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The Align Clinic Blog
​ Your Home For Orthotic and Prosthetic Knowledge

Understanding the Role of Pediatric Orthotists

8/17/2022

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Doctors, physiotherapists, and orthotists often work together to improve their patient’s mobility-related ailments and disorders. An orthotist is a medical professional who provides, designs, and custom-fits orthosis devices for patients. They are trained to supply braces, splints, and supports of many different kinds.

An orthotist’s job is to support and better the function of existing limbs; they don’t deal with amputated limbs and artificial limbs. In the US, about 6000 trained and certified orthotists are currently working.

Out of these, only a tiny fraction are trained as pediatric orthotists and can cater to the needs of children needing orthosis devices. This article looks at how pediatric orthotists differ from general orthotists and how they can help your child.

What Does a Pediatric Orthotist Do?

Every child deserves the best care, especially in times of crisis. Pediatric orthotists are trained to deal with children and make orthosis devices to accommodate their malleable, energetic, and growing bodies. Correcting any deformity through the help of orthosis gear is a long road.

Your child’s orthotist will periodically check, tweak and change the equipment to support your child’s treatment. They might also need regular appointments for physical therapy to improve muscle function and gait.

As adults, patients can get fitted once and use the same orthosis gear for years or even decades. That’s not the case with children going through the critical initial years of growth. Since children’s bodies are still undergoing massive transitions, some disorders can be corrected without invasive intervention. A pediatric orthotist will have a better knowledge of bracing techniques and rectifying your child’s disorder.

Secondly, children suffering from a birth disorder, deformation of a limb, or accident are going through a tough emotional time. A professional specially trained in dealing with children can help your child better navigate this confusing time. Also, children are more likely to comply with at-home care directions of orthosis gear when they trust their care providers. 

Professional pediatric orthotists can help the child emotionally and improve his chances of recovery.

For some children, treatments start before they can talk and communicate. Pediatric orthotists are trained to understand the cues of these non-verbal children better. For example, identifying when the child is in pain or if the brace is uncomfortable or tight.

These skill sets make pediatric orthotists more capable of helping your child on his journey to complete recovery.

What Disorders Can a Pediatric Orthotist Help With?

Pediatric orthotists are trained to help young patients with many genetic, neuromuscular, and skeletal disorders. They also make braces for children hurt in accidents or with weakened limbs from other illnesses such as cancer. Here are some conditions that a pediatric orthotist can help your child with

  • Toe-walking
  • Hypotonia
  • In-toeing
  • Clubfoot
  • Hip Dysphagia
  • Tibial torsion
  • Cerebral Palsy
  • Foot pronation
  • Foot supination
  • Plagiocephaly
  • Scoliosis
  • Spinal Bifida
  • Fractures
  • Contractures
  • Spinal cord injury
  • Leg and foot spasticity
  • Muscular Atrophy
  • Muscular Dystrophy
  • Post-surgical support
  • Foot or ankle mal-alignment
  • Severe metatarsus adductus

How Can a Pediatric Orthotist Help Your Child?

There are many benefits your child stands to gain from regular visits to the orthotist. Not only do they help your child, but they also guide you about the best practices to keep up the care at home. Here are some ways a pediatric orthotist can help support your child’s recovery:

Providing the Right Orthosis Equipment

Orthosis gear either comes pre-fabricated or is tailored to your child’s particular needs. An orthotist can best guide you in deciding which type of gear would suit your child. They will do a complete evaluation and order any tests and scans necessary before finalizing a brace. The brace will then be fitted to accommodate your child’s limb. In addition to bracing, rehabilitation or physiotherapy is also recommended in most cases.

Keeping Their Spirits Up

Your child’s orthotist has most likely dealt with children in circumstances similar to yours. That places them in a position to lend better support and encouragement by sharing success stories and other children’s experiences. Sometimes, being able to draw parallels with someone else makes a difficult phase a little easier and more relatable.

Helping Them Understand the Process

Children are visual learners. Quoting statistics and research may work for adults, but a different approach is needed when a child needs treatment, bracing, and physiotherapy. Going to the orthotist office after school instead of little league practice like all their peers is a difficult adjustment for a child.

Orthotists trained in dealing with pediatric cases can explain to your child why they need to wear the orthosis device, how it helps support their limb and how long they need treatment. Understanding the process can help make your child more compliant with receiving the care they need to rectify their ailment.

Supervising Progress

Orthosis devices need to be periodically monitored, and adjustments need to be made. Especially with children going through growth spurts or puberty. To ensure that the bracing supports their limb’s recovery correctly, your pediatric orthotist will schedule regular appointments. That allows them to keep track of your child’s progress and nip any potential complications in the bud.

