Monday, December 9, 2013

Common Misconceptions About Physical Therapy

Common Misconceptions About Physical Therapy

There are many common misconceptions about what physical therapy entails.  Let’s discuss a few common misconceptions and explain how physical therapy can help you get back to the activities you love, without pain!

Myth: Physical therapy is the same as receiving a massage

While physical therapy utilizes soft tissue mobilization similar to massage, the main difference is physical therapists are more target specific with their techniques.  With soft tissue mobilization, physical therapists look for muscles that are tender to the touch, which means the muscle is in some dysfunction.  Therefore, to decrease the tenderness, more pressure is applied to release muscle tension and decrease tenderness by releasing scar tissue and increasing blood flow to the area.  Soft tissue mobilization usually includes some discomfort.  These techniques are not used on every patient and are injury specific.

Myth: Physical therapy is only for athletes or people who had surgery

Physical therapy is useful in treating a large variety of pain and injuries from simple strains/sprains to post operative care.  We also treat a large range of the population from pediatric conditions to elderly with a wide range of activity levels.   Physical therapy can be helpful to people injured in car accidents, weekend warriors (recreational sport players), pregnant women, seniors, teens, elderly, post-operative, and job related injuries.  Physical therapists are also trained to detect symptoms that might require a referral to another health care professional to help treat any underlying issues that might be causing the symptoms.

Myth: Physical therapists will only use passive therapy and exercise for my problems

Some of the passive techniques people commonly think of are ice, heat, ultrasound, and electrical stimulation.  While these techniques are utilized, they are used in conjunction with manual techniques and specific exercises to help assist in the healing process.  Yes, physical therapy does include exercise, but we use specific exercises to strengthen and stabilize areas of weakness that might be the underlying cause of your symptoms. 

Myth: Physical therapy will be painful

It is possible to experience temporary soreness from manual techniques or exercises.  However, these effects should not last more than 24 hours and the end result is usually relief of your initial symptoms/pain.  Physical therapists use specific techniques and exercises to assist the body by aiding with the normal healing process and help it rebuild to function normally.  Physical therapy is safe and the soreness/discomfort will be minor and temporary with the goal of decreasing your symptoms.

I hope after reading this article you have a better understanding of physical therapy.  If pain is limiting your daily activities, please contact AZOPT at (623) 242-6908 to schedule your evaluation. 

Tuesday, November 26, 2013

Recommended Toys For Childhood Development

Recommended Toys For Childhood Development
By Ian Larson, AZOPT Physical Therapy Student

Birth to 3 months

During the first couple of months your baby needs plenty of tummy time and opportunities to reach for toys.  By the end of the third month your baby can hold their head up while on their tummy, and what better way to encourage your child than to use the tummy time prop up mat.(1.)

The tummy time cruiser is a great way to encourage your little one to push themselves on their elbows and arms.  This amazing toy will help your little one develop their arm and neck strength:
Twist and Fold Gym

Bright Starts Tummy Cruiser Prop & Play Mat(2.)                               

The activity gym will help your child develop arm and trunk strength while they are on their back.

Infantino Vintage Twist and Fold Activity Gym (2.)

4-7 months

Elephant Shape Sorter
Your baby has grown so fast and can now sit and reach for toys that are close by and bring them to their body.  Your baby may now be rocking on their hands and knees and creeping on his tummy.  Your child will also start to place their hands around toys. (1.) 

Here is a great toy to encourage your baby to reach for objects, identify shapes and begin to solve problems:

Growing baby elephant shape sorter (2.)

8-12 months old

Your baby amuses themselves by putting things in containers and taking them out again.  Your baby is getting closer to walking each day.  At this stage in their development the child should work on strengthening their legs and increasing their balance. (1.) 

This toy is great to build your baby’s balance and abdominal strength.  This toy will also help strengthen their leg by getting on and off the toy:

Rockin’ Tunes Giraffe (2.)

1 to 2 years old

During this time your child is moving around more and learning how to play through walking and some jumping.  This is a great time to encourage your child to walk as much as they can in order to improve their balance and leg strength. (1.) 
This toy is fantastic for your child’s development because it can be used for many activities that will help your child walk, balance, and improve their overall coordination:

Fisher-Price 3-in-1 Push N' Scoot (2.)

3-4 years old

Your child continues to be on the move.  At 3-4 your child should walk up and down stairs, kick , throw, and catch a ball.  Your child should also demonstrate run and ride a tricycle, hop, ride a tricycle, and walk forwards and backwards. (1.)

