referral is required, seeking help earlier is better to optimize the amount of change obtained with the helmet.

 If you have any questions about your baby’s head shape, feel free to contact us!

 

Written by: Maegan Mak

 

 

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What is Torticollis?

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Our first post was on infant motor milestone assessment and one of the things we also screen for in this assessment is torticollis, the shortening of neck muscles that causes a preference in the direction baby looks.

Understanding Toricollis.

Torticollis: shortening of one of the neck muscles, usually the sternocleidomastoid (SCM), resulting in the baby’s head tilting slightly to the side and rotating in the opposite direction.

Do you need a doctor’s referral?

We see these referrals from doctors, chiropractors, midwives and parents who have noticed that their baby looks one way more than the other. You do not need a doctor’s referral to book an appointment. If you have extended benefits that cover physiotherapy, you can use these to cover your session.

What does a torticollis assessment involve?

When you come into physiotherapy for this issue we assess how much baby moves their head on their own to each side and also how much we are able to passively move their head. If there are any restrictions we can teach you some stretches and strengthening exercises, as well as positioning techniques that would be best for your child.

We find this a great opportunity for the you to gain education on positioning, gross motor milestones and ask any questions you may have about development of your baby. When we are assessing a baby for torticollis we are always monitoring their gross motor skills and development for their age. If there are any concerns, we can have the you work on these areas as well!

Often times the families were unaware of the skills noted as needing improvement, or they noticed and were unsure of who to ask. This “one on one” time with your family is beneficial to decrease the stress for you and allow any questions to be answered. If we are unable to answer your questions we can refer you to someone who would be more knowledgeable in that area.

When is the best time to get assessed?

The earlier torticollis is identified the easier it is to resolve. Early identification also reduces the likelihood of secondary issues of torticollis such as plagiocephaly. If you are unsure if your baby should be assessed, feel free to call or email us and we can answer any questions!

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What is an Infant Motor Milestone Assessment?

Understanding Your baby’s development.

We are so glad you asked. It can be confusing for new parents to understand exactly where their child’s development is currently at. Luckily, we can help break it down into understandable milestones and processes, eliminating the guesswork and give you a greater understanding of your child’s health and motor skill development.

What are Motor Milestones?

Infant motor milestones are a specific skill that we expect babies to reach around a certain age range. Often times parents will be aware of the major milestones such as rolling, crawling and walking, but not know the ones in between. I find parents have lots of questions about what they should be expecting to see next, what ways they can help their babies achieve various milestones and what toys are appropriate for their baby’s specific age.

What does a physio assessment look at?

In these sessions, I observe how the baby moves and assess where they are for their age. From here I educate the parents on where their baby is compared to other babies of the same age. If the baby is behind in any gross motor skills I describe what they should be doing and specific tips to help them achieve this. If the baby is on track, we discuss what to expect next and different ideas of how to facilitate devolvement of that particular skill. We practice the movements and exercises together to ensure the parents are comfortable with doing them at home.

Another area covered in the infant motor milestone session is positioning for their baby.

Many of the babies I see will spend majority of the time on their back, a portion on their tummy, a bit of time in a seat of some sort and then being held by family members. There are different ways to hold babies, pick babies up and different ways for them to be on the floor which all assist in their development. This is information that parents are usually happy learning about and implement into their daily routine immediately!

What parents say…

I hear time and time again how being a new parent is overwhelming and it’s difficult to know what information from the internet is correct. Families love coming in to learn about where their baby is at from a physical stand point and learn strategies to help them reach their next milestones. They appreciate the one on one time spent with them and the safe environment to ask questions about their baby. Often times, moms will say, “I wish I knew about this sooner!”

What about baby toys?

On top of the gross motor skills, I often get asked about what sorts of toys are worth purchasing and which toys provide the most benefit for their baby’s development. I find that it’s not so much about the toy but about the different ways they can use the item. As a pediatric physiotherapist, I can identify several different purposes and benefits of an average toy. If families already have certain toys or equipment I will give them different strategies on how to use it to gain a specific developmental milestone. If they are looking to purchase new toys then I give suggestions on ones that are good for development at their baby’s specific age. Parents find this beneficial because they don’t want to spend money on a toy that will be used for a short period of time or one that that doesn’t promote different areas of development. Space is a large issue for many families as well, and they do not want to fill their space with unnecessary toys or equipment.

Stay Tuned!

Infant motor milestone assessments are just one reason why kids or babies come to physiotherapy! Stay tuned for more information on why kids come to physiotherapy. I will be releasing more blog posts on different reasons of why kids come to physiotherapy!

           

 

 

Photo by li tzuni

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