Erb’s Palsy is also known as Shoulder Dystocia or Obstetric Brachial Plexus Injury. Erb’s palsy is a condition where the brachial plexus nerves that supply movement and feeling to the arm are damaged, and this usually occurs after a traumatic birth. Each baby’s symptoms are different depending on the damage done to the nerves and results in difficulty moving their arm. The paralysis can be partial or complete as the damage to each nerve can range from bruising to tearing. Some babies recover on their own, however, some may require specialist intervention.
Tips to Help your Baby’s Recovery:
Positioning
Always make sure the affected arm is supported and does not hang away from the body, you can use soft toys in the cot to help prevent this.
Dressing
Always put the weak arm into clothes first when dressing and take it out last when undressing.
Stimulation
Gentle stroking and massage to the arm to provide sensory input will help with recovery. Try to use different textured materials on the arm to increase sensation (e.g. silk and soft brush) and help your baby bring their hands together and touch their face with their hands.
Stretches
It is important to maintain the range of movement in all the joints in the arm to stop the arm muscles becoming tight. One of our paediatric physiotherapists will teach you the appropriate stretches for your baby and it is advised that you do them regularly (for instance during every nappy change) to get the best results.
Activities and Exercises
As your child gets older our paediatric physiotherapists can advise on appropriate strengthening exercises to help promote recovery of the arm.
Function
Our paediatric physiotherapists can help your child reach optimal function by providing fine motor activities and practicing other skills (e.g. throwing and catching a ball).
Are you looking for a highly specialist paediatric physiotherapist to assess and provide specialist advice and treatment for your child? We can treat your baby the comfort of your own home and we can usually set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com
A bursa is a gel filled sac that lies in between two surfaces to prevent friction. They can become inflamed from trauma, overuse or disease. You may have heard knee bursitis referred to as “housemaids knee” or “roofers knee”.
There are numerous bursae around the knee (approximately 14) and they are named after their location in the knee. The five main ones are prepatellar (found in front of the kneecap), semi membranous bursa (at the back on the knee), Infra patellar (under the knee cap), supra patellar bursa (underneath the thigh muscle), and the pes anserine bursa, (located approximately two inches below the knee joint on the inner aspect).
Typical symptoms are pain, tenderness (at the location of the bursa) stiffness and sometimes redness and warmth. Good news is that with rest, ice, compression and anti-inflammatory and pain medication this can settle down. However it’s important to get a proper diagnosis from a physiotherapist; who can advise you on what to do and what not to do. Sometimes bursitis can require further intervention such as aspiration (removing excess fluid) or a pain relieving injection. Your physiotherapist can help you to regain full strength and mobility in the knee and to prevent reoccurrence.
Are you or someone you know suffering from knee bursitis? Our specialist physiotherapists can see you in your home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com
Around 400-500 children in the UK develop brain tumours each year and they are the most common solid tumours that occur in children. Children of any age may be affected but boys are affected slightly more often than girls. Sadly brain tumours are the leading disease related cause of death in children. However the prognosis of survival is improving all the time with advances in medicine, and currently one out of three patients survive for five years following the diagnosis. It is important to be aware of the signs and symptoms of brain tumours and to raise your concerns with your GP if you are concerned.
Signs and Symptoms of Brain tumours:
- Headaches – particularly if your child wakes up with a headache.
- Vomiting
- Seizures
- Torticollis – sudden onset of a head turn preference
- Change to walking ability
- Balance problems
- Weakness in arms or legs
- Visual changes disturbances e.g. squint, visual loss, blurring
- Difficulty with coordination
- Weight loss and decreased appetite
- Change in behavior – irritability, very sleepy, withdrawn
The Road To Recovery
If your child has been diagnosed with a brain tumour, the key to recovery is rehabilitation. Because there are so many different types of brain tumours, treatment won’t be the same for everyone but our experienced physiotherapists will help your child to identify their impairments and provide evidence-based assessments and treatments to help maximise your child’s abilities.
How Physio can help your child:
- Strength exercises - regaining strength is essential for recovery.
- Restoring joint range of movement – a stretching programme will help prevent muscles from becoming tight.
- Balance and Coordination – working on sitting and standing balance in preparation for walking.
- Gait re-education – providing treatment and exercises that will help your child to learn to walk with an improved gait pattern again.
- Endurance – building up endurance to help reduce fatigue and regain fitness
- Independence and function – working on specific activities that your child is finding difficult in every day life.
