Poor Posture and Shoulder Pain

By Mark DiSalvo, MPT, OCS, MTC, CGFI

Recently, I have had a rash of patients with shoulder pain and injuries coming into the office. One of the most consistent findings I see, is that people are very rounded in their posture and have very tight pec (chest) muscles. A simple and effective way to approach this type of shoulder pain is a corner stretch. Place your hands AND ELBOWS (this is important) on each wall on either side of a corner. Lean your whole body into the corner so you feel the stretch in the front of you shoulders and possibly in the middle of your mid back. Hold this stretch for 30 seconds and repeat throughout the day.

Developmental Speech And Language



Colleen Riordan

By Colleen Riordan, SLP

If you are a new parent or grandparent, you may be wondering when your “little one” will start babbling and using words. Here is a quick guide on what to expect.

By 12 months of age, your child should:

· Babble using a variety of consonant and vowel sounds

· Imitate movements, environmental sounds and speech sounds

· Use gestures with sounds or word approximations to communicate

· Have at least 1 or 2 words that are used consistently

By 2 years of age, your child should:

· Follow simple commands

· Point to named pictures in books

· Say more new words every month

· Begin putting 2-words together

By 3 years of age, your child should:

· Follow 2-step directions

· Use phrases of at least 3 words

· Have speech that is understood by most familiar listeners

By 4-5 years of age, your child should:

· Pay attention to a story and answer simple questions about it

· Use sentences that provide details

· Name some letters and numbers

· Produce most sounds correctly with the exception of l, r and th

· Communicate easily and be understood by children and adults

I Pulled My Muscle While Exercising. Should I See A Dr.?

By Mark DiSalvo, MPT, OCS, MTC, CGFI

Many people feel little “tweaks and pulls” as they workout. The question I often hear is “When should I see the Doctor or therapist?”If you have been good about icing and stretching after a minor muscle pull and nothing feels better in about 2 weeks, it is probably time to see the doctor. If the pain gets progressively worse in the first few days – this is another indication that it may be time to see the Doctor or PT. As physical therapists, we offer free 15 min screens for musculoskeletal issues and can help you determine if your injury is more serious and needs the attention of a physician. One more thing to look out for - at the time of the injury if you see bruising and swelling, it may be a sign that you have a more serious injury such as a muscle tear. This type of muscle injury needs more rest and specific treatment.

Child Motor Development

By Teri Roberts, DPT

Skill	Normal age range	Concerned time period	Quality of movement
Rolling	4-6 months	7 months not rolling any direction	Rolling should be both directions.
Sitting without assist	6-8 months	After 8 months	Child should also be able to transition in and out of sit by 8 months and play with a toy without falling
Crawling (on belly or hands and knees)	6-9 months	After 10 months	Crawling should be seen with both arms and both legs moving either on tummy or hands and knees
Standing (at a stable surface)	7-11 months	Child should place weight through feet with support for balance by 6 months	Child should be pulling to stand by 11 months and feel stable enough to hold on without loss of balance
Walking	11-13 months	After 17 months	As long as your child is taking steps with hand held assist and can push a push toy it is okay that they are not walking independently

As new parents many concerns arise with regards to motor movement. As a pediatric physical therapist I receive many questions from parents regarding their child’s ability to roll, crawl, stand and walk. The first year of life is such a dynamic time of movement and growth and new parents tend to be concerned with making sure their child is on target for gross motor development. “Normal” development is a very large continuum, with skills occurring at different times for each individual child. The continuum allows for a wide variety of ages to meeting skills, which makes determining normal and delayed development difficult to detect for a non-medical professional. The variations in development can be related to the child’s personality, motivation towards movement, experiences with different positions, the amount of tummy time a child is receiving, head size, muscle tone, etc. The time at which a child is developing a new skill is not as important as the quality of movement. However, it is much easier to see skill development than assess quality of movement, which is the reason we have specific ages that children are supposed to meet their gross motor “milestones”. The following are the averages of meeting gross motor development and the age at which a parent should be concerned.

Again, the above are averages for meeting milestones. The quality of movement is much more important than meeting the skills at a certain age.  If you, or your pediatrician, are concerned about your child’s development  - please call Kids Place for a free developmental screening to determine if your child  has a gross motor developmental delay.

Stretching But Still Tight?

By Mark DiSalvo, MPT, OCS, MTC, CGFI

A lot of people tell me that they do "a lot" of stretching but are not seeing any improvement in their flexibility. When you have tightness that does not seem to improve with consistent stretching, it may be a sign that you are not tight. Instead, this may indicate a protective mechanism from the body trying not to allow another area of the body to be injured. There is a pattern of movement to the body that allows for maximal motion. This can be referred to as the mobility/stability model of movement. Your foot, knee, lumbar spine, scapula, and elbow joints should all be stable. Most of your movement should come from the ankle, hip, thoracic spine, shoulder and wrist joints. As you work up from the ground you see a pattern, stable joint, mobile joint, etc. When a joint isn't doing its job, surrounding muscles may tighten up to protect from injury. Until you address the underlying problem, flexibility will not improve. A detailed exam from your therapist can address these areas and see if there is more to your un-improving tightness. 

Heat vs. Ice

By Mark DiSalvo, MPT, OCS, MTC, CG

One of the questions that I hear a lot in therapy is... "What's better to use, heat or ice?". If you have a recent injury (less than 3 weeks old) and there is any amount of swelling, the answer is ice. Place an ice pack in a pillow case or some other thin barrier and surround the entire area for 15-20 minutes each hour. The more often you ice the better. Heat really should be used only in chronic conditions or if there is a need for increased blood flow (arthritis, chronic back pain).