The little basketball set is a great way to enhance your child’s ball catching, and throwing skills:

Little Tikes Easy Score Basketball Set (3.)

This hopscotch fun rug is a timeless classic to strengthen your child’s legs, coordination, and balance while alternating between single or double limb jumping:

19 x 29 inch Primary Hopscotch Fun Rug (3.)

5-7 years old                     

At these ages your child will enjoy complex tasks such as swimming, climbing, jumping rope, and other complex tasks. (1.)

This sports set is a fantastic way for your child to develop and strengthen a variety of hand eye skill, coordination, and balance:
Stats Multi Sport Set - Soccer, Hockey and Lacrosse(3.)

This jump rope set is a great way to strengthen your child’s balance, coordination, and legs:

Stats Double Dutch Jump Rope (3.)


1. Center for disease control and prevention. Developmental milestones( all ages).  Accessed October 19, 2013.
2. Fisher Price. Infantino Vintage Twist and Fold Activity Gym, Bright Starts Tummy Cruiser Prop & Play Mat, Growing baby elephant shape sorter, Rockin’ Tunes Giraffe  , and Fisher-Price 3-in-1 Push N' Scoot. Fisher Price online store. Accessed October 19, 2013.
3. Toys R Us. Little Tikes Easy Score Basketball, ,19 x 29 inch Primary Hopscotch Fun Rug, Stats Multi Sport Set - Soccer, Hockey and Lacrosse, and Stats Double Dutch Jump Rope. Toys R Us online store. Accessed October 19, 2013.

Thursday, November 21, 2013

Tips For Proper Work Station Ergonomics

Tips For Proper Work Station Ergonomics

If you have a job that requires primarily a seated position, poor posture can easily contribute to back, shoulder, and neck pain.  Spending lots of time on the computer in any setting can also be a problem if you are not using the correct posture. The good news is that there are a number of helpful tips that can improve your work station ergonomics and help decrease your symptoms of pain. 

Ergonomics are design factors, for the workplace, intended to maximize productivity by minimizing your fatigue and discomfort.  Some companies have an ergonomics department which will assess your work station and order any necessary equipment.  If your company does not have this department, here are some examples of what can be done to best prevent pain:

First of all, your feet should be flat on the floor.  If your chair needs to sit high to reach your work station, you still need somewhere to support your feet.  When buying a new stool is not an option, an old phone book usually works just as well.

Your hips and knees should rest at approximately a 90 degree angle.  As a general rule, your knees should be level with your hips, or slightly below, when seated.

Your elbows should be bent to 90 degrees when working on a keyboard.  You should not have to reach up or down to get to your keyboard.  Your shoulders should be relaxed and not elevated.  Your wrists should not be bent up or down while working.  A wrist support for the keyboard and mouse are useful.

Your chair should have good support for your low back, so be sure to use it!  Sitting on the front edge of the chair for an extended period of time does NOT allow for good back support.  If you do not have good support on your chair, a lumbar roll should be used.  A small pillow or rolled up towel can be just as effective as a professional lumbar roll. 

Remember to change positions often to allow your muscles to work and rest.  Changing positions allows for better posture and blood flow to your tissues.

And finally, your monitor should be at eye level.  An old phone book can again be used to help raise a monitor to the proper level.

With these tips, you are capable of completing an ergonomic assessment to your own work station.  Spending the time now can help reduce current pain or prevent future problems!  If you are experiencing back, shoulder, or neck pain, call us at 623-242-6908 to schedule an evaluation.

Tuesday, November 12, 2013

When Should I Be Concerned About my Child’s Development?

When Should I Be Concerned About my Child’s Development?
By Josh MacDonald, OTR/L
Kids Place Clinic Director and Pediatric Occupational Therapist

As pediatric therapists, we get asked this question a lot.  Parents will ask us about their child’s eating habits, if their child should be walking by 12 months, why their child cannot tie their shoes in first grade, and countless other areas of childhood development.  Through our many years of experience we are able to offer our best and most reasonable answer based on typical development; however, many times the best answer begins with “it depends.”

If you are blessed to have a child without any major medical concerns, you will inevitably spend time worrying over every other aspect of their development and growth.  When an area of development seems to be lagging behind, most people turn to the Internet for answers.  Unfortunately, the Internet is full of conflicting data and just enough information to thoroughly confuse and frustrate parents.   So if not the Internet, then where should you turn for answers?

