Pediatric Physical Therapy at Home in New York City

Free consultations are welcomed, click the red phone or 212-289-1586 What is Pediatric Physical Therapy?
Benefits of Physical Therapy for Babies & Toddlers
Signs Your Baby Might Need Physical Therapy
Signs Your Child Might Need Physical Therapy
Growing Pains
Pediatric Physical Therapy for Sports Injuries
What Parents Can Expect in a First Visit

What is Pediatric Physical Therapy?

Movement, an important aspect of development, allows babies and children to explore their environment, their bodies, and all that’s part of their world.  The ability to move easily and successfully is fundamental for learning and growing. I work with babies, children and families to develop a child’s ability to easily move and participate in the activities they need and want to do, like going to school, playing, and becoming part of a community. This is especially helpful for children struggling with developmental delays. 

Pediatric physical therapy deals with a wide variety of problems that may affect your child’s development from infancy through the teen years.  Helping babies and children through pediatric physical therapy is quite different from helping adults.  Children are built differently, think differently, and move differently than adults. Thus it’s essential that your child sees a physical therapist with a thorough understanding of these differences and is versed in early child development to ensure the best possible outcomes for your child and family.

Our physical therapy practice meets the needs of babies, toddlers, young children and teens through delivering clinically advanced treatment, usually reserved for the hospital setting, to an outpatient setting, at the convenience and in the privacy of your own home. 

Pediatric physical therapy treats children who have issues and challenges with movement or muscle problems. It helps children reach developmental milestones and treats children who’ve suffered an accident or a disease affecting their musculoskeletal system.  In summary,  pediatric physical therapy involves:

• Helping infants, toddlers, children, and teens 
• Treatments in response to bone & muscle issues, sports related injuries, illnesses, spine, brain, genetic, or nerve disorders.  
• A variety of techniques, routines and exercises focusing on specific muscles and movements aimed at strengthening muscles and tendons. 

• Helping children attain developmental milestones getting them back on track
• Improving mobility, recovering from injury or surgery
• Overcoming challenges that might be affecting a child’s growth
• Reducing pain   

It’s important that children follow their physical therapy regimen closely due to the fact that they are growing while receiving treatment.   To this end I create treatment plans that are designed to be fun and motivating. 

3 Key Benefits of Pediatric Physical Therapy for Babies & Toddlers

Promotes Independence: One of the earliest types of personal independence a child will gain is physical independence.   Crawling, moving and eventually walking are pivotal milestones in their development and enable them to effectively explore their surroundings.  An extension of this are the fine motor skills allowing them to eat, draw and pick up items by themselves. Developing these skills on schedule and correctly is important as any existing muscle disorders and imbalances can surface, worsen over time and create a more complex and protracted developmental process.

Increases Activity Participation: Correcting or improving any physical developmental delays typically increases the number and variety of activities a child can participate in. This is particularly important for encouraging social and communication skills development.  Improvements in muscular and motor skill movements is a confidence builder driving further interaction with other children and greater independence. Learning encounters happen out in the world, daily; and while lots of things can be taught, children benefit more by first-hand exploratory experiences.

Motor Skills Development:  Pediatric physical therapy enables children to learn how to independently perform gross motor skills (those involving the whole body’s core muscles such as back, arms, and leg muscles) and functional mobility skills (moving around, bending, standing, walking, etc).  Research has shown gross motor skill command by 6 months and fine motor skill command by 1 year tracks strongly to the healthy development of communication and social skills by age 2.

Signs Your Baby Might Need Physical Therapy

Anxiously awaiting a child meeting their next developmental milestone is a common parental concern.  Whether it’s when they start sitting, crawling or walking, it’s easy to compare one baby’s skills to others – and start to worry a bit.  Stay mindful that due to numerous factors, babies develop at different paces.   Having said that, there are valid milestones and indicators that are helpful in identifying a possible issue warranting physical therapy, which are: 

• Baby favors turning their head only to 1 side
• By 3 months baby has difficulty lifting their head to look around while on their tummy
• By 6 months baby is not bearing weight on their legs 
• By 8 months baby is not sitting 
• By 12 months baby is not crawling
• By 18 months baby is not walking 
• Child walks on tip toes only & for more than 6 months, which can lead to  muscle and bone alignment problems as the child grows. 

If a baby isn’t achieving within these milestones, of the many potential underlying reasons low muscle tone might be the most common.  In an initial evaluation this is something that would be assessed and if determined as likely, pediatric physical therapy can deliver improvement.  Working to improve any muscle tone issues or correct muscle imbalances can be helpful in your baby developing better postural strength and movement patterns to achieve their gross motor milestones.

Signs Your Child Might Need Physical Therapy

It isn’t always easy and apparent to recognize if your child is coping with cognitive or motor development challenges, however there are signs to look out for. Be mindful your child does not require a diagnosis to receive pediatric physical therapy services.  I evaluate each child on an individual basis and treat them for their specific needs. If you’re reading this, it’s likely some concerns have already surfaced about your child.  Children generally make the greatest improvements the sooner they begin a therapeutic program, so be careful about taking a  “wait and see” approach if you notice:

• Child is having trouble returning to their previous level of function after a sports injury (i.e. limping, decreased flexibility, etc.)
• Child frequently trips, falls or seems to be off balance
• Child has trouble sitting up straight while sitting on the floor, showing a preference to rest their head in their hands, or often slumps when at a desk
• Child is displaying decreased strength (i.e. trouble walking up & down stairs or getting up off the floor)
• Child has trouble keeping up with their peers on the playground or at school during recess
• Child has trouble with coordination of their  movements such as jumping jacks
• Child complains of persistent pain in the same body part
• Child is developmentally delayed (see developmental norms below)

Growing Pains

“Growing pains” refers to pain syndrome that commonly occurs in children, and slightly more prevalent with girls.  Growing pains can surface when a child is as young as 3-4, but are most common from 8 years to pre-teens. Symptoms are commonly pain in the legs (calves, thighs, heels, ankles & knees) and occasionally in the arms as well.

