Pediatric Rehabilitation: Birth to 21 Years

Children love to move! It is one way they are able to play, to learn about things in their environment, about cause and effect, and how gravity works, not to mention, to get where they want to go! But not all children move the same way. If you have concerns about the way your child moves, we can help! Some things to look for include:

frequent walking on toes
moving much more slowly than their peers
weakness and early fatigue
having stiff muscles
not crawling before they walk
not able to stand or sit still
difficulty with steps or curbs
frequent falling
uncoordinated movements vs. their peers
reports of joint or muscle pain
difficulty jumping, hopping or skipping
fear of movement or low heights

Here are some general gross motor milestones that you should see in the first year of life:

bringing hands and feet to the middle while they are on their backs at 3 months
rolling from back to tummy and tummy to back around 4-5 months
sitting by themselves at 6 months
moving from sitting to hands and knees and back at 7 months
crawling on hands and knees around 7-8 months (see our blog on crawling)
pulling to standing at 9-10 months
walking sideways along furniture or walls (cruising) at 10-11 months
taking steps while holding your hands at 10-11 months
walking by themselves at 10-14 months.

If you have any questions or concerns about the movement patterns of your infant, baby, or child, I would be happy to talk with you, offer some things to look for and to try, or to perform an evaluation in our Chapel Hill clinic.

– Lisa Mangino PT, DPT, C/NDT, PRC, SBS-C2

Lisa Mangino, PT, DPT, C/NDT, PRC, SBS-C2 is a pediatric physical therapy specialist with 15 years of experience in hospital, outpatient, and home health settings. She can be reached at Advance Physical Therapy at (919) 932-7266.

Here’s what parents who have worked with Lisa have to say:

My daughter had an amazing physical therapist when she was younger. Lisa Mangino really took the time to find out what worked and what didn’t for a head strong little girl who wouldn’t let anything slow her down. Emily credits Lisa with her desire to become a pediatric PT and give back to other children.” — MC, whose daughter has Juvenile Rheumatoid Arthritis.

My husband and I don’t know how to thank Lisa enough. She identified our son’s visual processing difficulties and knew how they related to his coordination disorder. He no longer falls and is enjoying soccer and basketball, and his self-concept is now super positive. She is our hero.” –JH, whose son has developmental coordination disorder and hypermobility syndrome.

Lisa’s dedication and creativity are unmatched. Thank you!” — SR, whose daughter has spastic quadriplegic cerebral palsy.

Lisa was extremely helpful. She worked very hard with our son and went a long way to help him. She was so resourceful and found us a beach wheelchair for our upcoming vacation. She did not have to do that!” –MH, whose son has orthopedic anomalies.

Testimonial

Scoliosis Treatment from the Teenaged Perspective

— A. J.

When I was 14 years old in 2006 my family and I found out that I had scoliosis. It means my spine is curved. It is sure that all spines have curves, however when there are abnormal side-to-side curves in the spine, it is called scoliosis. I learned that a curve is considered bad if it is greater than 25 to 30 degrees. My doctor said my curve was 37 degrees and recommended using a brace while sleeping.

He also informed us that 45 degree is a critical degree for a surgery.

After knowing a brace and surgery are all treatments in a hospital, my mother started researching about scoliosis. She wanted to know any treatment for my scoliosis. My mom took me to chiropractic and physical therapy. We chose to keep going with physical therapy because we believed that it would be better to make the muscles stronger, instead of cracking my bones in place. The stronger muscles will finally push my spine and straighten it.

For half of a year I had used a brace while sleeping, and I had done special Postural Restoration exercises taught by my physical therapist. However, in April 2007 my curve turned out 42 degrees. My doctor warned my family and me if the curvature exceeded 45 degrees at the next visit, we would need to seriously consider a surgery. He said he would put metal rods next to my spine to straighten it in an operation.

My mom, my physical therapist, and I discussed about this situation and decided to try hard one more time. Three of us have worked hard together and especially my physical therapist has been wonderful. She has kept encouraging me and has been cautious about my situation. She always helped me.

Finally, I took an x-ray again at my hospital in September 2007, and my curve was 29 degree. It was even better than my first degree (37 degree). The option of the surgery was out of topic. My doctor came to measure the curve of my spine again and again because it was not normal. Usually the curve tends to go worse and worse. He said the measurement of truncation is also better. He finally concluded the brace worked very well. However, we don’t think so. The exercises taught by my physical therapist have worked well for me.