Keeping the Parents in the Loop

The right information empowers you to make better decisions for your child. A vital job of pediatric orthotists is keeping parents updated about their child’s condition. They will guide you about

  • Duration of treatment
  • How to care for their equipment at home
  • How often to take your child for physiotherapy
  • Help your child on his journey towards full recovery
  • How to take off and put on the orthosis gear correctly

Help Your Child on The Journey Towards Full Recovery
​
As a parent, dealing with your child’s condition can be challenging. Align Clinic has experts who understand how hard the treatment phase can be on you and your child. Book an appointment with our expert orthotists today and receive the care your child deserves.
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Physical Therapy and Orthosis Devices. How Physical Therapy Helps Speed Up Your Recovery Process.

8/10/2022

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‘Orthosis’ is a broad term used for many different genres of supportive gear for the limbs and body. In most cases, orthosis gear is used to optimize joint positioning and support weakened or injured limbs.

Orthosis devices and braces can be incredibly effective in fixing slight to severe bodily abnormalities. Gone are the days when orthosis gear was large, bulky, and heavy. Today’s equipment is the next generation of supportive gear made with strong and highly durable material. They can often be worn under clothing discreetly and don’t cause any hindrance in your daily routine.

Orthosis gear can improve posture, reduce pain, and support limbs or the back. Orthosis devices are often custom-made for the patient to target their problem areas in a non-invasive way. Here are some conditions orthosis devices are recommended for:
​
  • Polio
  • Arthritis
  • Back trauma
  • Cerebral Palsy
  • Plagiocephaly
  • Multiple sclerosis
  • Weakened muscles
  • Muscular Dystrophy
  • Unnatural spinal curvature
  • Nerve damage or numbing
  • To support limbs after surgery
  • Diabetes-related complications
  • Charcot-Marie-Tooth disease
  • Treatment of chronic limb pain
  • Congenital disabilities and limb deformities

Physical Therapy and Orthosis

Physical therapy is the science of using massage, movement, heat, and exercise to improve a patient’s physical symptoms. It’s a highly effective way to improve one’s range of movement in a non-invasive way. Regular physiotherapy done with a professional can help regain muscle mass and mobility after accidents, paralysis, or trauma. 

The ancient methodology effectively improves a patient’s quality of life and functionality without medication or surgery. Although medication can also be used in combination with physiotherapy at times if necessary.

Coupling orthosis bracing with physical therapy has taken on recently. The results have been more promising than using orthosis alone to help correct a patient’s malformation and manage pain better. Both orthosis bracing and physiotherapy aim to improve a patient’s quality of life in a similar way. Using non-invasive approaches to reduce pain and strengthen muscles and their function. 

Here are some ways physiotherapy can help double up the effects of wearing orthosis gear:

1. Pain Management

Physiotherapy can help manage pain for patients using orthosis devices. Gentle stretching and massaging the injured/deformed limbs can help promote healing and decrease rigidness in the muscles that cause pain.

2. Balance and Coordination

Many physiotherapy exercises are specifically designed to help patients improve balance. Walking with orthosis gear can be a very different experience than walking without it. Exercises can help re-train the mind to balance the body with the gear until it becomes second nature. 

3. Improving Endurance

Regularly stretching and exercising your limbs and muscles can improve your stamina and muscle mass over time. Improved endurance means your body will be in a better position to benefit from custom-made orthosis gear.

4. Improving Confidence

Transitioning to walking around with orthosis gear can be challenging, affecting you physically and psychologically. Enlisting the help of professional physiotherapists can help you regain your confidence. Physiotherapy can teach you better posture and ways to reclaim your mobility with confidence.

5. Lowers Risk of Injury

Practicing walking under the guidance of a trained physiotherapist can reduce your chances of injury. At the same time, you adjust to life with orthosis devices and regain your balance. Physiotherapists can better guide you about limb positioning and weight distribution, reducing your risk of an accidental trip or fall.

Secondly, they train you to properly put on and take off your orthosis gear. Optimizing the benefits of the bracing devices for your body.

6. Better Overall Health

Exercise is essential to maintaining a healthy body and can play a vital role in minimizing your chances of chronic diseases. Physiotherapy is a great way to improve your general well-being and save the rest of your body from taking on additional stress because of your orthosis gear.

7. Building Muscle

Another thing physiotherapy can help you with is building muscle mass and strength. Regularly exercising under the supervision of a physiotherapist can help improve circulation and avoid orthosis-related muscle spasms. The increase in blood flow also helps speed up your recovery time.