An individual episode of growing pains can last between 30 minutes to 2 hours. The term of experiencing growing pains may last a few short months or continue for years – and be intermittent, many children go days to months where they are entirely pain-free.  

Children often describe the pain as sharp or cramping, mild or very severe, and more likely to occur after increased physical activity. Growing pains generally strike in the late afternoon, and on into the nighttime, even waking children up from sleep. Rest is not needed for children enduring growing pains and they can continue to participate in their normal activities.   

What’s going on? Medical science has not yet identified the exact cause of growing pains – other than as the name implies, ‘growing pains”. The body undergoes massive growth and changes from birth through puberty  – more than any other time in life.  Ligaments, joints, bones and muscles all grow and develop however not always at the same rate,  producing  musculoskeletal imbalances, strain, stress, pressure, – all culminating in pain.   Simply put, with growth, a child’s bones can grow faster than their muscles producing flexibility deficits and pain.

In treating your child, I first ask a series of questions to you and your child regarding the pain and its pattern, the amount of physical activity done by your child and a few other lifestyle related questions.  After ruling out any other underlying conditions that may be causing the pain I conduct a thorough physical assessment which includes testing of joint range of motion, flexibility, strength and a detailed examination of the surrounding bone structures.  Should ‘growing pains’ be determined as the cause of pain, I can prescribe a set of treatment strategies for your child which include:

• Home Exercise Program: Exercises tailored to the pain point and improving the strength and flexibility of the associated muscles.  Applying heat to the pain points prior to stretching can also help lengthen tight muscles.
• Hands on “manual” stretching and massage: I will perform these techniques with your child to ease their muscle tension, mobilize stiff joints, lengthening tight muscles in efforts to reduce pain and inflammation.

Pediatric Physical Therapy for Sports Injuries

Participating in sports is an excellent way for children and teens to enjoy regular exercise while learning all about teamwork, perseverance, and leadership.  Unfortunately a side effect of youth sports is the occasional injury that requires pediatric physical therapy to properly heal. 

The bones, muscles and joints of children and teens require special care. Growth plates—tissues at the ends of bones in children and teens that influence the future shape and length of the bone once mature —are still open and vulnerable to damage.  Should growth plates become injured, and not diagnosed or treated correctly, it can lead to long term debilitation leaving children and teens permanently sidelined from the activities they enjoy.  

Some of the most common sports injuries that children and teens experience are due to impact (with other players or objects like balls) and repetitive motions or overuse and include:

• Ankle injuries
• Pulled muscles
• Shin splints
• Knee injuries
• Tennis elbow (tendinitis)
• Hip flexor injuries

While children and teens do recover faster than adults from injury, they should still be treated and as soon as possible once suffering an injury.  Beginning therapy early enables the young athlete to benefit from joint mobilization and manual soft tissue massage to decrease any inflammation and initial pain resulting from an injury. Treating sports injuries purely with rest and medication does not target the movements,  skills, and strength demands for your child to safely return to a sport with a reduced risk of re-injury.   In rehabilitating your child I will have them safely perform exercises that mimic the specific motions and stressors they will experience when they return to their sport.   Upon completion of a tailored treatment both you and your child should feel confident that they can return to their sport without fear of injury.

What Parents Can Expect in a First Visit of Pediatric Physical Therapy

The first step in the pediatric physical therapy journey is a thorough baseline evaluation consisting of 3 basic components:

• A parent interview exploring your child’s medical history and the outcome and goals parents vision from pediatric physical therapy.
• observing how your child interacts with and moves in their environment.
• standardized testing to gain perspective on how your child is functioning when compared to other children his or her age. 

The evaluation is a time for the parent to voice questions and concerns about pediatric physical therapy.  I review all information and then collaborate with parents, where appropriate the child, and in some cases other professionals involved to determine objectives, aligned to and targeting the child’s functional deficits, delays, injuries or recovery goals.

Your child’s physical therapy treatment plan may include different therapeutic modalities, including:

• Tailored exercises such as gait training, strengthening & stretches
• Elongating tight muscles and building strength in weak muscles during active exercise
• Specialized equipment to assist your child in meeting their therapy goals
• Training a child in the use of assistive and adaptive devices
• Sport specific rehabilitation to ensure timely return to sport

Therapy sessions involve fun and engaging activities to promote and improve things like strength, motor development, range of motion, endurance, balance, coordination, gait, and endurance. Your child will learn new skills and gain new abilities. My objective is that through fun and challenging therapy, coupled with providing answers and education and programs for parents, that your child becomes more independent with all the areas of childhood that are so important for you, your child and your family. 

Maria Muto, PT, DPT

Free consultations are welcomed, click the red phone or 212-289-1586

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Free consultations are welcomed, click the red phone or 212-289-1586

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