Our first suggestion is to spend time around other children the same age.  Get your child involved in play groups or play dates with other children the same age.  This will give your child a chance to work on socialization skills and peer play as well as give you a chance to see what other kids are doing.  There is no “one right answer” to when a child should acquire any given skill.  Because each child develops differently you are likely to find out that your child excels in some areas and not in others.  Whether it happens in a church nursery, park play group, or one-on-one play date, give your child lots of chances to play with others.  They will learn from the skills of others as well as improve their social skills.

If you still have concerns about your child’s development, you can browse the Internet, but we urge caution.  Stick to websites attached to institutions with substantial reputations.  Stay away from any website whose parent organization you don’t know or can’t identify from their home page.  Also stay away from individuals’ blog posts or websites.  There might be accurate information, but you can’t distinguish the difference between good and bad blog sources.  Below are a couple suggestions of the type of sites you can research:

If spending time around other children of similar age and research on reputable websites leaves you concerned or uncertain, you can ask your doctor for a referral for an evaluation with a Physical, Occupational or Speech Therapist.  These specialists will be able to complete an initial evaluation between 45-60 minutes and give you solid information (based on experience and standardized tests) about your child’s development.  If additional services are necessary, they will help you determine which specialist is best suited for your child.  This may mean a visit to a different clinician (developmental optometrist, neurologist or developmental pediatrician), but the value of being certain is worth the extra appointment. 

It isn’t easy being a parent, and life is full of questions.  We all want the best for our kids.  Knowing how to achieve that is not easy.  There are options and resources available to help you answer these questions.  If you are still unsure, feel free to contact us at Kids Place, and we will work with you to schedule an appointment for an evaluation.

Thursday, November 7, 2013

Incorporating Proper Body Mechanics

Incorporating Proper Body Mechanics

Often times, patients will ask me if the combination of physical therapy and exercise will be enough to heal their neck or back problems.  Don’t get me wrong, treatment by a physical therapist and a specialized home exercise program contribute heavily and play a significant role in achieving your treatment goals.  But is it enough?  Not entirely.  So then the question becomes, what more will help you achieve your goals and avoid future recurrences?  The answer is proper body mechanics.

Proper body mechanics are certain positions of everyday activities that keep your spine and body properly aligned.  This ultimately prevents symptoms like pain and stiffness in the spine. These positions are further recommended for people without back problems to help prevent stress on the spine, to help conserve energy, and keep you safe.

Our joints do not like staying in stretched positions for elongated periods of time.  For example, think about a time when you felt pain or discomfort in your neck after painting the ceiling.  Or a time when you awoke with stiffness in your neck or back after sleeping on your stomach with your head fully rotated to one position throughout the night.  Maybe your neck started getting tired after sitting at your computer with the neck and trunk flexed.  All of these examples, and others, will cause stress on your spine, which leads to pain and potentially degenerative joint disease.

So let’s talk about ways in which you can help achieve proper body mechanics in your everyday life.  There are sometimes multiple ways of doing certain activities.  Choose the best option for you.  If these options do not work with for you, consult your physical therapist for other options.

Things to check:
·         Your bed should be firm and not sag.
·         Your pillow should not be too big that your head is bent forward or too small that your head is extended backward.  Thus, you head and neck should align with the spine.
·         While sleeping, the pillow should only support your head and neck and not your upper back.
·         Try to avoid sleeping on your stomach with your head fully rotated to one side.
·         Instead sleep on your side or back or ¾ stomach using a body pillow.
·         It may take some restless nights of sleep to get used to sleeping on your back or side.

Image Courtesy of WebMD
To sleep on your side:
·         Place 1 or 2 pillows between your legs in such a way that the top leg is supported to prevent it from pulling the spine in rotation; OR
·         Sleep on your side with a small rolled towel under the waist to prevent sagging of the spine on the waist area.

To sleep on your back
·         This is the safest method if you have night pain.
·         Place a pillow under your knees placing the low back in a neutral position; OR
·         Place a small rolled towel under your lower back helping it maintain its curve.

Things to remember:
·         For long periods of sitting, try to stand up at least once an hour to relieve your spine.
·         Ensure that when seated, your hips are higher than your knees.
·         In most cars, the driver’s sit with their knees higher than the lower back, which causes a lot of stress on your spine, especially during long drives for people with neck or lower back problems. 

