Things You Didn’t Know a Physiotherapist Could Do for Your Kids

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Marie is my physiotherapist and I've learned so much from her about what doesn't need to be painful and what I need to pay attention to, both for myself and for my kids. I asked her to share some advice to parents when it comes to some of the things that we don't think of physio for when it comes to our kids, but that can be SO helpful. Both my twins have REALLY benefitted from physio for their growing pains. Read on!  ~Lara

I have been a physiotherapist for too many years than I care to mention.  I have worked with everyone from premature newborns who fit in the palm of your hand to the elderly facing end of life issues.  I must admit though, school aged children hold a very special place in my heart.  Don’t they just say the darndest things sometimes?  I love their absolute candor and their ability to call you on your you-know-what.  When you are working with them you had better be prepared to answer questions honestly or you will pay. 

When people find out I am a physiotherapist they often ask me questions about things like their kids’ sports injuries or maybe their own back pain.  However, there are some things people never ask me that I wish they would.  There are a number of things a physiotherapist can help your kids with that no one knows about, so I would like to share a couple of them with you. 

Growing Pains

Let me tell you about a stellar parenting moment of my own.  When my daughter was about four years old she started complaining about pain in her legs.  She would be walking just fine and then suddenly stop and say she couldn’t go any further, or she would complain at bedtime.  I just wrote it off as drama queen behaviour and ignored it.  Then one night she was really crying so I gave in and checked out her legs.  The moment I got hold of her muscles I felt horrible.  They were incredibly tight through the entire length of both legs.  My heart sank because I knew that all this time she was having growing pains and I could have stopped them. 

What?  You can treat growing pains you say?  Despite everything you will read on the internet that says no one knows what causes growing pains and the only thing you can do for them is give pain medication like Tylenol, yes growing pains can be treated and here’s why.

I believe growing pains are caused when the long bones like the ones in the legs, which is primarily where growing pains occur, grow rapidly.  The problem is the muscles lag behind and this is what causes the pain.  These growth spurts are not just your imagination.  They are indeed very real.  Studies in which kids were measured daily have shown that kids don’t grow about 90 – 95% of the time, so all of their growth occurs within a very small timeframe. 

The bones have specialized areas from which growth occurs.  These are called growth plates and they are found at each end of a long bone.  When growth occurs the bones sprout new cells to either side of each growth plate so lengthening can occur rapidly.  Muscles do not have these specific growth areas so they take longer to lengthen. 

The obvious result when a growth spurt occurs then, is the muscles get tight since they can’t keep pace with the lengthening of the bones.  It is the tightness in the muscles that causes the pain, particularly when kids are active.  They are running around trying to use their muscles but the muscles aren’t happy because they are too short. 

This begs the question, well why can’t we just have them do stretches to make these pains go away?  The problem with stretching is that it indiscriminately pulls the ends of the muscle in opposite directions.  This applies a stretch along the entire length of the muscle.  That’s good right? 

The reason this isn’t terribly effective is that tightness in a muscle never occurs evenly throughout the entire length.  It is localized in small bunches of tight fibres, so you have very tight parts interspersed with loose parts.  When we stretch the entire muscle the loose parts happily give while the tight parts huddle together giggling and saying “why should I lengthen when my neighbour is willing?” 

To release the tight parts and relieve the growing pains you have to get your hands in there, find the tight bits of muscle, and manually release them.  This stops the growing pains every time, usually with one or two treatments.  I knew this and I still let it happen for a while before I did something about it, so don’t feel bad if you didn’t know. 

Preventing Knee Injuries in Girls in Early Puberty

Did you know that girls who play sports requiring quick changes in direction such as soccer or rugby are far more likely to sustain knee injuries when they hit puberty than boys?  In fact, girls who play sports are four to six times more likely to injure the anterior cruciate ligament (one of the main ligaments of the knee) than boys. 

Dr. Google will tell you that this is due to things like lack of strength in the hamstrings and gluteals (buttock muscles).  But why would muscles that have been working perfectly fine suddenly quit in puberty?  And why just in girls and not boys?  The reason is alignment. 

When girls hit puberty one of the biggest changes in the skeletal structure that occurs is a change in the shape of the pelvis.  They go from stick figures to curvy figures.  The pelvis widens and they suddenly have hips.  This changes the angle of the long bone in the upper leg called the femur.  As the pelvis widens it pushes out the top end of the femur farther to the outside.  This then changes the angle at the other end of the bone where it forms the upper part of the knee joint. 

