TREATMENTS

Babies and children

Description

There are 2 types of torticollis in children:

 

Congenital Postural torticollis :

Postural torticollis: This is the most frequently encountered and which regresses quite quickly if we adopt the right gestures and good postures at home early. It is a vicious attitude of the neck and the head. It is present from birth and is generally part of a postural syndrome due to the fetal position in the uterus. It is called comma syndrome or banana position. It is in fact initially, a simple preferential position which can increase and settle. It is a benign torticollis, often accompanied by plagiocephaly (or flat head), without muscle retraction. However, if this torticollis is neglected, the orthopedic, functional and psychomotor consequences can hinder the harmonious development of the baby. Muscular torticollis: As its name suggests, there is a muscular retraction causing the neck in an abnormal and permanent attitude in relation to the shoulders. The head is tilted and rotated opposite (we speak of right torticollis if the tilt is to the right). Sometimes it is even possible to feel the muscle retraction which is shaped like an olive. Associated with this rotation / tilt, there is an asymmetry of the face and plagiocephaly (flat head).

Congenital Muscle torticollis  :

Postural torticollis: This is the most frequently encountered and which regresses quite quickly if we adopt the right gestures and good postures at home early. It is a vicious attitude of the neck and the head. It is present from birth and is generally part of a postural syndrome due to the fetal position in the uterus. It is called comma syndrome or banana position. It is in fact initially, a simple preferential position which can increase and settle. It is a benign torticollis, often accompanied by plagiocephaly (or flat head), without muscle retraction. However, if this torticollis is neglected, the orthopedic, functional and psychomotor consequences can hinder the harmonious development of the baby. Muscular torticollis: As its name suggests, there is a muscular retraction causing the neck in an abnormal and permanent attitude in relation to the shoulders. The head is tilted and rotated opposite (we speak of right torticollis if the tilt is to the right). Sometimes it is even possible to feel the muscle retraction which is shaped like an olive. Associated with this rotation / tilt, there is an asymmetry of the face and plagiocephaly (flat head).

What are the causes ?

Bronchiolitis is the most common respiratory disorder in babies caused by a viral infection of the lower respiratory system. There is a seasonal peak between late October and early March, but it can sometimes appear at other times of the year.

Its main cause is RSV (respiratory syncytial virus). 90% of babies under 2 years old are colonized by this virus and 40% of them will develop the disease, which makes this childhood condition the most common between 0 and 2 years old.

Additionally, bronchiolitis can have other causes such as allergies or environmental factors. For some children, bronchiolitis is the first manifestation of asthma.

This is why the role of the physiotherapist will be to determine what is the cause of bronchiolitis and then to develop an appropriate treatment.

How do I know if my baby has bronchiolitis?

Your doctor or physiotherapist will make the diagnosis if there is:

  • A hiss on the exhale
  • Runny nose
  • Signs of respiratory distress
 

How does bronchiolitis progress? 

Bronchiolitis usually begins in the upper airways (nose and back throat) and then progresses to the lower part of the respiratory system (bronchi and lungs).

The first symptom is a dry cough caused by inflammation, Inflammation is our body’s natural protection against external attacks. The inflammatory reaction can lead to edema (swelling of the airways) or even bronchospasm (this is the contraction of the small muscles located inside the respiratory system).

The combination of the 2 reduces the diameter of the airways, making it difficult for your child to breathe.

Secondly, a fatty cough appears due to the increased production of mucus. Our lungs continuously produce mucus to evacuate foreign cells (bacteria, viruses) and other impurities entering the lungs. The mucus is collected in our mouth and then swallowed and digested and passed in the stool. Adult or child, we do it all day long without even notifying it.

However, when there is inflammation or infection, the cleansing mechanism is overloaded and mucus builds up in the lungs. This is problematic for 2 reasons.

First, it reduces the diameter of the airways making it harder for the baby to breathe. Second, it increases the risk of developing another infection since bacteria or viruses will get stuck in the lungs.

Left untreated, the combination of inflammation, edema, and mucus make it harder to breathe forcing your baby to breathe faster and use the accessory respiratory muscles. This type of breathing is exhausting for the baby who is often already tired of being sick, not being able to sleep and without energy from eating less.

If this situation persists, your baby will be too tired and unable to maintain his rapid breathing reducing the oxygen entering his body. Medically, we speak of respiratory distress, characterized by:

  • A high respiratory rate  (over 50)
  • An increase in the beating  heart
  • Dilated nostrils : the nostrils open quickly (we can perceive the same thing when we try to recover oxygen, by running for example)
  • Augmentation of the hole under the Adam’s apple:  As we use the accessory neck muscles to breathe, this increases the hole under the apple
  • Increased depression under the ribs:  similarly, the use of accessory muscles around the rib cage creates a depression below it.
  • Perspiration:  but without a feeling of heat to the touch
  • Color change : The mouth and fingertips turn blue, the rest of the skin turns pale or gray
  • Apneas of 10 seconds or more: the baby does not have enough energy and takes long pauses without breathing
 

These symptoms often appear in that order. However, they can also be caused by other medical conditions besides bronchiolitis. In any case, if one or more of these symptoms are present, do not hesitate to go to the nearest emergency room or to call an ambulance.

How to treat bronchiolitis?

Drug treatment: Your doctor or pediatrician may prescribe bronchodilators (to open the baby’s airways) or corticosteroids to decrease inflammation. Another effective way to reduce inflammation is by using a nebulizer with hypertonic saline.

