Physical Therapy

Gross motor skills involve the use of large muscle groups to perform movements such as walking, running, jumping, and balancing. These skills are fundamental for a child’s overall physical development, enabling them to navigate their environment, participate in sports, and engage in everyday activities with confidence.

Typical milestones for gross motor skills include:

• By 6-12 months: Babies typically begin to roll over, sit independently, and start to crawl.
• By 12-18 months: Most children are walking independently, climbing onto furniture, and beginning to run.
• By 2-3 years: Children often develop the ability to jump with both feet, kick a ball, and navigate stairs with support.
• By 4-5 years: Most children can hop on one foot, catch a ball with both hands, and ride a tricycle.
• By 6-7 years: Children typically master skills like skipping, riding a bike without training wheels, and participating in more complex physical activities like team sports.

If your child is not meeting these milestones or shows difficulty with gross motor tasks, early intervention with a physical therapist can support their development and help them build the necessary skills for active participation in daily life.

W-sitting is a position where a child sits on the floor with their legs bent backward on either side of their body, forming a “W” shape. While this position may feel stable for some children, prolonged W-sitting can lead to various issues related to posture, muscle development, and motor coordination.

Potential concerns with W-sitting include:

• Impact on Core Strength: W-sitting can reduce the need for children to engage their core muscles, potentially leading to weaker trunk muscles and poor posture.
• Limited Hip Rotation: This position restricts the natural rotation of the hips, which can affect balance and coordination, making it harder for children to develop skills like running, jumping, and climbing.
• Delayed Motor Development: Over-reliance on W-sitting can interfere with the development of more advanced motor skills, such as crossing the midline, which is essential for activities like writing and throwing.

Typical milestones for sitting and posture include:

• By 6-9 months: Babies usually start to sit independently with their legs in front of them, supporting themselves with their arms.
• By 10-12 months: Most children can sit without support and begin to transition smoothly between different positions, such as moving from sitting to crawling.
• By 18-24 months: Children typically develop strong core muscles, allowing them to sit with proper posture and balance during various activities.

If your child frequently engages in W-sitting, a physical therapist can provide guidance on alternative sitting positions and exercises to support healthy posture and motor development. Early intervention can prevent potential issues and promote optimal physical growth.

In-toeing, commonly known as “pigeon-toed,” occurs when a child’s feet point inward while walking or running. This condition is relatively common in young children and can result from various factors, such as the shape of the foot, shin bone, or thigh bone. While in-toeing often resolves on its own as a child grows, persistent in-toeing can affect balance, coordination, and overall movement.

Potential concerns with in-toeing include:

• Balance and Coordination Challenges: In-toeing can cause a child to trip or stumble more frequently, impacting their ability to participate in physical activities like running, jumping, and playing sports.
• Posture and Gait Issues: Prolonged in-toeing may lead to improper alignment of the legs and feet, which can affect posture and the development of a healthy walking pattern.
• Delayed Gross Motor Skills: Children with in-toeing may experience delays in reaching certain gross motor milestones, such as running smoothly or riding a bike.

Typical milestones for walking and gait development include:

• By 12-18 months: Most children begin walking independently, with their feet pointing forward or slightly outward.
• By 2-3 years: Children typically develop a more stable and coordinated gait, with feet aligned forward as they walk and run.
• By 4-5 years: In-toeing, if present, often begins to correct itself as a child’s bones grow and muscles strengthen, leading to a more typical walking pattern.

If your child’s in-toeing persists beyond the preschool years or seems to impact their ability to move comfortably, a physical therapist can assess their gait and recommend exercises or interventions to promote proper alignment and movement. Early support can help ensure your child develops a healthy and confident gait.

Torticollis is a condition in which a baby’s neck muscles are tight on one side, causing their head to tilt to one side and their chin to point to the opposite shoulder. This can lead to Plagiocephaly, a flattening of one side of the baby’s head due to the consistent pressure in one position. Both conditions are relatively common in infants and, with early intervention, can typically be treated effectively.