- Equipment – some children may require specialist equipment. Our physiotherapists can recommend appropriate aids to help with walking and promote independence.
Our team of highly specialist physiotherapists can assess your child, make recommendations and provide an individualised exercise programme to help reach optimum function. It is our aim to make rehabilitation a positive experience and support your family every step of the way.
Our specialist physiotherapists can see your child in your home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
Talipes is also known as positional talipes equinovarus (PTEV) or can be described as clubfoot. It is a condition that can affect one or both feet in babies causing the foot to turn inwards. In positional talipes, the foot is not fixed in this position and it can be easily be manipulated into the correct position. It is thought to develop as a result of abnormal pressures on the foot whilst it is developing in the womb. However it is usually a short-term condition that can be corrected with stretches.
Positional talipes should not be confused with structural talipes, also called congenital talipes equinovarus (CTEV). This is a more complex condition associated with bony deformity in the foot and tight calf muscles. In these cases surgery and casting may be required to correct the foot position.
What can you do to help your baby?
- Give your baby some time out of their baby-gro to allow them to kick their legs freely. Bath time is a good time for kicking.
- Make sure your baby’s clothes are not too tight around their feet.
- Touching and massaging your baby’s lower leg can help stimulate and strengthen the foot muscles.
- Regular stretches as instructed by your physiotherapists.
Our specialist paediatric physios are able to instruct you in suitable stretches for your baby but you may wish to try the following exercises on your own:
Stretches 1
- Hold the baby’s calf in one hand, keeping the knee bent (do not hold the heel).
- Take hold of both sides of the foot with the other hand using thumb and finger.
- Firmly but gently, stretch the foot outwards towards the point where the knee and foot are in line.
- Hold for 15 seconds and release. Increase up to 1 minute if your baby remains relaxed.
Stretches 2
- Hold the baby’s calf in one hand and the foot with the other.
- Bring the whole foot up towards the shin in order to stretch the back of the heel.
- Hold for 15 seconds and release. Increase up to 1 minute if your baby remains relaxed.
A meniscus is a C-shaped cartilage in between the knees. You have one around each half of the knee and it acts as a protective layer during weight bearing and impact (i.e. jumping). The menisci can be injured in three difference ways: innocuous activity, traumatic force or degeneratively. Doctors will diagnose an injured meniscus using an MRI scan and will refer to it as “torn cartilage”.
With a meniscal tear you may suffer from a combination of pain, swelling, clicking, catching, or locking during motion of the knee joint. Symptoms you experience are normally dependent on the type of meniscal tear that you have occurred. Pain is normally only present when weight bearing through your knee.
Treatment usually involves anti-inflammatories and physiotherapy to reduce swelling, improve range of movement and correct biomechanics that may have contributed to the tear. If the symptoms do not resolve you may require surgical interventions, such as a knee arthroscopy (keyhole surgery) to mend or cut away the damaged part of the meniscus. If you do have a knee arthroscopy you will also require post-surgical physiotherapy to ensure you regain a fully functioning knee.
Do you or someone you know have a mensical tear? Our specialist physiotherapists can see you in your home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
Behind your knee cap and tendons of your knee, there is some soft fatty tissue known as “Hoffa’s Pad” or “infra-patella fat pad”.
Occasionally this tissue can become pinched or ‘impinged’ between the articular surfaces (joints) of your knee, causing swelling and severe pain when your leg is extended (straightened). This usually happens if the knee becomes over-extended or from an awkward impact onto the knee such as a fall or sporting injury.
It is important not to ignore the pain as fat-pad impingement does not resolve spontaneously. Ignoring the pain can lead to scarring or fibrosis of this tissue making it shorten, which can lead to further impingement and pulling the knee cap into incorrect positions.
Your physiotherapist can help with swelling management and taping to unload the pressure on the fat pad, in order to limit the pain and provide advice before forwarding your case to an orthopaedic surgeon if needed.
Are you concerned that you may have fat pad impingement? Our specialist orthopaedic physios can help to assess and treat in the comfort of your own home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
Patellofemoral pain is an umbrella term used to describe pain in and around the kneecap (patella) and the femur (thigh bone). There are numerous structures that can give off pain signals around the knee: fat pads (tissue which acts as a cushion to protect the joint), the joint capsule (a fibrous sac containing fluid) and other soft tissue structures. Over time this can lead to softening of the cartilage, which is known as chondromalacia.