8. Reach and Grasp Tasks

Physiotherapy can help you regain your gross and fine motor skills after injuring a limb in an accident or ailment. Orthosis gear can support your limb while your practice reach and grasp tasks with your therapist.

What to Expect During Physiotherapy Sessions

Remember that orthosis, surgery, medication, and physiotherapy are all part of the long game to getting back on your feet. Recovery takes time, and regaining mobility takes even longer. Unlike surgery, orthosis gear and physiotherapy require a longer time for the results to be noticeable. It can sometimes be painful as your muscles are stretched, bent, and moved in unfamiliar ways.

Discuss with your orthotist if physiotherapy can help you get more out of your orthosis gear. They will refer you to a physiotherapist experienced in dealing with similar patients.

Your first meeting with your physiotherapist will include a baseline evaluation. That will enable them to formulate a more informed treatment plan for you. Make sure to disclose any medications you are on and any physical restrains or issues you might be experiencing. 

Feel free to discuss the level of physical mobility you are comfortable in and what you’re looking to improve by taking physiotherapy sessions.

Ready to Reclaim Your Mobility?
​
Using orthosis gear as recommended and taking PT sessions regularly can return your body’s mobility and facilitate you in leading a healthy, independent life. Align Clinic is committed to helping patients like you make better-informed decisions regarding their physical well-being. 
​

To discuss if physiotherapy can help you, reach out today.
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Risks and Benefits of Pectus Excavatum Treatments for Adults

8/3/2022

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Pectus excavatum is usually perceived as a childhood deformity affecting the chest wall and its surrounding tissue. Usually, the condition is diagnosed as a child enters toddlerhood, but in some cases, the congenital disability doesn’t present itself until it hits adolescence.

The condition can vary from patient to patient. Some face many difficulties, such as lung and chest problems and breathing difficulties, while others just have a slightly concave chest appearance. Click here to read more about the condition and how it can affect you.

Pectus Excavatum in Adults

In most cases in the US, pectus excavatum is diagnosed and treated in childhood or young adulthood. There are many reasons behind this haste in treatment, the primary reason being the malleable nature of children’s bones and chest walls. But that’s not always the case. There can be multiple reasons why some adults may present with untreated pectus excavatum, such as

1. Medical Advancements

Medical science has come a long way in the past few years. Advancements have been made both in surgical techniques and pharmaceuticals. Paving the way for many new treatment possibilities and changing the way medical intervention takes place. 

2. Underlying Conditions

Certain pre-existing medical conditions can make the child an unsuitable candidate for surgical correction of pectus excavatum. Such as blood disorders or connective tissue disorders. Such conditions make surgery riskier for the child; hence the condition is left untreated till adulthood.

3. Lack of Excess to Medical Facilities

The availability of medical facilities is not the same across the globe. Many children growing up in less privileged parts of the world only learn about their condition as adults.

4. Worsening of Condition in Adulthood

In some cases, symptoms of pectus excavatum exacerbate in adulthood. Even if the patient’s experience has been relatively smooth in adolescence and childhood.

Treatment Options

Treatment options for adult pectus excavatum are limited compared to the treatment of the condition in children. The reason is that growing bones are more flexible than adult bones that have entirely formed. So treatment options like bracing or vacuum bell therapy can’t be used to treat pectus excavatum in adults.

In mild to severe cases, surgery can be used to rectify the condition in adults. Here are the two procedures used most commonly to correct pectus excavatum:

Ravitch Procedure

The Ravitch procedure is also called open repair because it’s a highly invasive surgery to fix sunken chest syndrome. It's only used in the most extreme cases of pectus excavatum when all other options are deemed unsuitable. 

The surgeon makes a horizontal cut on the patient’s chest to remove the excess chest tendons. The chest wall is then moved into the optimal position for the chest to retain a more normal appearance. A metal bar is sometimes inserted in the chest to ensure the chest wall maintains its position.

Nuss Procedure

The Nuss procedure is relatively less invasive than the Ravitch procedure. An arched metal bar is used in this procedure called the pectus bar. The curvature of the bar is adjusted depending on the shape of the patient’s chest. The bar is placed across the rib cage and gently propels the sternum forward over the coming months. 

Once the bar is in the optimal position, it’s screwed into the chest wall before closing up the patient’s chest.

Using an endoscope makes the procedure safer by ensuring no accidental damage is done to any major organs during the surgery. It also guides the surgeon and makes the procedure less invasive than the Ravitch Procedure.

Risks of Receiving Pectus Excavatum Treatment as an Adults

All major surgeries carry risks for the patient. All surgical procedures done to correct pectus excavatum are no different. Surgery is used only as a last resort or when other treatment options have failed.

