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Pediatric Occupational Therapy Keeps Kids Focused on Recovery

Giving kids “pediatric occupational therapy” might at first sound like a curious contradiction in terminology. How can a kid have an occupation?

To many young athletes, their sport is their job, or at least that’s how they see it, say experts at Hospital for Special Surgery. Children participate in afterschool sport programs with as much verve and dedication as adults who work 9-to-5 jobs. In effect, it becomes their occupation. When youth sport injuries occur, a pediatric occupational therapist can be the key to not only helping a child get back on the playing field more quickly, but also ensuring that they can play sports and be active for years to come.

When injuries occur in young athletes, parents are sometimes faced with a dilemma, says Meghan Featherston, OTR/L, a pediatric occupational therapist and advanced clinician at Hospital for Special Surgery in New York. They want to help their injured children get back in the game quickly, but there is a risk that their children could suffer the long-term effects of improper skeletal development. “These are youngsters who emulate professional athletes and have similar goals and aspirations,” Featherston added.

As a case in point, consider nine-year-old Owen, a competitive wrestler as well as a lacrosse and football player from Ridgewood, N.J., who suffered a severe elbow injury at wrestling practice. His opponent landed awkwardly on Owen’s right elbow, causing severe hyperextension and leaving his elbow displaced by 10 millimeters. Owen was in need of surgery. With lacrosse season around the corner, his parents looked to Hospital for Special Surgery because of its highly regarded surgeons and its pediatric occupational therapy rehabilitation program. They felt confident that this combination would help Owen get back to having fun on the lacrosse field quickly and ease their concerns regarding his future bone development.

It was important to act quickly because there was only a short window of time to ensure that Owen’s elbow could resume normal alignment without deviation.

Roughly a week after the injury, surgery was performed on Owen’s right elbow. Because of Owen’s multiple small bone fragments, pins and wires were used to temporarily stabilize his elbow. To aid the healing process, Owen was fitted for an elbow splint that would keep his bone immobilized, yet allow him to remove his elbow to promote supervised mobility while engaging in rehabilitation exercises. Within days, Owen was being evaluated by Ms. Featherston for exercises that focused on increasing range of motion, which promotes independence for functional activity.

Owen progressed to upper extremity strengthening exercises such as elbow tricep activities using elastic resistive bands, a modified biceps curl, a shoulder press with a small medicine ball, and stability exercises for the trunk and shoulder region that resemble various Yoga positions.

Weeks later, the hardware was removed from his elbow and a new splint was fabricated for night wear to promote full, or end range, extension. Occupational therapy then focused on achieving full range of motion and improving core trunk balance. Ms. Featherston also created exercises that challenged Owen’s arm strength as well as his mind. The two played a creative game of “Connect Four” where Owen not only had to contend with placing four checkers in row, but also had to maintain his balance, weight bear through his affected side, and reach in all planes of movement to deposit each checker in the appropriate slot.

At present, Owen’s arm extension displays a full range of motion and is nearly back in proper alignment. Along with exercises during rehab, Ms. Featherston has provided targeted/routine exercises for Owen to carry over at home, where his mother, Bronwyn, ensures that the youngster will get his arm back to 100 percent.

“Wrestling and lacrosse are so important to Owen’s life and when the injury occurred, it was essential to find a program that would get him back to playing sports,” said Bronwyn. “What I liked about this program is that Owen got individualized care from the pediatric occupational therapist that kept him engaged and active, as if he were at sports practice, rather than visiting a 'doctor’s office.'”

While it is unlikely Owen will participate in the remainder of this lacrosse season, Owen will be ready to go “full tilt” at football tryouts in the fall.

 

June 2008

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