Here are some tips to assist your seated posture:
·         Fold a pillow lengthwise or roll a large towel and place it on the back half of the seat so when you sit on the chair, your hips are higher than your knees. This places your pelvis in a neutral position which in turn helps correct your posture.
·         If it is not possible to place a rolled towel or a folded pillow on the seat, sit astride a chair and place feet under the chair. An alternative if you need to study or have to work over a desk is to sit at the edge of the chair and then bend your knees and put your feet under the chair.

Things to remember:
·         Avoid standing in one position for a long time. It relieves the stress not only on your spine, but it also helps with the circulation on your legs.

Prolonged Standing
What to do:
·         For prolonged standing, place your foot up on a stool and alternate your legs if possible.
·         In front of your sink, you can open the bottom cabinet and place your foot in there.

Lifting and carrying
Things to remember:
·         Check the distance to transfer the object so you can plan accordingly.
·         Assess the weight of the object so you can decide if you need to use 1 or 2 arms/hands to lift an object or if you need assistance.
·       Remember to widen your base of support by separating your legs, making sure you bend at your hips, not your trunk.
·         Objects should be as close to your body as possible.

For Lifting Smaller Objects
There are two ways to lift an object:
·    When picking up small objects from the floor or lower areas, remember the golfer’s lift: place one foot in front of the other, while holding on to something for balance and support, and kick the back leg up while reaching.  This will keep the spine in a neutral position.
·         To pick up a heavy item, squat, placing yourself close to the item, keeping your back straight and lift with your legs.  Do not lift and twist your body in a bent position.  If possible, stagger your stance - positioning one foot in front of the other before you lift - so you can easily take your first step.

Household Chores
Vacuum and mopping
·         Walk with the vacuum or mop, keeping them close to your body to avoid reaching and protect your back.
Cleaning high areas
·         When cleaning something high like a tall window or trying to retrieve an item from a high shelf, avoid reaching up.  Find and use a step stool to raise yourself high and be safe.

Practice and repetition are keys to incorporating proper body mechanics into everyday home and work activities.  The mix of treatment by a physical therapist, a specialized home exercise program by your physical therapist, and proper body mechanics will help you achieve your goals in physical therapy.  While the treatment and exercises will work to improve your flexibility, range of motion and strength, proper body mechanics will make all of this easier. 

As always, consult a licensed physical therapist at AZOPT if you begin to have problems with your neck or back.  We will help you with the appropriate body mechanics that you will need in your everyday and work activities based on your specific condition.

Friday, October 25, 2013

Enjoy Halloween Candy with a Challenge

Enjoy Halloween Candy with a Challenge
By the Kids Place Pediatric Speech Therapists

What’s a parent to do when your child has a three-pound bag of candy after trick-or-treating?  While some families allow candy consumption in moderation, here are some other ideas for limiting your child’s candy intake:
  1. Agree in advance on a set number of candies your child will be able to choose from their bag/bucket
  2. For older children, agree on a percentage of their total number of candies
  3. Agree on special activities/items for which your child may “trade-in” their candy (books, videos, games, etc.)
  4. Use candy for arts and crafts

For the candies your children do eat, consider the following ideas to help develop speech and language skills:
  1. Use words to describe the qualities of your candy (sweet, sour, crunchy, soft, sticky)
  2. Have your child imitate oral-motor movements while enjoying their candy (For example, holding a lollipop, have your child protrude tongue forward then to the right/left to touch it. You can also practice holding the lollipop with lips only)
  3. Encourage longer sentences by offering your child choices of candy that differ only by one quality (“Do you want the big square chocolate or the small square chocolate?”)
  4. For nonverbal children, model signs for “eat,” “more” or “candy” and encourage imitation before reinforcing.
  5. Have your child follow directions incorporating the candy (“First, get the red one, then, get the blue one”).

It is especially important to be aware of choking risks.  According to the Center for Disease Control and Prevention, 15% of choking episodes in children under 14 are caused by hard candy.  An additional 12.8% is caused by other candies.  This amounts to nearly 30% of choking incidents from candy.

Halloween foods that have the highest choking risk include:
  • Gum
  • Peanuts
  • Hard candies
  • Jelly beans
  • Gum drops
  • Gummy bears
  • Licorice
  • Fruit snacks
  • Raisins
  • Pumpkin seeds
  • Popcorn 
  • Caramel
  • Candy corn
  • Taffy
  • Marshmallows

Lastly, be cautious of non-food items that have a high potential risk for choking.  Especially small toys or balls/marbles which a diameter of less than 1 and 1/3 inches.

