Torticollis and Plagiocephaly in Infants

What is torticollis?

Torticollis is the shortening of muscles in the neck causing a rotation or bending of the cervical spine.  Congenital torticollis (present at birth) may be caused by malpositioning of the head in the uterus, or by prenatal injury of the muscles or blood supply in the neck.  Torticollis can also be caused due to positioning of the infant following birth.

Treatment of congenital torticollis involves stretching the shortened neck muscle.  Passive stretching and positioning are treatments used in infants and small children.  These stretches can be taught to caregivers through physical or occupational therapy.  Treatment with a physical or occupational therapist can last from 1 visit to 5 months.  Appointments start weekly and slowly are decreased as the family becomes independent with a home exercise program.

 

What is plagiocephaly?

Plagiocephaly is flattening of the skull, also called a “flat spot”.  This can occur when the infant is repeatedly put in the same position or from the torticollis.  During the first year of life the skull is more malleable and can be moved out of the correct shape. 

 

With treatment for proper positioning the skull can slowly move into a better shape.  In extreme cases of plagiocephaly a helmet may be needed.  New positioning techniques are the preferred method of treatment though.  These can be taught to families through physical or occupational therapy appointments.

Nicole Nord, PT, DPT
Pediatric Physical Therapist
Meridian (208)706-5775
Central Boise (208)489-5880

Find Your Voice: Lee Silverman Voice Treatment (LSVT®)

Nearly every person (89%) with Parkinson disease will have problems with speech that start early in the disease process and progressively diminish quality of life:

·        Soft Voice

·        Mumbled speech

·        Monotone speech

·        Hoarse voice

·        Decreased vocal stamina

Medicine and surgery may dramatically improve the other symptoms of Parkinson disease, but they don’t help speech disorders. The only way to improve speech is by speech therapy.

The LSVT ® is an intense 1 hour a session, 4 times per week, 4 week course of therapy that teaches people with Parkinson disease to develop the strength required to speak at a normal vocal loudness. (may be modified to fit your schedule)

LSVT® teaches self-empowerment by improving the ability to communicate and thereby enhancing quality of life.

The strong theoretical and clinical research base behind LSVT® has demonstrated substantive results:

o       Improved vocal loudness

o       Improved intelligibility

o       More facial expression

o       Improved ability to swallow

o       Better neural functioning (PET)

For more information, visist: www.lsvt.org and to schedule an appointment, call 208.489.5060

Allison Berglund, MS, CCC-SLP

What’s Your Scope: What Massage Therapists Offer

Respect What We Offer:

-Massage therapists are and will be increasingly necessary in the health care field:

-We manually manipulate soft tissue in trained ways to increase circulation

-We stimulate metabolism and the production of endorphins in response to “good pain”

-We can help prepare athletes for competition

-We move and direct Lymph

-We can manipulate deeper level connective tissue

-We can help stretch broad level connective tissue

-We can facilitate positive diaphragmatic breathing (Neuromuscular Release techniques)

-We can guide and direct healing imagery to enhance pain thresholds

-We can use our developed skills to assess a body from a torsion perspective,

-Although bodywork often “feels good” its not just about the feel good; it should be about the efficacy of goal achievement in relationship to the stated plan of care. -Qualified and skilled personal touch in these areas cannot be overrated!

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

May is Better Hearing and Speech Month

Anything that impairs your ability to communicate limits your life. Yet 14 million Americans have a speech or language problem, and many do not know that they can be helped.

If you stutter, have problems pronouncing certain sounds, or don’t always understand what people say to you, you could have a speech or language problem.

People of all ages have these problems. With proper treatment you can eliminate or minimize their impact. If you need to know more about speech and language problems, call a speech-language pathologist this May, Better Hearing and Speech Month.

SLIERS has many speech-lanuage patholgists.  For pediatrics call 489-5700 or 489-5880 and for adults call 489-5060.

PLANTAR FASCIITIS

Plantar fasciitis is one of the most common medical diagnoses associated with heel pain and makes up 25% of all foot injuries most noted in runners & athletes. Typically plantar fasciitis is brought on as result of over-training or over-stressing the tissues of your lower extremity. History most likely will indicate a change in level of activity.

 

You may be at risk for developing plantar fasciitis if you:

v     Participate in endurance sports (running most common)

v     Work in a setting requiring prolonged standing or walking

v     Have a quick change in lifestyle or level of activity

v     Are obese

v     Have calf tightness

You may have plantar fasciitis if you:

v     Experience pain upon standing after period of nonweight bearing

v     Pain with first step most noticeable when arising from bed in the morning

v     Heel pain which slowly reduces with activity

v     Pain in heel region & arch of the foot

You may help rid yourself of plantar fasciitis with:

v     Anti-inflammatory medication (consult with your M.D. to assure you are able to take meds such as Ibuprofen, Aleve, etc)

v     An ice massage to your arch and heel - rubbing frozen water in Dixie cup

v     A deep tissue massage to the inside part of the arch & heel region

v     A disciplined stretching program as shown below:

o       Step 1: Place involved leg over opposite knee

o       Step 2: Grasp ball of foot & dorsiflex* 15-20 times

o       Step 3: Extend toes & dorsiflex 15-20 times

o       Step 4: Maintain stretched position & massage using palm of hand

o       This stretching & massage program should be performed every morning at bedside & after periods of inactivity before setting foot on the ground (should be the first thing you do)!!!

