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!

Filling up our tool boxes

WARNING: There is a rant coming your way. You might want to leave now while you still can (but I really hope you don't - sniffle) or grab a coffee and come back prepared to take a moment to read my plea about "milestones."

Oh good, I am so glad you stayed...here goes.

I don't know if you've noticed over the course of reading and following the blog that I am not really one for comparing other kids, worrying about when milestones will be reached at what time, or giving praise for how quickly some kids do things compared to others. I am not sure how many times I have been asked...

"Is she walking yet?"

I always just answer in the most honest way that I can and hope that it satisfies the person asking. I find it interesting how our culture and society is always worried and focused on that next step. We just don't spend enough time focusing on the present (which if y'all have been reading for a while, know how I feel about "being present"). Enjoying the phases our kids go through in that moment. Let me ask you this...

"What is the next milestone you are going to ask me about if I tell you she IS walking?"

What do you want to know about after the walking? I have no idea what is after this. Is it talking? Running? Reading? Drawing? I'm not sure.

What I can tell you about the way that I see things is that every child reaches milestones when they are ready. We can't force them to feel confident enough to take that first step, say their first word, turn the pages in a book or feed themselves with a spoon. All we can do as parents is be there to teach, support, challenge, be patient and give them a soft place to land when the first 50 attempts end in a little heap on the floor or a huge mess on the wall. Developmentally, as our children show interest in these things, we start to fill our tool boxes with the necessary items to help them achieve, progress and grow.

Even before Hazel came along and taught me about being present, I mean really forced me to live in the moment, I never placed much emphasis on what milestones kids were reaching when. I would always be there to celebrate their success but never wonder when they were going to do certain things. Of all my nieces and nephews, I couldn't tell you what age any of them were when they started to meet milestones and become the little people they are. I am just proud of them. All of them. For the things they can do and the things they are learning. I like the people they are becoming and to me that is all that matters in the end. I'm just glad to be a part of the journey.

In the last 18 months (cause Hazel is 18 months now...crazy!) I have met and become so close with so many other mamas who have babies with DS. I embrace every single milestone that their children reach. I am proud of them. I know what goes into being a mom of a child with special needs. I know how much effort and energy goes into OT, PT, and Speech. I KNOW some of what's in their tool boxes. I get it.

Are all our babes reaching milestones at the same time? Of course not. But we all take out our hammers, levels, and cordless drills and give it the best we got.

Mamas to typical children: Do your children reach milestones at the same time as their peers? Of course not. But you take your measuring tape, screw driver and chalk line and give it the best you got.

Children are individuals and that is what makes them ours. That is what makes them the people we love. Watching them overcome challenges and hurdles is what makes us beam with pride. To see something that was once so difficult become so easy, makes us proud.

In the end we are all the same. We all want what is best for our babies. We want to provide the foundation that they need to become stronger, successful, stable, productive members of society. It's just that the tool box we use is filled with different tools and tricks.

But it's ok...there's more than one way to build an empire (just ask the Romans).

Sometimes we share the tools of others because they make sense to us and sometimes we hoard our little boxes and stick with what we know works best for our kids. Either way, we have all spent the time slowly collecting the tools that are helping us do what we need to do.

Make our children happy.

So I guess I just took the really round-about way of telling you all that Hazel has started to walk.

She took her first steps at 16 months and has been practicing at her own pace ever since. She is still very wobbly and it ends in a heap on the floor a lot of the time, but she is proud of herself. She is confident and she gets back up and tries some more. To me this is a success. Looking at her determined little face makes me feel like my box has all of the right tools stashed away in it. I'm sure in the future I will take some away and add others, but for now I feel fully equipped to build my empire. My empire is Hazel's confidence. As long as she gets back up and tries again, I am proud.

She was not letting go of that stick for anything. Also, she was giggling and laughing the whole way walking down the sidewalk.

Keep on gettin' back up baby girl. You got this!

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!!!

PT & OT 9-12months (for Hazel)

First, I MUST share this video. It's the John McGivney Awareness Video, the facility where Hazel's therapists work. LOVE!!!  

Click here if having trouble viewing 

Amazing, right?

Ok...moving on...

This post is a medley of old and new(ish) Physical Therapy (PT) and Occupational Therapy (OT). I am working on a new post of activities from 12 months and up.

YIKES!!! Time fly's...Hazel grows and then we start new activities.

Hazel started to do these activities when she was 9 months. She is still working on some and has mastered others. As with all of my PT and OT posts, these activities have been approved by Hazel's therapists for Hazel, please check with a therapist in your local community before trying any of these activities with your children.

Occupational Therapy

1. In & Out

Hazel is working on putting objects in a bowl and taking them out. We use any big bowl available. I think maybe a metal one would be better so that when she drops something in, it makes a louder noise. Sometimes when I am feeling brave, we use a huge metal pot (side note: holy it's loud!!!) Any little toys work to drop in, links, cubes, pegs, balls. Hazel often has a hard time hearing anything drop in because she is constantly talking and babbling while playing. What is that saying - "you can't talk and listen simultaneously" - wait...did I just make that up? Oh, either way, you know....

She takes toys out of her bin, not so much put them back in. That's my job. I think she just wants to make sure my position as maid is secure. She's so kind and thoughtful.