Potential concerns with Torticollis and Plagiocephaly include:

• Asymmetrical Head Shape: Plagiocephaly can result in an uneven head shape, which may become more noticeable as the baby grows.
• Limited Neck Movement: Torticollis can restrict a baby’s ability to turn their head fully in both directions, potentially impacting visual tracking, feeding, and early motor development.
• Delayed Motor Milestones: If left untreated, these conditions can lead to delays in reaching important motor milestones, such as rolling over, sitting up, and crawling.

Typical milestones for head and neck control include:

• By 2-3 months: Babies should be able to lift and turn their heads from side to side while lying on their tummy, demonstrating increasing strength and flexibility in their neck muscles.
• By 4-6 months: Most babies can hold their heads steady without support and turn their heads freely to follow objects or sounds, showing balanced neck muscle development.
• By 6-9 months: Babies typically begin to sit independently, with symmetrical head and neck control, and can easily rotate their heads to explore their environment.

If you notice signs of torticollis or plagiocephaly in your baby, early assessment by a physical therapist is crucial. Through gentle stretching, strengthening exercises, and positioning strategies, these conditions can often be corrected, helping your baby achieve healthy development and symmetry.

Pelvic floor dysfunction in children refers to difficulties with the muscles of the pelvic floor, which play a crucial role in controlling bladder and bowel movements, as well as supporting the pelvic organs. When these muscles are weak, tight, or uncoordinated, a child may experience issues such as urinary incontinence, constipation, or difficulty with toilet training. Early recognition and intervention are key to managing these challenges and supporting healthy development.

Potential concerns with pelvic floor dysfunction include:

• Bladder and Bowel Control Issues: Children with pelvic floor dysfunction may struggle with frequent accidents, bedwetting, or constipation, which can affect their confidence and daily activities.
• Difficulty with Toilet Training: Pelvic floor dysfunction can make it challenging for a child to achieve successful toilet training, leading to prolonged use of diapers or pull-ups.
• Discomfort and Pain: Tight or uncoordinated pelvic floor muscles can cause discomfort or pain during urination, bowel movements, or physical activities.

Typical milestones for bladder and bowel control include:

• By 2-3 years: Most children begin to show signs of readiness for toilet training, such as staying dry for longer periods, expressing discomfort with wet diapers, and showing interest in using the toilet.
• By 3-4 years: Children typically gain more consistent control over their bladder and bowel movements, with fewer accidents during the day and night.
• By 5-6 years: Most children have fully developed bladder and bowel control, are independent with toilet use, and experience minimal accidents.

If your child is experiencing challenges related to pelvic floor dysfunction, a physical therapist specialized in pediatric pelvic health can provide targeted exercises, behavioral strategies, and guidance to improve muscle coordination and support successful toilet training and bladder/bowel control. Early intervention can help your child achieve greater comfort and independence.

Pediatric orthopedics involves the diagnosis, treatment, and management of musculoskeletal issues in children, including bones, joints, muscles, ligaments, and tendons. Children’s bodies are still growing and developing, which means they can face unique challenges such as growth plate injuries, congenital conditions, or alignment issues. Early orthopedic intervention is crucial for ensuring that children develop strong, healthy bones and joints, and can participate fully in physical activities.

Common concerns in pediatric orthopedics include:

• Growth Plate Injuries: Since children’s bones are still growing, injuries to the growth plates (the areas of developing tissue at the ends of long bones) require careful management to prevent long-term complications.
• Congenital Conditions: Some children are born with conditions like clubfoot, hip dysplasia, or limb length discrepancies that may require early intervention to correct and promote normal development.
• Posture and Alignment Issues: Conditions like scoliosis or leg length discrepancies can affect posture and alignment, potentially leading to pain or difficulty with movement.

Typical milestones for musculoskeletal development include:

• By 6-12 months: Babies typically begin to pull to stand and take their first steps, marking the start of weight-bearing activities that promote bone and joint health.
• By 2-3 years: Children should be able to run, jump, and climb, demonstrating strong coordination and alignment in their legs and feet.
• By 5-6 years: Most children have developed mature gait patterns and can participate in a wide range of physical activities with balanced muscle and joint function.

If your child has an orthopedic condition or has experienced a musculoskeletal injury, early assessment and treatment by a pediatric orthopedic specialist are essential. A tailored treatment plan can include physical therapy, bracing, or, in some cases, surgical intervention, to ensure your child grows and moves with confidence and strength.