Physiotherapy - Strengthening Hamstrings & Quads

Physiotherapy (PT) is the therapy we use in order to help Hazel with limitations she may face due to low muscle tone. To read other posts about Hazel's therapies click here.

 

The latest in PT around here is that Hazel very rarely bends her legs to step over things. She side steps everything. She defaults to a bear crawl when she thinks her legs aren't strong enough to lift over an uneven surface. So, she has basically learned to overcompensate for her low muscle tone and still get where she needs to be. Sounds about right. Something Hazel would do. NOTHING is going to slow this girl down.

As a result, we are trying to help her gain strength in her hamstrings and quads by doing 3 activities in PT.

1. Stairs

Going up and down the stairs is a great muscle strengthener. There is a lot of bending and supporting herself, balancing on one leg (holding the railing too, of course). We have her facing the stair rail and side stepping up and down. This ensures that she gets that bend in her knees and still feels safe and secure holding the railing. We happen to live in a ranch so stairs are not easy to find around here. We have 2 steps coming into our house that we use. Up. Down. Up. Down.

What do we do?

• Use stairs at someone's house
• Use stairs at the park on the equipment
• Use stairs at our PT center

We do it where ever we can! Sometimes we have to be creative.

2. Tricycle

I have yet to decide which tricycle I am going to buy Hazel. The problem is that I can't find one that is suitable for her arms and legs. No matter which one I buy I will have to make modifications to it. For now we use the tricycle at our PT center.

Here are the 2 I am trying to decide between:

Kettler...

Radio Flyer...

Any and all suggestions are welcome. What have you done to modify your tricycles for your little ones?

3. Jump

Trampoline = jump.  I bought ours at a local store called Mastermind. Click here to view. We LOVE it. Hazel LOVES it. She has a blast on it and she started to immediately use the muscles in her legs to bounce. It took her until about the 3rd time on it to start to trust her legs enough to start to bend. This model is small enough to fit into any home. They also have a bigger one that we use at the PT center we visit.

Hope this gives you some ideas to bring to your next PT session.

As always ideas and suggestions are welcome here. Would love to hear from you!!!

Please check with your child's PT before trying any of these activities with your kiddos.

Top 3 Physiotherapy Activities

It has been a great summer in terms of PT for Hazel. We have been given a bit of a break. Hazel has been going through a huge gross motor change and focus since she has figured out how to walk. It's so nice to let her just do her thing and watch her try to figure out how her body moves. She's constantly experimenting with movement and balance, dancing and swaying. Some of our best entertainment is to just sit back and watch her go.  

Small Disclaimer: I just want to remind everyone again that these activities were given to Hazel, for Hazel, by her PT. If you would like to try any of these at home with your babes, please ask someone in your local community for support and advice on what will work best for your children. Also, we always follow Hazel's lead in terms of how often we work on certain skills with her. If she doesn't want to, we don't force her (especially with PT - she has a motivation that is all her own - Yikes!)

Please feel free to leave any questions you might have about Hazel's therapies in the comments of this post, or email me and I would be glad to answer.

 

1. Stairs

This one is difficult for us to do on a regular basis because we have a ranch. Whenever we go somewhere with stairs, I try to get Hazel to go up. She can go up if she chooses to, BUT we all know if she doesn't see the value in it, then she really doesn't see the point. So there's that...

We are now starting to work on going down the stairs. It usually results in tears of some kind, but only because she is not in full control and needs help to get where she's going. Although, lately she has been very interested to learn how to go on her belly down the stairs. I think she realizes going down gives her freedom to explore new places. FUN!!!

2. Riding Toy

We are working with her on being able to move the rider herself. The goal being to get her to activate her hamstrings and pull herself along.

And to be completely honest we don't put her on it as much as we should (it's been a little more difficult for me to bend that way for long periods of time). It doesn't usually happen at this point, but she has started to show interest in being on it. I am not sure if it's too slow for her and she wants to get off and walk or if she doesn't really see the point in sitting on the car. She likes to get off and on but no forward movement so far. She has managed to make it go backwards a few times.

3. Walking Toy

Hazel has been showing interest in using the walking toy recently. It was difficult to get her to want to do this, as crawling was so much faster for her and she knew it. Now that she is more comfortable walking, she seems to want to do this more often. I know it seems backwards that she learned how to walk without it and now she wants to push it.

Even though babies know how to walk it is still important for them to learn how to push, pull, and maneuver different push toys. Eventually they learn how to reverse, go in a zig-zag pattern and so on, which is important to children's development.

Here's how we start...

And usually how we end...

I like this push toy because you can determine the weight that goes into it. We have 25 lbs in the base so it WILL NOT tip over when she pulls herself up on it. I think you can get them at IKEA. I also like it because there are no "bells or whistles" on it to distract her from what she is supposed to be doing - pushing it.

Helpful PT & OT Resource:

You can find more information in the book, "Fine Motor Skills in Children with Down Syndrome."

I love this book. It really breaks down all the tasks and skills that help children to learn and develop. It gives useful toy suggestions and great teaching techniques. Even though it is more focused on fine motor (OT) activities rather than gross motor, it does touch on PT as well. I will refer to this book more when I do the next OT post.

 

There you have it. PT in a nutshell!

PT & OT for Children with Down Syndrome

Since Hazel started crawling our main focus for physio has been to encourage her to crawl as much as possible. We have not been working at all on bringing her to the next step which is walking (although she has her own ideas about standing independently and cruising). I am a huge fan of keeping her crawling for so many reasons.  

