Hi, I’m Dr. Anne Wolfe,
I’m pediatric physical therapist and the Clinical Manager at Emerge Pediatric Therapy in Carrboro!
Whether you are a parent considering if your child might need PT, or you are a physician who wants to know what signs to look for, here are my top 5 unexpected indicators that a child might need a PT referral.
1. Skipping Crawling
Crawling is important! Although it was recently removed from the CDC’s list of developmental milestones for infants, it remains an important skill for many reasons. For children that don’t crawl, there is often an underlying cause. We also notice that many infants who do not tolerate tummy time have difficulty acquiring crawling skills later. Crawling has the following benefits :
- It is a great way to improve core strength. Children who don’t crawl often lack the core strength required to maintain a hands-and-knees position.
- Crawling is a full body movement! It is one of the first complex bilateral coordination tasks, since it involves reciprocal movement of the arms and legs.
- Crawling assists with reflex integration of the Symmetric Tonic Neck Reflex (STNR) by facilitating the head moving through different planes of movement, while the arms and legs stay in a static position.
2. Toe Walking
Although toe walking is frequently related to a child’s sensory system, it can quickly become a musculoskeletal issue. Prolonged toe walking can cause tightness to the calf muscle, which will limit the ability to attain heel contact during walking and running. It becomes impossible to get “flat feet” without compensating in another way. A physical therapist can assess for muscular tightness, weakness of surrounding muscles, and balance deficits. Toe walkers often have poor balance due to the development of poor balance strategies from being on their toes so frequently.
3. Poor Posture
Poor posture can be a sign of core weakness. This, in combination with poor body awareness, can lead to back and neck pain over time. A physical therapist can assess strength, as well as muscular tightness and endurance. They can help improve a child’s body awareness, so they are better able to recognize their posture and correct it when needed.
4. Reduced Motivation to Participate in Physical Activity
Kids are inherently built for movement and exploration. Although all children have their own temperaments, there are no “lazy children” by choice. If a child has difficulty with gross motor movements or endurance, they will be less likely to participate in physical activity. However, with the right amount of support and motivation, we can improve their ability to participate in desired activities with family and peers. A physical therapist can assess a child’s endurance, muscular strength, coordination, and balance to help determine the underlying cause of inactivity.
5. Head Rotation Preference
When an infant has a preference to look toward only one side, this may be diagnosed as torticollis. Torticollis is caused by a tight muscle(s) in the baby’s neck and trunk, which can impact their ability to look toward both sides. It can also affect breastfeeding and the development of symmetrical gross motor milestones. Over time, torticollis can lead to a flattened spot on the skull (called plagiocephaly), due to resting their head in one position consistently. A physical therapist can assess muscle tightness of the neck and trunk, as well as complete a check of gross motor milestones. We can also provide you with exercises and stretches to complete at home!
Parents:
Click here to get started with an Emerge PT!
Physicians:
Click here to make a PT referral!