When this significant change in alignment occurs the muscles get discombobulated.  The angle at which they are used to pulling is all wrong suddenly and they don’t quite know what to do with themselves so they just up and quit.  This leaves your daughter with instability through the hips, pelvis, and down into the knees and ankles, which sets the stage for a catastrophic knee injury.  This is so prevalent now that physiotherapists are seeing girls as young as 20 who have had two or three knee surgeries and are having to quit their sport of choice.

These injuries are preventable.  All that is needed is to manually realign the muscles in their new slightly different-angled environment.  They need a little guidance to settle into their new angle of pull.  Once this is accomplished stability is restored and the risk of injury is greatly reduced. 

While many people seek physiotherapy treatment when they are injured, no one ever thinks to seek help to avoid injury.  I would love to see this change.  We tune up our cars to avoid a breakdown, why don’t we do the same for our bodies?

If you are wondering if your daughter is having issues with stability, here are a couple of simple things you can check out.  Have her try a single leg squat making sure that she stays aligned square to the front.  If she can’t do this with solid balance then there is likely a problem of stability. 

Hopping on one foot with both arms in the air is another good test.  By raising the arms we take away one major balance cheating strategy and we can better evaluate the stability in the core.  If she can hop several times in one spot without travelling all over the place, losing her balance, and remaining square to the front then things are good.  If not, she may need some help to restore balance and alignment.

Physiotherapy Can Help

Sometimes when kids fall or have an accident we make the assumption that they are fine.  After all kids, seem to bounce like rubber and carry on.  While they may do so, they often need treatment after an incident just like we do.  If your child is complaining of pain don’t ignore it.  Even if it does go away, their movement patterns are likely off as they compensate around the affected area and this will have consequences down the road. 

Get your kids treated when something happens to them and don’t forget to consider physiotherapy for injury prevention.  Let’s keep them all active and healthy!

Marie has been practicing physiotherapy for almost 30 years.  She has extensive paediatric experience having worked the first decade of her career at CHEO.  She has two kids who suffer growing pains periodically and is the owner of M.A.P. Physiotherapy.  

10 Gift Ideas For Kids – That Are NOT Toys

I don’t know about your house, but my house has way too many stuffed animals hiding in beds and in closets, as well as un-played with plastic toys and small knick-knacky toys hiding under furniture. Every Christmas I try and come up with non-toy gifts that I know my daughter, as well as other kids we buy gifts for, will love. With that in mind, here are some fun gift ideas for kids – that are not toys!

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1)   Magazine Subscriptions

Whether the child is a nature-lover, crafty kid or likes quick facts, magazines such as Highlight, WILD Kids Magazine, Chirp and OWL are perfect for kids. They are quick reads, full of colourful pictures, and usually have many facts and puzzles.

2)   Books

Whether they are early, emerging or advanced readers, books make great gifts for kids of all ages! And if you’re unsure what kinds of books a child may want, a gift card for a local bookstore works just as well. AND if the child is not a reader – what about a notebook and artistic pencils or pencil crayons? Or a fact or joke book?

3)   Science Kits

Local stores such as Tag Along Toys offer many fun and educational science kits for kids of all ages! From creating candy to making your own soap, building a volcano to making batteries out of potatoes, science kids are always a hit for the inquisitive kid who likes to learn how things are made and how things work.

4)   Museum passes

Ottawa is lucky to have so many fun and engaging museums! Whether you decide on a 3-in-1 museum pass, a pass to the Canadian Museum of History or the Canadian Museum of Nature, you are giving kids a gift that will keep on giving (and a place to see and things to do all year long!).

5)   Movie passes or a movie date

If the kids in your life love movies, why not give them a gift card to the movie theatre! This time of year, Cineplex Odeon has a great deal on $40 gift certificates that includes coupons for lots of free stuff, such as popcorn! You could also create a coupon that promises them a movie date (complete with popcorn, of course).

6)   Sleeping bag or an “overnight bag”

If you’re a grandparent, aunt, uncle or Godparent, the gift of a sleeping bag or overnight bag filled with everything kids need to make a sleepover comfortable and fun is usually unexpected – and knowing that it comes with a sleepover with their favourite people makes it fun and something to look forward to long after it is unwrapped! You can have a lot of fun building this gift by including travel games, travel towels, treats, etc.