*Dorsiflex- to pull foot upward causing a stretch in the calve/back of heel

v     Physical Therapy to help plan a functional progression to return to a desired level of activity.

Tyler Williams, SPT

Kristi McMahan, DPT

 

 

 

 

Hamstrings & Injury Prevention

If you are an athlete, you are at a higher risk of injuring a knee when the hamstring muscles are much weaker than the quadriceps.  This is why strength and flexibility are great for preventing injury to the hamstrings and/or the knees.

 

Athletes are also at risk for hamstring and knee injuries when the gluteal muscles are not functioning properly or strongly enough. Tight hip flexor muscles are usually accompanied by weak gluts, which are responsible for shock-absorption during activity, but when not utilized, can lead to overuse of the hamstrings. Unfortunately the hamstrings are not structured to handle this type of workload, which results in injury to the hamstrings and even the knees, such as the ACL. In sum, it is also beneficial to have well stretched hip flexors prior to engaging in sports.

 

Here is a brief list of stretches and exercises to do as injury prevention.

 

Bridges – good for the gluts. Lay on your back with your knees bent, feet flat on the ground. Raise your hips off the ground so your torso and thighs make a straight line. Repeat this exercise until your feel a good burn in your buttocks. Remember you can always further challenge yourself by bridging with one leg.

 

Hip flexors stretch – Lunge forward with one leg and position the foot beyond forward knee. Straighten your hip of the rear leg by pushing hips forward. Hold this stretch for 30-60 seconds. Repeat with opposite side.

 

Walking lunges – To increase the challenge, start by bending your knees further to the ground or add dumbbells. Repeat until there is a great burn in your buns, hamstrings, and thighs.

 

If you are more experienced, other great hamstring strengthening exercises include dead lifts, good mornings, physioball hamstring curls, and many others.

 

Tyler Williams, SPT

Kristi McMahan, DPT

What’s Your Scope 5: Refer to Other Professionals

Refer immediately to the local PT, OT, or ATC any signals from your patient that are caution flags.   If operating independently, be confident with and know the health care provider you will refer this patient to.  Sometimes because we get such positive feedback from those with whom we’ve worked, we can have an “exaggerated idea of our skills.”  It is crucial to exercise caution when your higher senses flag danger, and move the patient towards the proper level of care.

 

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

 

 

 

Arthritis- Performing Tasks Easier without the Pain

May is National Arthritis Month.  Therefore, it is a great time to focus on fixing your arthritis pain.  Do you hurt after preparing a meal?  Do you have difficulty doing everyday things or leisure activities?  If so, it may be worth while taking time to find a simpler or easier way to do them. 

Identify – what are you having difficulty or pain doing?

Analyze – is there another way of doing it?  Do you need equipment to make it easier?

Explore – are their new products (or old ones like a buttoner) that will make the task easier or less painful?

Organize – look for ways to make what you use frequently easily available between shoulder and hip height.  “Use your head, not your back.”

I have found a few items very helpful and readily available.  Here are a few suggestions.

1. Reacher – long handled gadget for reaching.  Look in the pharmacy area of discount stores like Walmart.

2. Long handled shoehorn – I found an inexpensive one at Cabela’s in the shoe section.

3. Elastic shoe laces or curly laces – My patient told me that Payless carries these.

4. Electric jar/can opener – I saw one at Sears in the kitchen department.  It is made by Black and Decker.

 

If you have found something that has helped you let us know what it was and where you found it.

 

Susan Gordon, PT

Lead Arthritis Therapist

What’s Your Scope?:Don’t Interfere w/ or Contradict a Physician’s Recommendations or Prescriptions, and Don’t Support a Client (Patient) Who Wishes to Do So

I have had patients try to get me to badmouth doctors, or other physical therapists.  NOT GOOD.  Good medicine and effective therapy  is self evident.  So even if I might have inclinations towards different folks, or prescriptions, not only is it my job to point to them, but it is good practice to be silent on such dilemmas, and address the issues if they are significant with said therapist, or Doctor, if at all possible.  After all, the liability for such Prescriptions should lie where it falls.

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility

 

What’s Your Scope?: Avoid Presenting Yourself As Having Expertise That You Don’t

-In working sports massage with the Boise Burn, I am fascinated how a team can work together to achieve a goal, each team member having just the right job.  In just the opposite way it would be catastrophic if I jumped out and tried to play referee for the game (although some of you fans would disagree based on the performance of the refs during the home game opener against the Tri-Cities Fever!). 

 

-Use your developed professional judgment to determine whether or not the issue being brought to your attention during treatment is for some other more qualified therapist (and then make sure you at least try to glean what their recommendation becomes, in order to enhance your global understanding!).

 

-Not all physical assessments need be brought to a patient’s attention; be aware and courteous of sensitivity to their own health deficiencies.

Paul Greear

Therapy Tech

MCTMB Massage Therapist

Nampa North Outpatient Facility