Generally you will feel pain around the front of the knee, especially when you are loading the joint during activities such as walking, running, walking on stairs (especially down) or even just sitting for a long time. When we load the joint we can put through as much as half our body weight for just walking and up to 7-8 times out body weight when climbing stairs. So that’s a big load for a small joint!
As the knee bends and straightens it should smoothly glide through a notch, controlled by the thigh muscle (quadriceps) as in a pulley system. If there is a disruption of this pulley system with one side pulling it more than the other, then friction can occur. As the patellar femoral joint consists of numerous structures that can be easily aggravated, much pain and inflammation can occur here. A physiotherapist can assess your patellar femoral joint and diagnose why the system isn’t working properly. Flat feet, ‘knock knees’, excessive joint movement, weak muscles and reduced flexibility are linked to causing Patellofemoral pain.
As there are so many structures that could be at fault, your treatment will vary according to the underlying root problem. Lots of research has been carried out in this area to find out what the most effective treatment is. One study (Cowan et al, 2001) found that by strengthening muscles around the knee joint and reprogramming them in working together, it reduced pain in patients with Patellofemoral pain. Other options include acupuncture, taping, ice anti-inflammatories, releasing tight structures around the joint, insoles and braces. It really does depend on what’s causing your Patellofemoral pain.
Are you suffering from Patellofemoral pain? Our specialist physiotherapists can see you in your home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
Specialist paediatric physiotherapists can help monitor your child’s musculoskeletal system as they grow, and ensure they are referred to a spinal consultant and/or orthopaedic doctor if any of the following problems occur:
- Neuromuscular Scoliosis or Spinal Curve – children are most at risk during growth spurts.
- Hip Displacement (subluxation/dislocation of the hip) – children who are wheelchair dependant are most at risk although walkers can also be affected.
- Lower limb contractures (loss of range of motion within either hip, knee or ankle). The most common areas affected are:
Hamstring shortening leading to difficulty extending the knee.
Planter flexion/equinus contracture (ankle and foot pointing downwards).
Children tend to walk on their toes as a result and standing balance is affected.
Hip flexion contracture (unable to extend or straighten the hip).
This is most common in children who are wheelchair dependent as the hip flexor muscle is often held in a shortened position.
Fixed pelvic obliquity/rotation (when the pelvis is unable to be placed into a neutral position when siting).
This is most common in wheelchair dependant children.
It is important to remember that children who are wheelchair dependent are at risk of hip displacement, fixed pelvic obliquity/rotation and scoliosis, and often these orthopaedic issues can occur together and one can drive the formation of the other. Good seating and postural support is essential alongside regular orthopaedic review with your orthopaedic doctor.
Are you looking for a specialist paediatric physio to assess your child’s musculoskeletal system? We can often see your child within 24 hours at home or school. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
Vestibular rehabilitation (VR) is an exercise therapy used to help patients regain their sense of balance. According to the Chartered Society of Physiotherapists, “Vestibular rehabilitation is effective in reducing dizziness and vertigo and associated falls and improving quality of life in people with disorders involving balance mechanisms”.
VR encourages the central nervous system to compensate for problems inside the inner ear. Specialist physiotherapists can tailor a program including eye, head, standing, walking and balance exercises that are, “clinically effective [in] reducing distressing symptoms and improving quality of life”.
To find out more about how Physiotherapy can enhance the quality of life for people who suffer from dizziness and balance disorders, you can download the Chartered Society of Physiotherapy’s Information Sheet here.
Are you looking for a specialist Balance and Vestibular Rehabilitation physiotherapist to see you or a family member? We can often arrange the first appointment within 24 hours at home. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
The collateral ligaments are found either side of your knees and assist with controlling the sideways motion of your knee and brace it against unusual movement. You can sustain a sprain to these ligaments via any direct contact to the knee or hard muscle contraction. According to OrthoInfo, these can be graded to tell the level of injury as follows:
The most commonly injured collateral ligament is on the medial side (the side closest to the other knee). You may experience swelling and pain around the site injury, and a feeling of giving way in the knee. These injuries can be treated conservatively with icing, bracing and physiotherapy to restore range of movement and muscle strength.
If the injury is more severe or has not healed conservatively it will require surgical repair, which your specialist knee consultant will discuss with you. You will also require physiotherapy after surgery to regain full range of movement and muscle strength for knee stability. After treatment, you will gradually return to sports activities.
Are you or someone you know suffering from Collateral Ligament Sprain? Our specialist physiotherapists can see you in your home and we can set up an initial appointment within 24 hours. Contact us today on 0207 884 0374 or email info@physiocomestoyou.com.