This Halloween, allow your children to enjoy some of the candies from trick-or-treating, but challenge them to do more than just simply eating the candies! 

Happy Halloween!

Thursday, October 24, 2013

The Halloween Conundrum – What to do with Extra Candy

The Halloween Conundrum – What to do with Extra Candy
By the Kids Place Pediatric Occupational Therapists

Many parents struggle with what to do with all the leftover candy their kids have from trick-or-treating.  Candy can be used in many fun activities that do not involve actually eating it, but rather promote the development of fine motor skills, visual processing skills, cognitive processing skills, and sensory development. 

First, try sorting the candy by color, size, shape, first letter of the name, the type of candy, or any other way you prefer.  To improve your child’s fine motor skills, encourage the kids to use only their index finger and thumb or only the index and middle finger with the thu
mb.  Sorting this way will help children develop isolated finger movements necessary while using writing utensils.  Also, by using the index and middle finger with the thumb, you are promoting the correct positioning your child should use writing with their pencil. 

Furthermore, you can have your children sort their candies using clothespins.  With the index finger and thumb, or index and middle fingers with their thumb, children can pinch the clothespin to grip and move the candies.  The resistance of the clothespin will help strengthen your kids’ fingers and improve their endurance during writing tasks.  Tweezers and chopsticks are other tools that encourage isolated finger movements.

Secondly, making crafts with candy can also be a fun way to use the extra.  You can draw pictures and have your kids glue candies on the lines.  You can also have your children draw their own picture and explain what each candy represents at the conclusion.  Candies, such as lifesavers, can be strung to make bracelets or necklaces.  This activity promotes bilateral integration, or using two hands together.  If a candy does not have a hole, your child can use a toothpick to push through the candy, also helping to strengthen the fingers. 

Additionally, candy can be used to create a gingerbread house.  You can either freeze the extra candy until it is closer to Christmas time, or make a Halloween/Fall themed house.  Using frosting as the glue, place the candies on graham cracker walls for decorations.

Extra candy can also be used for finger painting.  Place one color of hard-shelled candy (Skittles, M&M’s, etc.) in a class of water and watch the coating dissolve and become colored water.  Children can then dip their fingers in the water and “paint” paper towels.  For more concentrated colors, use just enough water to cover the candies.  

These crafts are fun for all ages, but they are especially beneficial if your child has difficulties with messy play (does not like to get food on their fingers, does not like to play in sand boxes, or does not like to play with finger paints, etc.).  Your child will most likely get frosting on themselves in small amounts while placing the candy, and will need to dip their fingers in water to get color on them.  These experiences will provide them with tactile input (or feeling it on their skin).  Working with small amounts of tactile input and increasing it over time can help your child become less hesitant towards messy play. 

We hope some of these suggestions will help your family enjoy Halloween candy in new ways that promote positive development in your child.

Happy Halloween!

Wednesday, October 23, 2013

Halloween Themed Outdoor Activities for Children

Halloween Themed Outdoor Activities for Children
By the Kids Place Pediatric Physical Therapists

As snow and cold weather sweeps through many parts of the country, this time of year is a perfect reminder to why we live in Arizona.  The beautiful weather outdoors plays host to many possibilities of games and activities.  In the spirit of Halloween, we want to introduce you to some themed games that are sure to be fun for your children, but also beneficial to their development.

Spider Web Maze
With a piece of chalk, draw a large spider web on the ground.  Using paper, plastic, or extra candy, place the “spiders” along the lines of the web.  Have your child walk the lines of the spider web, keeping both feet on the line, and count how many “spiders” they can grab in one minute without stepping off the lines.  This game is beneficial in that it improves coordination and balance.

Candy Grab
Dump a bucket of candy on the floor.  Using only their toes, see how quickly your child can pick up the candy and place it in a bucket.  This will work your child’s ankle strength and balance.

Candy Hopscotch
Draw hopscotch on the ground.  Throw the candy on the ground to skip that step.  All you will need is chalk and your Halloween candy.  This game will benefit your child’s jumping, coordination, and balance.

Spider Web Catch
This game can be enjoyed both indoors and outdoors.  Using painter’s tape, build a spider web in an open hallway or tree.  Crumble up some newspaper into various sized balls, and count how many your child can throw and stick in the spider web.  Throwing is a gross motor task that can be improved with items typically found in your house!

