While toe walking is normal for periods during early walking, toe walking that persists greater than six months from mastery of walking could cause issues as a child develops. We don’t know why some children persist with toe walking.

Often, a child will have shortening of their heel cords, because they don’t stretch out when they walk. This tightness increases as a child grows. To compensate, they may turn their feet out, and start to stand and walk with their heels down.

If a child walks on their toes, it can lead to changes in their foot structure due to abnormal forces from landing on their forefoot. This in combination with heel cord tightness can lead to foot and knee pain as an adult.

It is well documented that a warm-up program that is implemented correctly, with good form, has the ability to reduce the amount of injuries in athletes. The WellSport team has sifted through some of this research and has developed a warm-up program that can be adapted for athletes in many different sports.

Athletic trainer Jared Slater, A.T.C., and Physical Therapist Jacob Hart, P.T., D.P.T. were instrumental in implementing this program within their community. In the spring of 2018, they began working with a high school girls soccer team. First, the athletes participated in a dynamic test so the team could see how their bodies responded to the normal demands of sports.

So, what is the rotator cuff? Cup? Rotary cup? While most people have heard some form of the term rotator cuff, less really understand what it is, how it relates to shoulder function and why there are often so many issues involving it.

First of all, what is it? The rotator cuff is comprised of four muscles in your shoulder. They are the supraspinatus, infraspinatus, subscapularis and teres minor. All of these muscles attach from your scapula (shoulder blade) to your humerus (arm bone).

What does it do? The primary goal of the rotator cuff is to provide dynamic geometric centering of the humerus. In other words, your shoulder joint is a very shallow ball and socket joint. When you attempt to reach out and move your arm, the rotator cuff muscles work to keep the ball and socket of the joint in the correct position. Without this, when you try to reach overhead, for example, your humerus would rise up instead of staying in position. This can cause shoulder pain and impingement.

Congenital torticollis is a shortening of the sternocleidomastoid (SCM) muscle in the neck of infants. There is a small lump seen in the muscle at times. This can be genetic, or from the baby’s position in the womb. It’s commonly seen in twins or larger babies where space may be tight and the baby can’t move his or her head around as easily.

The SCM muscle performs two movements. It tips the head to one shoulder and turns it to the opposite shoulder. Most commonly, a doctor will notice a flattening on the back of the head on one side due to the baby keeping their head turned one way. The flattening may be worse in babies who spend a lot of time on their back, or in car seats and swings. As a baby’s head control improves, the tipping of the head to one side may become more noticeable.

Did you know that more people suffer from pain than cancer, heart disease and diabetes combined?

Nearly one fourth of Americans suffer from pain annually, making pain the major driver of primary care physician visits.

There are various factors that cause and create pain, such as:

• Family history. You may be more likely to develop arthritis and some other conditions if you have a family history of the disease/diagnosis.
• Age. The risk of many types of diagnoses and pain injuries increases with age.
• Gender. Women are more likely than men to develop rheumatoid arthritis.
• Previous injury. Some people who have experienced previous injuries have pain related to those injuries throughout their lives.
• Obesity. Carrying excess pounds puts stress on joints, particularly your knees, hips and spine.

There is a growing trend in high school and youth football where players are buying their own helmets for use at practices and games. Traditionally all equipment, including helmets, are provided by the youth programs or high schools where the athletes participate. The advantage of this is all helmets are required to be reconditioned following each season by a National Operating Committee on Standards for Athletic Equipment (NOCSAE) approved provider.

All helmets are required to have completed NOCSAE inspection and meet their standards before they can be used in competition. NOCSAE requires “the complete disassembly of all helmet parts, cleaning, sanitizing, replacement of worn parts and shell inspection” before a helmet can be released for use in another season. Helmet use is limited to 10 consecutive seasons if the helmet has suffered no shell damage. Helmets purchased by an athlete will have to undergo the same reconditioning and receive the NOCSAE approved sticker before they can be used in competition.

Strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep). Overall, viruses are the most common cause of a sore throat. However, most viral infections are self-resolving.

How do people get this infection?

Group A strep live in the nose and throat and can easily spread to other people. It is important to know that all infected people do not have symptoms or seem sick. People who are infected spread the bacteria by coughing or sneezing, which creates small respiratory droplets that contain the bacteria.

People can get sick if they:

People have pain for all sorts of reasons. Sometimes it’s because of an injury, other times it’s a result of repetitive overuse. Sometimes we don’t know why someone’s in pain. It’s important to note that pain is a perception that our brain experiences. Did you know that the way we experience pain can be affected by other variables in our lives?

Our brain’s perception of pain can change with an alteration in different factors, such as when our bodies get warmer or colder. An increase in stress or anxiety can exacerbate our pain. Perhaps a particular movement similar to how we injured ourselves excites our pain response. Even our immune system and cardiovascular system can have an effect on the way we perceive pain.

Our bodies become sensitive to pain once we become injured, or once we hurt. We have a heightened awareness of this negative feeling and we almost come to expect it whenever we have an experience that reminds us that we “should” be having pain. However, sometimes when a pain becomes chronic, our pain threshold lowers and even the smallest of stimuli can be perceived as painful.

A question I always ask during the initial physical therapy evaluation of an infant is, “How is tummy time going?” The majority of the time, the response from the parents is a muttered, “Not well.”

Since the Back to Sleep campaign was initiated in the early 1990’s to decrease the risk of Sudden Infant Death Syndrome (SIDS), babies have been spending more and more time on their backs. While it is very important that an infant be placed on his back to sleep, as it has reduced the incidence of SIDS by 40 percent, it is equally important to a baby’s development that he be given frequent episodes of supervised tummy time throughout the day.

Most infants find tummy time difficult, and will often fuss and cry during it, making parents less likely to place their infants in tummy time positions.

Tummy time promotes the development of muscles in the neck, shoulders and back. It helps build the strength and coordination needed for rolling, crawling, reaching, and playing, and helps improve body awareness.

This year alone there have been three outbreaks of meningococcal disease on college campuses around the United States. In response to these outbreaks Rutgers University, Columbia University and San Diego State University, along with their respective municipal health departments, have recommended vaccination of at-risk populations.

But what is meningococcal disease? Why is dealing with it so important to college communities?

Meningococcal disease refers to any illness that is caused by a type of bacteria called Neisseria meningitides. There are several serogroups, including A, B, C, Y and W-135. The illnesses they cause are often severe and include infections in the lining of the brain and spinal cord (meningitis) and bloodstream infections. Up to 15 percent of people who contract it die, usually within 24 hours.

It is a vaccine-preventable disease.