7)   Blanket or pillow with a picture on it

Think about what your kids love to do, who they adore or if you have pets – think of how incredible it would be for them to have a blanket or pillow to cuddle with that on it! Photo blankets and photo pillows are a unique, personal gift that can be purchased from the comfort of your home computer and is sure to be a hit for kids of all ages. 

8)   A butterfly or bat House kit

If your kid is a nature lover then these kits that can be found at Lee Valley Tools or Home Depot are sure to be a hit. They can spend the winter building and decorating them as well as researching and thinking of a good place to put them come spring.

9)   Fun socks or pajamas

It’s a well-known fact that many kids don’t get excited when they receive clothes as gifts, so why not put a spin on it and find some funky socks or pajamas! One year we bought my daughter knee-high narwhal socks that continue to be a hit (holes and all).

10)  Kitchen tools

I am all about getting kids involved in the kitchen, so why not invest in some kid-safe kitchen tools so they can help you bake and cook! You can even make copies of some of their favourite recipes and create their very own personalized cookbook!

What not-toy gifts do you enjoy giving the kids in your life? We’d love to know!

What to say to your kids when a pet dies

We recently lost our pet cat of 13 years. Our cat was the first pet my nine-year-old daughter knew and loved, and we considered him a member of our family. He was so good with my daughter when she would dress him up, spontaneously pick him up for cuddles, or attempt to teach him tricks for treats. He was her “bud.” He was a buddy to all of us.

What to say to your child when a pet dies

Our hearts broke when we suddenly lost him. Who knew one little bundle of fur could have such an impact on our lives and our hearts!?

As soon as I suspected something was wrong with our cat, I brought him to the vet. It was a school day, but before my daughter left that morning I made it clear that our cat was sick and was going to see his vet. I told her because our cat was not eating or drinking and generally wasn’t himself, and in case the worst case scenario happened while my daughter was at school, I felt honesty was the best policy. Had she been younger, I may have simplified it a bit by saying he was going to the “doctor” because he wasn’t feeling well, but she is older and recognized he had not been eating or drinking.

When the vet told me it was cancer and the outlook was grim, my immediate thoughts went to my daughter – how was I going to tell her that her “bud” would never get better? Within 24 hours of that diagnosis, we said goodbye to our beloved family cat.

My daughter had yet to lose a close family member and I wanted to make sure I could help her understand death as best I could. At first, I struggled with how to talk to my daughter about when a pet dies. I found this discussion especially hard because I was emotional too.

What to say to your kids when a pet dies

Firstly, I let her know that it is common for pet owners to feel as though they’ve lost a member of the family when their pet dies. Not all family members are human. Our cat was a member of our family for 13 years!

Show emotion

I also let her know that is okay (and good) to feel sad and show emotion. We cuddled and cried a lot together that first couple of days.

Share special memories

Amidst the tears we each shared special memories, funny stories and looked through old pictures of our cat.

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Answer questions the best you can

When questions arose regarding why it happened so quickly, I assured her the veterinarians did everything they could to try and help our cat and were very kind. I also reassured her that our cat is no longer in pain or is scared.

Be honest

One thing I wanted to make sure of was that my daughter understood that our cat died. I wanted her to understand death and not think our cat was at a fictional farm – even if she were younger I would still make sure she understood this on whatever level she would have been comfortable with. I let my daughter guide me about how much information she needed, but remained truthful.

My daughter believes our cat is in “pet heaven” now. She often tells our dog, who continues to look for her furry friend, to look up at the sky – because the cat is probably up there telling her to not eat his treats. When I hear this it makes me sad all over again, but I don’t hide my sadness. I want her to know that it’s okay to cry when you are feeling sad.

Keep the conversation going

We continue to talk about our cat and have discussed adopting another cat… but not as a replacement, and not right away. Our hearts need to mend first before we welcome another cat into our family.

My daughter has handled our cat's death very well - better than me, I think! She has asked lots of questions regarding what we're going to do with his stuff, where his spirit is, and if it feels weird to expect to see him all the time. And I answer each question as best and as honestly as I can.