2. Drinking/Eating

We are always working on eating and drinking. Hazel practices drinking out of a cup and a sippy-cup everyday. We try to encourage self-feeding by giving her pieces that she can pick up herself and put into her mouth. Her pincer grasp is not finessed enough for her to pick up really little objects like Cheerios, but she does well with penne noodles, crackers, bread and bananas (to name a few). Poor girl still has no teeth, so taking bites is difficult. When she gets the pieces into her mouth, she can't bite a piece off. Frustrating!

3. Rings

Put them on. Take them off. Put them on. Take them off. Put them on...

So that's that one.

Oops...that's cheating! You can't just dump them all, Hazel!!!

Oh yes...bang them together is another game she likes to play.

Physical Therapy

(these activities are not all we do, just some)

1. Weight Bearing on Arms

This one is a precursor to crawling. Here is one of the positions that works for getting her ready to push herself up in a 4 point. It is also encouraging her to weight bare on her arms. We try to get her to go from one side to the other. I find it easier if you hold a toy out for her to see, however, it feels like I need another hand to support her and hold the toy. You have to find what works for you.

When I move the toy in front of her, she follows along with it and sits looking forward and then I drag it to the other side and she leans to reach it. It's a tricky one!!! This was also great for getting her comfortable with putting herself in the sitting position. She would push herself back into a sit.

She would often shift her weight and would be in a 4 point stance for a couple of seconds, which was great to get her used to the crawling position.

2. High Kneel

This was my favourite PT activity (now she does it all the time on her own while she's playing)

It is easy and efficient for mommies and very effective in teaching backing in to a sit. It is also perfect for strengthening her arms by encouraging her to weight bare on them for a extended periods (by this I mean about a minute...maybe more if she was really into the toy that day). When backing into a sit she just pushes off the toy with her arms, leans to the side and goes down.

I would often switch up the tools we used to get her into a high kneel. Here she is leaning on a pillow or nursing pillow that is on top of the foam piece we have. Works perfect. Sometimes I would put her mirror in front of her so that she would stay there and talk to herself for a while.

At some point, she started going into this position and rocking. Crawl prep...

3. Crawling

Turns out this is the best PT there is. So, we just encourage her in which ever way motivates her that day to crawl around the house. Under the advisement of her therapist, we are not working on walking with Hazel. She is gaining so much strength in her arms, legs and core by crawling that we are just content to keep her doing that.

Speech Therapy

1. READ! READ! READ!

Lots and lots of reading. The same books over and over. We make sounds of animals, we point to the text. We start again...

Girlfriend is obsessed with books. She will sit forever with me and read. I LOVE IT!!!

Sometimes, she can't decide, speech or OT??? Decisions...

  

We have since added a bunch of new activities to our daily routine. I will share in a later post. Hope this helps to give some ideas!

Happy Days...

Silver Lining

  When the geneticist sits down and tells you your baby has Down Syndrome, many thoughts go through your mind. Lots of things are said. Doctors and nurses tell you about the "challenges" that may lie ahead.

One of the thoughts, is that your baby will be different from all the other babies. Immediately you think, "woah, 'different' - that can't be good - doesn't sound good."

We all want our babies to be different, unique in a way, but when push comes to shove, not really. We don't want them to be that different. We want them to be the same, and do all the things that every baby does.

Any one of you moms out there that has been on Baby Center - EVER - FOR ANYTHING - knows what I mean. It's fine...no judgements!!! Chasing Hazel is a judge free zone...really...I have no room to judge - TRUST ME!! I digress...

So, I was saying...you find out your kid has Down Syndrome. For a minute (k...so way longer than a minute really) you feel like life as you knew it is over. Long story short (for now), you try to figure out what does it mean for your baby? Will they do all the things other babies do? It's scary and daunting and scary.

Here is the silver lining...

Hazel and all other babies like Hazel, will do all the things other babies do. They might work a lot harder to get there, but one day it just happens, they are there. We are blessed to be a part of their journey.

And mama pride!!! Well proud does not even begin to break the barrier of emotions you feel that your baby is different, but also very much the same.

Best of both worlds really.

Hazel crawled today...

Click here if you are having trouble viewing.  Click here if having trouble viewing 

With pride and a happy heart

See you tomorrow

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).

Hazel Continues to Impress

Have you heard of the John McGivney Children's Center? We are lucky enough to live in a community with an amazing resource to help parents with children like Hazel who just might need a little guidance to keep them on the right track. They help children with Trisomy 21, as well as other children with special needs. We are grateful for their expertise and guidance. They have proven to be a great support to us as we try to do our best to raise our daughter.

We had a visit last week from the speech pathologist. She came over to make sure Hazel is on the right track with early language development. Her goal was to offer suggestions and learning strategies for us to use to help Hazel continue to develop new skills to the best of her ability. Upon her arrival she was surprised to find such a strong and healthy looking little girl. A far cry from her days in London. The description of the baby in the file she read was not the same baby she came face-to-face with. She was very impressed with Hazel and all her accomplishments so far.

It is common for children with Down Syndrome to have difficulties with speech. One of the reasons they experience this can be due to low muscle tone in the jaw. So far, Hazel seems to be ahead of the game in this regard. Her muscle tone is very good and she has begun to babble and imitate, skills a 6-9 months old baby can do. The speech pathologist was shocked to see her progress so far.

We don't know what future challenges await Hazel, but we are proud of the milestone that she has achieved. We are never looking at the things Hazel can't do, but celebrating the things that she can!!

Here is an example of how vocal Hazel is. She is perfectly happy in this video by the way...