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Stairway to FUN! (safely)

As a pediatric physical therapist working in an early intervention setting, I spend a good amount of time on the stairs. Steep stairs, wide stairs, narrow stairs, wooden stairs, carpeted stairs, baby gate, no gate, one flight of steps, steps broken into two segments, rail on left, rail on right, no rail at all, no steps at all! I’ve studied construction of steps almost as much as my contractor father. I’ve also learned that parents have as many different views on steps as they do on nutrition and discipline. Some are so fearful of their child falling down steps that they are off limits all together. Others refuse a baby gate reasoning that the steps are there so they need to learn to be safe as soon as possible. And then there is everything in between.

If you are a parent with a child ready to take off (and up and over the horizon) of the steps in your home, we have a few tips to share:

 

  • Allowing your child to learn to crawl up and down the steps is am important pre-curser to walking them. It allows for the cognitive experience of learning the depth of the step, the distance, the texture etc. through exploration of movement and touch.
  • Before you let your child crawl up all the steps, let them practice crawling up and down one small “step” in the middle of the room – diaper boxes and small plastic bins work beautifully.
  • Like stepping, crawling down is typically harder than going up. Moving backwards without relying on your vision to see where you are going is not natural but is the safer option rather than scooting facing forward! Modeling to baby (siblings or yes, you yourself) can help!
  • Children may chose to walk up and down with both hands on the wall or rail (side stepping) or one (forward stepping). One is not better than the other – allow what feels natural to the child.
  • SAFETY is essential. We encourage use of baby gates until your child is proficient and that an adult always stands below the child when practicing.
  • Often times, especially with carpeted steps, the flight of steps appears as one big ramp to children. This may be particularly true if there is any visual challenges with depth perception. Lining the steps with colored masking tape or duct tape and placing a favorite sticker in the middle of each, may help highlight each step as individual and make the task of walking down less scary (and maybe even fun).

Just yesterday I was working with a child who would walk up the steps but not down. Her mother described her as “a mule,” digging her heels in and refusing to walk down no matter what motivators the family tried. Problem is, she is getting too big to carry down the steps. I know she is strong enough to descend a step because she does so with a single step into the home and for fun off an exercise step. So we lined the steps with tape yesterday and placed a snow man sticker on each and she literally walked down on the first try!

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I hope that these few simple tips make stair climbing fun and safe within your daily routines. We devote a generous portion of our gross motor cards (the pretty green ones) in 1-2-3 Just Play With Me to stair walking. If you don’t have a copy, make sure you get yours today! We share detailed milestones in 5 developmental domains with fun, purposeful play suggestions in a simple practical format – perfect for a parent or pediatric professional!

 

The Secret of “The Hot Pink Tape”

This post was originally written for Child Guide Magazine.  Check out the many resources Child Guide offers as well as this article and others HERE.

If you are a runner, or have watched a race or even perhaps a professional sporting event lately, you may find yourself asking, “What is that bright colored tape people are wearing? And why is it cut in crazy patterns?” That trendy tape, often seen in bright pink or blue or sometimes black, is called Kinesiotape and it isn’t exactly new, even though it may have gained popularity in recent years in the US. But did you know that Kinesiotape is not just for athletes? This versatile tape is actually a very effective tool for children with motor challenges as well!

 

Kinesiotape is a progression of Kinesio Tex, which was invented by Dr. Kenzo Kase in Japan in the 1970’s. Dr. Kase was searching for an alternative tape to traditional athletic tape. He noticed that traditional tape often restricted movement, did nothing to aid healing, and could potentially cause additional injuries. Out of his hard work, Kinesiotape was born. What makes it different? Kinesiotape is elastic, latex free, cotton based tape that can stretch up to 30-40% of its original size. These properties allow it to be more versatile than traditional tape. In additional to allowing full range of motion and being very comfortable on the skin, the elasticity of the tape allows it to perform many functions. Kinesiotape is meant to be placed very strategically depending on the reason why someone is wearing it. Depending on placement it can increase healing, decrease inflammation and swelling, and support weak muscle by encouraging activation, or increase function lost by spastic muscle by encouraging a decrease in muscle tone. In addition posture can be improved with use.

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Sounds pretty incredible, right? Here’s how it works. Our muscles are each individually covered in a think filmy layer called fascia. Between the skin and this fascia are layers of connective tissue. When Kinesiotape is applied strategically to the skin, it tugs on the skin, which pulls on the connective tissue, which pulls on the fascia, which tugs on the muscle. The result is either an increased “fascial envelope,” allowing for 1) increased removal of toxins (lactic acid and waste) and increased space to allow fresh blood to restore tissue or aid in healing or 2) Encouragement of activation of a specific muscle for a specific purpose., improving posture or strength through increased use.   When used this way, the tape is like a constant tapping on weak muscles saying, “Use Me!”

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This can potentially best be illustrated by looking at something concrete like a bruise.

In the images below, Kinesiotape has been used to increase the space between the fascia and the skin and allow quicker healing in the places where the tape was placed.

How is this used with children or anyone with motor challenges? In many ways! Children with atypical muscle tone (either hypotonia (low tone), hypertonia (high tone) or any sort of weakness may benefit from Kinesotape. When the tape is applied strategically over the muscles that need assistance or strengthening, the result is a slight tug that encourages the child to use their body in a specific way. When used this way, Kinesiotape can be used as a bridge to encourage strengthening or function through active participation. The child wears the tape, the tape encourages the child to move their body in a way that strengthens, stretches, or improves function, and eventually the child may get strong or functional enough to not need the tape. An example would be using the tape on the abdominal or back muscles in a child with Downs Syndrome who has trouble sitting alone or on the hand of a child with Cerebral Palsy who has a hard time opening the hand to grab for things.

Owen Ruffner is a 2 year-old child has benefitted from Kinesiotape in large ways. Owen has Mitocondrial Disease and as a result has weakness and low muscle tone, which challenge him when moving and attempting to control his body. Owen is learning to walk with a gait trainer and without tape, tends to drift to his left weaker side. When Kinesiotape is placed on the left leg, encouraging full activation of his muscles, he able to walk in a straight path. These results were immediately noticed after 1 application by his Physical Therapist. His mother Kasey McDaniel has been thrilled with the progress. She shares, “Kinesiotape has helped Owen by giving him a chance to use his muscles on his weaker side. I have noticed a huge difference with daily function and with helping him as he learns to walk.”

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The possibilities are quite endless with Kinesiotape as it is relatively low cost, is easily tolerated on the skin, is waterproof, and usually lasts 3-5 days per application. It is very important that anyone using the tape is initially taped by someone with strong knowledge of anatomy, such as a licensed physical therapist, and by someone who has had training on the Kinesiotape method.  Once a few applications are applied, tweaked as needed, and monitored, a successful method can be taught to a willing parent, who could continue the taping at home, with the help of a physical therapist.
It is true that Lance Armstrong was one of the first to expose Kinesiotape to the United States, swearing by the pink tape specifically for his knee injury, but your child may benefit as well. If you haven’t tried it yet, the risks and cost are low, but the benefit is often quite high. Ask your pediatric PT about Kinesiotape at your next visit.

 

For more information about Kinesiotape and the Kinesiotaping method, visit: http://www.kinesiotaping.com/ and http://www.kinesiologytapeinfo.com/pediatric-kinesiology-taping/