When considering a pet for your family, always keep in mind how you will handle it when your pet passes away. Losing a pet is the one thing my husband dreads the most when it comes to owning a pet, and unfortunately love and loss go hand-in-hand.

10 Back to School Hacks for Parents

The start of the school year means the return of a regular routine as well as a busier schedule with the addition of homework, extra-curricular activities, and sports. September, especially, can be overwhelming and stressful for many families, including my own, but I have found some back to school hacks that have helped make the transition from summer to school a little bit easier.

Back to school hacks for parents

1) Prepare breakfast the night before

My daughter does not last on cold cereal alone, so when possible I try to prepare a hearty breakfast beforehand. Whether it is cooking an extra large batch of pancakes on the weekend and freezing them, baking muffins, preparing berries and fruit that can be easily thrown on top of yogurt with granola, or preparing a pot of overnight oatmeal in my slow cooker, knowing I have a plan and have prepared a hearty breakfast saves time and fills bellies with a lot less stress. Websites, such as this one, offer many nutritious and easy-to-make breakfast recipes that can be prepared the night before.

2) Keep sticky notes handy 

School days are busy days and I am constantly saying to myself (or whoever is around to hear me), “Oh, I must remember….” And as soon as I say it, I forget it. Put sticky notes and a pen in your kitchen, on your nightstand, in the family room and anywhere else you’re known to have a brilliant moment that you know will vanish as quick as it came if you don’t write it down. Your memory (or lack there of) will thank you later.

3) If you don’t have a wall calendar – get one!

I don’t know how families survive without an old-fashioned wall calendar. Everyone in my family contributes to our wall calendar with birthday party dates, weekly activity times and anything else that everyone in the family should know about. We have ours hanging on our pantry door – a place everyone goes into and will see.

4) Keep your schedule top of mind

Take a picture of your weekly calendar and set it as your locked picture on your smart phone. It’s a fast and simple way to know what time you have to pick up who where, and a quick way to know what’s going on that week should someone ask you if you’re free.

5) Empty and fill backpacks as soon as you see them

Make looking for notes from the school a priority as soon as everyone gets in the door – either have a central bin and ask the kids to make sure permission slips and school forms that must be signed and returned are put in there on a daily basis or have a daily dumping of the school bag. Then sign the forms and have your kids put them in their bags right away. As this becomes part of your after school/work routine, you may notice less and less forms go missing (unless they get eaten by the school bus on the way home, which often happens in this house). ;) 

6) Google Translate is your friend

My daughter is in French Immersion and although I speak a little French, I cannot speak it well enough to help my daughter with some of her homework. So, I use Google Translate a lot – on my laptop and on my iPhone. So, if you don’t speak or read French (or English or any other language) well enough to keep up with your kids, get the Google Translate app on your phone – you can take pictures of documents and it will translate them for you. Time saver extraordinaire!

7) Schedule date nights (way) in advance

Book a night a month solely for date nights – no matter what. It doesn’t have to be a weekend either. If Tuesdays are better for you than Saturdays, then make Tuesday your date night! The same should also be done for self-care appointments such as massages, beer nights and girls night out – it’s important to step away from the every day and have fun away from the kids, regardless of how busy life is.

8) Batch cook or get an Instant Pot (or both)

Similar to planning and preparing breakfasts in advance, batch cook suppers so you have home cooked meals in the freezer that can easily be thawed and cooked when you need them. Meal preparation places, such as Supperworks make meal planning simple and can ensure you have nutritious meals every day of the week.

Similarly, the addition of an Instant Pot can save you valuable time on weekdays. We have one and I love that it can cook a whole chicken in 45 minutes and hearty soups in 30 minutes. It's my favourite kitchen appliance.

9) Don’t be afraid to set limits and stay within them

It can be easy to say yes to everything and then feel overwhelmed by all the commitments. If you can’t fit parent council meetings into your schedule or can’t make it to a book club meeting during busier times, don’t feel guilty about it. Be honest with yourself and those around you about what you can and cannot do. No one can do it all – and no one is, despite what you may think.

10) Remember Netflix is waiting for you

My favourite day of the week is Friday. It’s an evening of wine and Netflix with my husband. So remember, quiet moments will come and go throughout the school year, and they are there waiting for you despite the chaos and stress that comes along with the return of another school year.

What are some of your back to school hacks?