This Halloween, we are challenging families to use their candies in ways other than eating.  There are many additional games and activities that can be played for Halloween or any time of the year.  These ideas do not have to involve a lot of equipment or work.  The most important thing is to get up and play outdoors with your children.  Performing these activities with your children provides the proper foundation to encourage consistent exercise and activity!

We would like to hear from you.  What types of outdoor activities do you play with your children during Halloween?

Thursday, October 17, 2013

Celebrate National Physical Therapy Month with Activity

Celebrate National Physical Therapy Month with Activity
By Erik Bassett, DPT
AZOPT Physical Therapist

This October, we celebrate National Physical Therapy Month (NPTM)!  NPTM is an awareness celebration held each October by the American Physical Therapy Association (APTA) to recognize the important roles physical therapists play in restoring and improving motion in people’s lives.  Nobody understands this more than the “Active Adult” community.  Also known as Baby Boomers, the active adult community is one of the largest and most powerful generations in the United States. They have redefined aging and are more educated, wealthy, and tech savvy than their parents or any generation preceding them.

However, a Harvard study has found that too many boomers are overweight or obese, increasing the risk for chronic health conditions such as heart disease, type 2 diabetes, and certain cancers.  Further, as we age we may lose flexibility, strength, and balance, which makes staying fit after 50 challenging for even the most determined baby boomers.

Working with a physical therapist can help boomers address these challenges, maintain fitness, and avoid injury – in many cases without expensive surgery or long-term use of prescription medications.  Physical therapy is no longer simply just about rehabilitation.  Physical therapists can help restore and improve motion to achieve long-term quality of life.  Physical therapists significantly improve mobility, and ability to perform daily activities. 

Physical activity may be the closest thing we have to the ‘fountain of youth.’  Yet it’s a fact of life that health and mobility concerns often arise as we grow older. The good news is that we can keep many of these concerns at bay through regular physical activity.

Being active plays a crucial role in improving and preserving health and quality of life.  Regular physical activity can improve bone density, posture, heart and lung function, muscle strength, joint function, sleep, and memory, among many other benefits.  By sticking with a physical activity plan, Baby Boomers can lower their risk of health conditions such as fractures, falls, depression, certain cancers, stroke, hypertension, heart disease, and diabetes.

As experts in restoring and improving motion in people’s lives, physical therapists define physical fitness as having good aerobic capacity, muscle strength and endurance, and flexibility. We encourage adults to get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity, or an equivalent combination of the 2, each week. In addition, we recommend working all major muscle groups — arms, shoulders, chest, abdomen, hips, back, and legs at least 2 times per week and incorporate flexibility activities such as stretching, dancing, and yoga, into a physical activity regimen.

Physical therapists are uniquely qualified to help boomers stay fit and mobile.  To learn more about how we can help you at AZOPT, please call us at 623.242.6908 or email

The American Physical Therapy Association (APTA) is an individual membership professional organization representing more than 85,000 member physical therapists. APTA seeks to improve the health and quality of life of individuals in society by advancing physical therapist practice, education, and research, and by increasing the awareness and understanding of physical therapy's role in the nation's health care system.

Tuesday, October 15, 2013

Messy Play is Okay!

Messy Play is Okay!
Kids Place Pediatric Occupational Therapist

In early development, a child begins to piece together information about their world using their seven senses: vision, hearing, smell, taste, touch, proprioception (position sense), and vestibular (movement sense). Children use their sensory experiences to make sense of their environment.  As a child grows, the information they gain from their environment through their sensory systems shape their development. Cognitive skills are developed through curiosity and exploration.  Physical skills are developed through a desire to move to objects or areas of interest.  Finally, social skills are developed through interaction with objects and people in their environment.  So, how can you facilitate this growth through sensory experience? The answer is simple - MESSY PLAY!!!

