Cranial deformities - The clumsy child - Scoliosis - Posture - Pain in infants 1 - 2
Cranial deformities in the Market Place June 2007
The osteopathic and paediatric physiotherapists approach.
By Esther de Ru
Cranial deformity is a fairly common feature of new born babies. The pressure and strains during normal child birth on mother and baby are enormous.
One of the biggest problems with human reproduction is that being two legged animals with large heads, the limited size of the pelvis makes birth a tight squeeze. Ingeniously, the body gets around this by producing hormones that loosen up the pelvic ligaments in the mother and not fusing the cranial bones of the baby until after birth. This means that during birth, the skull is squeezed through the birth canal changing shape as it does so. During a complex birth, such as unusually long labour, ventouse delivery, premature birth, intrauterine constraint, the deformity can be more severe and long lasting.
Often children are born with “funny shaped heads” and parents are often worried that these deformities will be permanent. Over the following weeks most children will improve. The action of suckling is thought to act as a cranial pump that encourages expansion of the skull. Sometimes a baby with a cranial distortion will be unable to feed well as a result of their deformity. This problem can usually be corrected. Both paediatric physiotherapists and osteopaths have been trained to assess and treat these children. Both professionals will refer your baby back to the paediatrician in the presence of other underlying conditions. Physiotherapy is different to osteopathy but both therapies complement each other very well.
Physiotherapy treatment
The physiotherapist will educate parents to prevent further positional deformity and will evaluate spinal movements and the total sensory-motor development. Therapy consists of various tactile stimuli, stretch, pressure thereby stimulating weakened or tightened muscles in neck or trunk. Parents are instructed to facilitate correct movement by means of posture during feeding, positioning in bed or pram and by playing games with their baby. Back to Sleep & Tummy to Play – CPS fact sheet tummy time for tots www.csp.org.uk
Osteopathic Treatment
Treating a baby is different from treating an adult in that we never use manipulations. Instead babies can be treated by gentle and safely using cranio-sacral therapy. This type of treatment can release tension in the membranes in the skull that may have occurred during birth and this release of cranial tension encourages expansion of the skull to correct the deformity. We also use gentle stretching techniques on the neck to remove muscular tension. With this type of treatment the earlier you start the better. As time goes by, the cranial bones become less flexible and the deformity may become more permanent. My youngest patient was treated in the first 12 hours!
The clumsy child (DCD- Developmental Co-ordination Disorder). Article Market Place
Many terms are used to describe co-ordination difficulties: DCD, dyspraxia, perceptual-motor dysfunction and clumsy child syndrome. Specialists have agreed to use DCD as the overall term describing these children.
Children with these problems have difficulty processing information (vision, hearing, speech, balance) and they find it difficult to learn motor skills. Their movements are often hesitant and slow or clownesk, they often have problems sitting still, carrying out instructions and organising themselves. They can be disruptive in class, have difficulty coping with text from a book, eating with knife and fork, dressing or undressing and writing.
We all know them, the clumsy ones, always falling over a straw, bumping into people, spilling everything , balance problems, dislike (difficulty) with ball activities, games, playing outside) and having problems with their coordination. A lot of these kids are misunderstood.
These children fall into 2 categories.
1. the clumsiness is a sign or symptom of a medical or psychological condition
2. no hard neurological signs or biochemical, anatomical or sensory defects are found but nevertheless they have extraordinary problems acquiring motor skill needed to cope with everyday life. Studies have shown these children do not simple “grow out of” their difficulties. Without intervention the problems persist and are frequently accompanied by an increasing number of other problems at home and school.
Although not always curable, children can improve dramatically with appropriate treatment. Paediatric physiotherapists can asses your child (strength, motor skills, activity level, sensitivity to sensory stimulation) before planning a treatment programme.
Esther de Ru paediatric physiotherapist
Marketplace January 2008
POSTURE- POSTURE- POSTURE-POSTURE article Market Place
Everybody knows they should be looking after their back and lifting objects correctly BUT very few people actually do so.
Our body is actually made to move and do lots of physical labour.
The last decades physical labour is diminishing and we have all become sitting beings.
- we encourage babies to sit up straight as soon as possible-
- we bring our kids to school in cars or on bikes-
- we sit in cars, behind a desk, behind our computer or in front of the television ( so do our kids) -
- when we are old we sit more because we have worked hard our whole life –
Proper posture keeps bones and joint in correct alignment so that muscles are being used properly and economically.
Bad posture- increases abnormal wear of joint surfaces and fatigues muscles not being used efficiently. It can cause backache and neck pain, children included. It can cause the spine to stiffen in abnormal positions in the long run.
It does not flatter your appearance at all.
¿How many slough potatoes do you know?
I have seen many beautiful people in tailor made suites but with a horrible posture looking terrible!
What I recommend all patients is:
Look after your posture and give someone close permission to nag and “help”.
Move- after about 20 minutes in one position the blood flow will decrease so we should move.
Think before you lift or take in a position you have to stay in for a while.
Exercise, stretch, try to learn to listen to the signals your body is sending you. (everybody knows the sensation of wanting to stretch when in a long meeting)… do so.
Have fun…
Scoliosis article Market Place
With scoliosis the spinal curves are side to side instead of straight. It is confirmed by X-ray ( Cobb angle ). The female to male ratio is 6:1. There are many causes of scoliosis. Sometimes vertebrae are incompletely formed or misshapen. Sometimes people who have legs of different lengths develop a scoliosis and in other cases, diseases cause scoliosis.
The most common type is called idiopathic scoliosis. In idiopathic scoliosis some of the vertebrae are rotated because the muscles attaching the vertebrae to the ribs may not be pulling with equal force. One set of rib muscles pulls harder causing the vertebrae to twist and move out of a straight line down the back. This may also cause the ribs on one side of the back to stick out more, causing a hump.
The idiopathic infantile scoliosis has an early onset ( 0-3 years) and 80-90% resolves. Therapy is not always necessary but if the scoliosis is progressive surgery is often needed.
The juvenile scoliosis is seen between 4-9 years, therapy is observational and a brace is needed if the scoliosis is progressive.
The adolescent scoliosis is seen from 10 years onward. If the Cobb angle is >30° and progressive, a brace is needed. Surgery is only considered after bracing has failed, the curvature is severe ( > 50° ) and progression is expected beyond an acceptable degree of deformity.
Bracing: a brace can be effective and can at best slow or stop the scoliosis progress. It does not correct the deformity. Braces have various models and are custom made. The SpineCor Brace is relatively new and results are promising.
Physiotherapy is not always necessary. When prescribed, exercise programs are usually initiated in addition to, and not instead of bracing treatment. Careful monitoring of curve angles remains essential, regardless of exercise. Scoliosis is not caused by a deficiency of strength or flexibility, and therefore exercise is relatively ineffective in correcting scoliosis.
Scoliosis is not a result of exercise, and therefore normal physical activities can be enjoyed by people with scoliosis without a problem.
For more information go to:
http://www.scoliosis.org/index.php home of the National Scoliosis Foundation
http://www.youngwomenshealth.org/scoliosis-article.html a patient guide and
www.spinecor.com
Esther de Ru paediatric physiotherapist