1. She's easier to chase after while crawling

2. She is getting so much more coordinated by strengthening all her muscles by using them often and equally.

3. She is acquiring a keen body awareness for all her muscles. Even down to the pincer grasp. It is coming along nicely since she is constantly aware of her fingers because of the constant weight baring through her arms while crawling.

4. She is easier to chase while crawling (Oops...already said that)

Small Disclaimer: I just want to remind everyone again that these activities were given to Hazel, for Hazel, by her OT and PT. If you would like to try any of these at home with your babes, please ask someone in your local community for support and advice on what will work best for your children.

Another Small Disclaimer: My intention for these posts is to provide ideas and information about OT, PT and Speech for anybody who feels compelled to learn or is interested in what it looks like in our home. It is NEVER to compare Hazel to other children. My favourite thing about kids is that they are all different and do things when they are ready and in their own time.

Also, we have stopped doing some of these activities and still continue to do others. Since she has started standing and cruising on her own we have added some new activities that I will include in the next PT/OT post.

The activities this time around speak for themselves...

 

1.  High Kneel on Couch

2. Pull to Stand & Cruising

We use anything that is the right height for her to pull up on. Actually she is good at scanning a room and trying her darnedest to pull herself on everything in it. (Who says "darnedest"?)

3. Bench Sitting

We have the toys within reach on either side of her so she has to turn and reach/lean down to grab the toy and bring it up to center.

4. Crawling...crawling...crawling

 

1. Self feeding with a spoon and fork

She does great with this as long as I load it for her. She is pretty proud of her self, actually!!!

2. IN & OUT

We practice with anything and everything. PRAISE!!!! Girlfriend can put things IN & OUT!!!

Here is a pic of the toy that really drove the concept home for her. She is obsessed!!!

3. Lots of listening to music while we play

Listening to music facilitates movement and also allows me an opportunity to add actions and signs that she is starting to learn slowly.

4. Working on early feeding signs

We are working on "more", "eat", and "drink." She has mastered "all done" and knows when to use it. The other are more difficult because she won't let me use her hands to show her how to do it. She just gets mad and pulls them away. (Same with loading her own spoon, won't let me guide her hand)

5. Pincer grasp

Like I said crawling has helped her a great deal with this. I just try to give her small pieces of food and try to encourage her to use her fingers to grab it. We are laid back about it but it is coming along. We are going to start using 1 inch cubes and smaller toys for her to try and manipulate them with her fingers.

Have a good week everyone!!!

5 Physiotherapy Tools - Down Syndrome

Here is the latest PT happenings in our house (from 7-9 months).

Sorry about the randomness of some of these photos. We do so many different things that is is hard to keep them all in order. Also, I am sure I have missed something because she grows and changes so fast, which means all her PT changes as well.

Disclaimer:

All of the activities shown here have been approved by our PT and OT. Also, these activities benefit Hazel and you should consult your PT and OT if you are thinking about trying any of these with your children.

Another important thing to mention, is that when Hazel is not happy doing any of these activities, we stop. We try something new and if she's not into it, we drop it for a while. I never pressure her or force her to do any PT or OT.

Our Tools:

1. The Foam

When using the foam in this position, it encourages Hazel to weight bare on both her knees as well as her arms. These pics are from a while ago.

If I lean her up against the side like this, she leans and rests her arm on the foam. It gives her practice weight baring on one side at a time. It, also, helps her to support herself better because her arms are a little shorter than most.

We cut the foam so that Hazel's legs will stay together. This ensures that the weight is on her knees and that she is not flat on her hips.

Sometimes I put the foam out in front of her so that she can reach to put weight on her hands as well as her knees. Trying to get her into the 4-point crawling position.

We are doing some PT outside (this pic is old). I think it's nice to change the scenery so that Hazel always has something new to look at.

In this position, Hazel is learning to put weight on her hands and elbows.

I often will hold a toy up for her to reach for so that she learns to shift her weight from one side to the other.

Sometimes she doesn't like to do PT, so we stop.

We have her sit on the foam and pull herself up. She gets a great bend in her knees and it forces her to use all the muscles in her legs to stand.

As you can see, she is pretty proud of herself (I know the pic is blurry but look at that face).

2. The Mirror

One of my favourite PT toys to use is this mirror. Hazel will sit up for the longest time talking to herself, and trying to grab at her face and hands. It is great for encouraging her to remain in the sitting position, rather than grab a toy and then fall over and just lay down and play.

Plus, it has the added feature of being the most entertaining thing for me to watch. She yells, dances, makes silly faces. It's great!!!

Oh yes...and tries to give herself a kiss.

3. The Medicine Ball

The medicine ball is the BEST!!!

Hazel loves it and it is so effective for core strengthening. It was a little nerve racking at first but we took it slow and now I really love it. We use it everyday. I bounce her really slowly and move the ball from side to side and front to back. Her natural reaction is to stay up so she is constantly flexing her abs trying to balance. She thinks it is pretty funny.

4. The Play Mat

These pics are pretty old but I still put her on her play mat sitting so that she can reach up and play with her toys.

Hazel has been really working on core control. Her posture is getting very straight. She practices sitting often and enjoys the freedom she has with her hands.

5. The Exersaucer

She spends time in here everyday and is really getting the hang of standing and sitting. She thinks she's hilarious when she stands (again...blurry but the faces kill me).