Messy play is an excellent way for your child to use all of their sensory systems.  It encourages curiosity, exploration, and creativity.  Because there is no wrong way to messy play, the child gains confidence as they are successful in their activities.  Messy play can be used to learn letters and numbers, to interact with peers, and to develop fine motor skills. Here are some messy ideas to get you started:

    Image courtesy of The Imagination Tree
  • Cook some spaghetti noodles, strain and place in a large bowl (or on a high chair tray or play table). You can add food coloring if you choose. You can hide small toys in the noodles for your child to find or use the noodles to form shapes, letters or numbers.
Corn starch and water
  • Mix corn starch and water in a large container (flatter surfaces work better, i.e. casserole dish). This should appear to be a fairly solid mixture.  Pick up a handful and watch it melt in your hands! 
Puffy paint
    Image courtesy of
  • Mix equal parts Elmer’s glue and shaving cream. Add your desired color (food coloring or paint work well).  Paint onto paper of your choice with your fingers (or paint brush if you must) and let it dry into a puffy masterpiece. 
  • Gak is a gooey, slimy, glob of fun.  Making it with your child can teach sequencing skills, following a recipe, measuring, and attention.  The finished product can be stored in a plastic bag to play with again and again. 
  • For a simple Gak recipe, click here!
  • Similar to Gak, following any recipe is a great way to teach kids valuable skills such as counting, sequencing, following directions, attention and social skills. 
  • For a simple, uncooked Play-dough recipe, click here
Finger Paint/Shaving cream
  • Great way to get messy while practicing writing letters, or just drawing using a pointer finger. 
  • A dry alternative to other messy play options, but still a great way to gain the desired sensory experiences.  Fill a small bucket or large bowl with rice or beans (uncooked).  You can hide small toys inside for a treasure hunt.  Make two or more bowls to make it a race or work together to find all the treasures.
I would like to hear from you.  What other forms of messy play have you experienced with your child?  Did your child and you enjoy any of these ideas?  Please leave me a comment in the section below.

Tuesday, October 1, 2013

Keeping Your Child Safe in their Car Seat

Keeping Your Child Safe in their Car Seat
Kids Place Clinic Director
Pediatric Occupational Therapist

At Kids Place, our therapists see a lot of children coming into the clinic in their infant carriers.  Unfortunately, too many of them are fastened into the car seat incorrectly.  While every car seat is different, there are a few standard rules about how to fasten them into infant carriers and forward facing seats.

First, the plastic retainer clip (the plastic clip across the chest) should be slid up to the level of the armpits.  This may seem high and appear to put pressure between the straps and the child's neck.  But, if the clip is not high enough, it will not hold the belt in place, and the child will slide between the straps and out of the seat in an accident.

Second, the seat belt should be tight enough that you cannot pinch any excess at their shoulder.  This is relatively snug.  When applied taught against the body, the seat belt assists in riding out the deceleration slowly.  If the strap is too loose, then the child will 'collide' with the seat belt in an accident, resulting in further injury.

Lastly, no additional pieces of aftermarket items should be added to the car seat.  These pieces are often not fire retardant, and could catch fire quickly.  Any padding on the seat belt strap to protect the neck will only create space between the child and the strap.  Remember, this needs to be a tight fit.  Space is bad.  Items hanging from the handle or on the seat of the vehicle will come loose in the accident and potentially strike the child.  These items are marketed well to convince us of their necessity or cuteness, but they are not crash tested and will be dangerous in an accident.

These are only a few of the rules and guidelines about car seats.  Your local fire department is able to assist you installing your car seat, and will teach you how to properly use the car seat.  This may seem like a hassle, but 90% of car seats are installed incorrectly and will not protect a child during an accident.  Make your child's safety a priority.

Saturday, September 28, 2013

Celebrating Family Health and Fitness Day

Celebrating Family Health and Fitness Day

with advice from Josh McDonald, OTR/L, MS
and Mark Salandra, CSCS
Celebrating Family Health and Fitness Day
Americans young and old have been gaining weight and slowing down. A report on physical activity and health from the U.S. Surgeon General’s office in the late 1990s found that “nearly half of young people aged 12-21 are not vigorously active on a regular basis” and that more than 60% of adults aren’t as active as they should be.

(A more recent study in 2010 didn’t show any improvement, finding that only 15% of high school students achieve the recommendations set by the CDC for physical activity.)

These findings led to the creation of Family Health and Fitness Day on September 28, a celebration marking its 17th year in 2013 that celebrates activity for the whole family.

Why is this something Americans should commemorate? “Staying healthy as a family provides motivation to all members, and it increases support for the members of the family that are not as motivated for physical activity,” says Mark Salandra, CSCS, the founder of (one of Physiquality’s partner programs). He adds that daily physical activity should be as routine as brushing your teeth or any other healthy activity you do for your body every day.

If we want our children to value healthy and active lifestyles, then we need to model those choices for them.Activity expert Josh McDonald reminds parents that every action is a lesson for children. “If we want our children to value healthy and active lifestyles, then we need to model those choices for them,” says Josh, an occupational therapist at Kid’s Place, a clinic for children run by Arizona Orthopedic Physical Therapy (a Physiquality network member with two locations in Arizona).