Respiratory physiotherapy is a manual treatment including a nose wash and techniques to lift the mucus and avoid respiratory distress and limit the risk of infection.

DDH (Developmental Hip Dysplasia) is the fact that the head of the thigh bone is improperly inserted into the hip joint.

Babies who present by breech or have a family history of DDH have an increased risk of developing this disorder.

Signs include the baby’s inability to move the thigh outward at the hip and, later, difficulty walking and pain.

The Pavlik harness is used to correct DDH.

About one in 20 babies with DDH needs surgery to correct the defect.

More information ? Click on the link below:
www.aboutkidshealth.ca

Scoliosis is a permanent deviation of the spine, linked to a rotation of the vertebrae. It occurs mainly in childhood and adolescence, but can also appear in adulthood. This condition is sometimes the consequence of another disease or a malformation. However, its causes often remain unknown.

Scoliosis is a permanent deformation of the spine (or rachis) in the three planes of space, that is to say:

  • up or down
  • to the right or left
  • forward or back
 

This deviation of the spine is linked to a rotation of the vertebrae with respect to each other. In scoliosis, the spine is twisted. Its natural curves, forwards and backwards, are modified.

This disease causes a gibbosity (deformity of the upper back in the shape of a bump).

Potty training is an essential part of your child’s growth.

The school, for example, will only accept this one if it is clean and no longer wears diapers.

Potty training should normally be acquired by the age of 2, but learning to walk is as, if not more, a complex process.

And since there are many taboos surrounding it, it is as much a motor and neurological process as it is a psychological one.

– Nocturnal enuresis  is a condition characterized by the occurrence during sleep of involuntary and unconscious urination in children over five years of age or adults. This is what is colloquially referred to as “wetting the bed”. Bedwetting is due to too deep sleep, a lack of maturity of the urination reflex or a psycho-affective disorder. In rare cases, bedwetting is a sign of a malformation of the urinary tract.

Nocturnal enuresis is said to be  primary  if the child has always wet his bed and  secondary  if a period of cleaning of 6 months has been observed. In this case, the cause is often a psychoaffective disorder.

It is said to be  mono-symptomatic  if it is isolated, that is to say if it is not associated with enuresis or daytime voiding problems. ”

– Encopresis  is a form of fecal incontinence. It can be present in a child over four years old or in adults. The main manifestation is the involuntary loss of fecal matter. The causes and origins can be physiological or psychological.

 

Treatments

Constipation in babies is manifested by periods without passing stool causing pain and followed by periods of relaxation when the rectum is empty. The baby’s abdomen is often very tight and gives the impression of swelling. Gas and digestive problems can have less obvious repercussions, such as not getting enough sleep, having difficulty falling asleep, or crying inconsolably for hours. Thanks to visceral osteopathy, the therapist will not only restore mobility to the frozen abdominal tissues but will also use a global approach to analyze the impact of these abdominal dysfunctions on the rest of the body with a particular interest for the diaphragm.
In the case of cerebral palsy or developmental delay, the child will have difficulty organizing his posture and initiating movement or managing its amplitude and intensity (this results in an inability to hold the head or the trunk, movements too slow or too fast, stiff or abrupt) The goal of the physiotherapy assessment is to take stock of these difficulties in order to anticipate their consequences and find compensation. The goal of rehabilitation will be to teach the child movements that will become automatic, and allow them to respond in an appropriate way to everyday situations. In cases where spasticity is present, the sessions will also aim to inhibit it in order to allow the child to relax and the movements to be less abrupt, less stiff. Depending on the stage of development of the child, the physiotherapist will work on straightening, posture (lying on the stomach, sitting,), turnovers. The child will be guided little by little towards locomotion (movements on the ground by turning over, crawling, on all fours then straightening up on the heels, passing the step in the position of serving knight and finally standing and walking). The rehabilitation will also stimulate the motor skills of the upper limbs (catching an object, precision of movements, etc.).

Do not confuse reflux and vomiting ( reflux-gastro-oesophageal-rgo in children ), the second being due to a violent contraction of the baby’s abdominal muscles, passively bringing up the contents of the stomach through the esophagus and then the mouth.

While some reflux symptoms are fairly obvious (your baby spitting out everything they swallow, for example), others will be quieter:

  • Frequent waking up at night
  • Weight loss or gain
  • Heavy crying or irritability after a feed
  • General discomfort or pain when lying down
  • Persistent cough

The main cause of these problems is the immaturity of the baby’s digestive system. This is why the symptoms decrease or even resolve around 6 months.

The second cause is food. Whether it is breast milk or formula milk can constipate the baby, give gas and reflux. For industrial milk, it is sometimes necessary to change milk in order to see the impact of this on the digestion of the child.

If you are breastfeeding, your diet will need to be changed. Stopping irritating foods like spices, vinegars, coffee, chocolate, dairy products and stimulants like nicotine can reduce or even solve the problem.

Here are some other tips to follow:

  • Don’t hesitate to burp your baby regularly
  • Avoid feeding him too much and too quickly (take breaks in the suckling)
  • Keep your baby upright after eating

Osteopathy does not resolve the root cause (digestive immaturity or diet) but the treatment is very effective in reducing symptoms by reducing abdominal and diaphragmatic tension.

At the very least, this allows your child to have symptom-free periods by giving the digestive system time to mature or change their diet.

Treatments

TESTIMONIALS

Words of patients!