He encourages parents to make good choices for the entire family. By turning off the television and taking them out to play catch, by enrolling them in sports and camps, or by gathering everyone for a bike ride, parents are showing their children the value of health and wellness. As a parent, he notes, “When I initiate healthy decisions for myself, and I include my kids in those decisions, I establish lifelong patterns that they will carry with them into adulthood.”

The easiest way to be active with the family is to take a walk.The easiest way to be active with the family is to take a walk. The CDC recommends walking at least 10,000 steps a day, Mark notes. Why not strive for that goal with a daily walk after dinner? It’s a way to burn off some of the calories in your meal while continuing discussions started around the dinner table.

There are lots of ways to make healthy choices with your family, but Josh reminds parents that the responsibility for such healthy choices starts with them. “These decisions aren’t always easy,” he notes, “but the benefits are immense for both the parents and the children.”

Tuesday, September 24, 2013

IT Band Syndrome

IT Band Syndrome 
By: Brooke Smith, DPT

Do you have knee pain or hip pain that occurs with walking or increased activity?  It could be caused by a tight Iliotibial (IT) Band.  The IT band is a thick band of fibrous tissue that begins at your hip and runs down the outer part of the leg, crossing the knee, and attaching to the top portion of your shin bone (tibia, figure 1).
The IT band and the associated musculature act to stabilize and coordinate muscle function of the knee with running and walking.  It is a common overuse issue that occurs in “4.3-7.5% of long distance runners”.3   However, IT band syndrome can also occur in military recruits, cyclists, tennis players, adolescents undergoing rapid growth, weightlifting, people who perform a lot of squats, short distance or sprint-distance runners, rowing, and cross training.   IT band syndrome has been reported to occur equally in men and women and most frequently occurs between the ages of 15-50 years old.

Some common mechanisms of injury, creating pain, could be decreased strength, decreased flexibility, abnormal hip alignment (pelvic tilt), “bowlegs”, improper alignment or mechanics of the feet with walking/running, improper posture/mechanics with running or exercises, running on angled or uneven ground, leg length discrepancy, poor footwear, sudden increase in activity, returning from injury too soon, overuse, or over-training.   

Someone who has IT band syndrome will usually experience pain on the outside of the knee.  However, some people can present with pain over the hip joint (greater trochanter), or pain starting at the knee traveling up to the hip. Sometimes the pain can be described as stinging or needle-like pricks that can occur every time your heel strikes the ground with activities.  Pain will usually increase with activities such as running or cycling, especially when running hills, and with walking up/down stairs.  This is due to inflammation of the IT band causing it to snap over the hip bones (greater trochanter), leading to pain.  Other common symptoms may include repetitive popping sounds in the knee when performing activities, as well as tenderness with pressure over the outside of the leg just above the knee. Some tenderness might also be present at the hip joint (greater trochanter).  

However, there could be multiple reasons for pain at your hip or knee and these include: hamstring strains, MCL and LCL injuries, meniscus injuries, myofascial pain, osteoarthritis, overuse injuries, patellofemoral syndrome, and trochanteric bursitis.  Therefore, it is critical to have a professional MD or physical therapist assess your individual problems to determine if it is truly IT band syndrome.

Physical therapists will help diagnose IT band syndrome by taking into account the patient’s history of the present condition, performing special tests specific to IT band syndrome, alternative tests to rule out any other pathology, and assess strength and joint motion/mobility.  Some common treatments provided by physical therapists include strengthening of weak musculature, stretching of tight muscles that are contributing to the pain, manual therapy, soft tissue mobilization, assisting in custom orthotics, modalities such as ultrasound, TENS, and ice, and providing home exercise program to maintain results.   All treatments are specific to each individual patient and their specific biomechanical faults are taken into consideration to fix the cause of IT band syndrome.

If you think you might have IT band syndrome here are some simple tips, exercises, and stretches you can try: rest, ice, appropriate use of ibuprofen/NSAIDs, IT band stretching, and use of a foam roller to release the IT band, use proper footwear, stretch prior to and after running, get adequate rest between workouts, and gradually increase your training or exercises.  If you continue to experience pain, you should seek the advice of a licensed physical therapist to assist in diagnosis and treatment.  If you have any questions, concerns, or would like to schedule an appointment contact AZOPT at (623)-242-6908.