Surgical correction is often avoided and postponed for children with the condition. But for adult patients, it’s often the only treatment course. Here are some of the risks of all pectus excavatum-related surgeries:
​
  • Pain
  • Infection
  • Bone fracture
  • Excessive bleeding
  • Injury to the heart or lungs
  • Lung puncture leading to lung collapse
  • Permanent or temporary nerve damage
  • Reaction to the bar placed during surgery
  • Damage caused by migration of the metal bar
  • Reversal of the condition after the bar is removed
  • Chronic discomfort due to the presence of the pectus bar

Benefits of Correcting Pectus Excavatum

Before we discuss the benefits that a patient stands to gain from the surgical correction of pectus excavatum, it’s essential to understand that the condition affects patients both internally and externally. While issues such as reduced heart and lung function are of concern, the psychological effects of the malformation should not be ignored when deciding on a treatment plan.

In most cases, the Nuss and the Ravitch Procedure have shown excellent results in correcting pectus excavatum in adults. Provided there are no underlying conditions or complications during surgery.

Quality of life and patient satisfaction  also improves in most adults that undergo surgery. Most patients report having more energy and stamina, reduced shortness of breath, and a clear improvement in the appearance of their chest. The improved sports endurance can be attributed to improved heart and lung functions previously affected by pectus excavatum. 

Chronic chest pain also got resolved for many patients after healing from surgery.

Almost all adult patients report improved confidence and self-image after successfully reversing pectus excavatum. The betterment in their chest appearance seems to affect their body image and quality of life positively.

Is Pectus Excavatum Surgery Right for You?

Dealing with pectus excavatum can be a challenge at any stage of life. Our doctors at Align Clinic have helped many patients just like you. Contact us today to discuss treatment options and see if you’re eligible for surgical correction.
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San Mateo, California
700 S Claremont St
Suite #105
San Mateo, CA 94402 
Hours: 8:30-5:30 M-F
​Phone: (650) 375-2231
Fax: (650) 627-4632
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Fax: (844) 308-8462


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The Woodlands, TX  77380
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​Phone: (346) 770-2970
Fax: (281) 419-1615
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  • Home
  • The WCR Brace
    • Case Presentations >
      • Infantile Idiopathic Scoliosis
      • Juvenile Idiopathic Scoliosis
      • Adolescent Idiopathic Scoliosis
      • Switching to a WCR Brace
      • Adult Scoliosis Bracing
      • Neuromuscular Scoliosis
      • Treating Upper Thoracic Curves
    • Brace Articles
    • Patient Testimonials >
      • Grant's Testimonials
      • Paul's Testimonials
    • WCR Partner Testimonials
    • Grant's MS Thesis
    • Our Patients
    • Patients and Sports
    • Patients and Hobbies
    • Brace colors
    • Scoliosis Fashion
  • Locations
    • AC San Mateo, CA >
      • Inside AC SM
      • Advanced Technology
      • Stanford Children's Health Partnership
      • Local Hotels
      • Contact Us
      • Team Members
      • Our Practitioners >
        • Grant Wood
        • Paul Burnette
        • Steve Baum
        • Miguel Bustamante
    • AC Green Bay, WI >
      • Inside Wisconsin
      • Patient Testimonials
      • Contact Us
      • Emery Maloney
    • AC The Woodlands, TX
    • AC Fort Lauderdale, FL
  • Patient Resources
    • WCR Brace Clinics >
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      • China Clinics
      • Canada Clinics
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    • Clinical Photos and X-rays
    • Scoliosis Rehab PT, CA
    • Blog
  • Events
    • Brace Clinic Calendar
    • Sosort 2022 - San Sebastian, Spain
    • Past Events >
      • Advancements in Conservative Treatment of Scoliosis 2018 >
        • Award for Advancements in the Conservative Treatment of Scoliosis
      • Past USA WCR Clinics and Conferences
      • Advancements in Conservative Treatment Of Scoliosis 2017
      • Shanghai Clinic
      • AAOP Meetings
      • BSPTS Schroth PT Training
    • Past SOSORT Conferences >
      • sosort2019 San Francisco - CA
      • SOSORT2018 Dubrovnik/Croatia
      • SOSORT2017 Lyon/France
      • SOSORT2016 Canada
    • Northeast Region Re-Align Clinic
  • Services
    • Scoliosis & Spine Online Learning
    • Prosthetics
    • Orthotics >
      • Pediatric Orthotics
      • Cranial Remolding Band
  • Hope's Embrace® Undershirts
  • Wall Grids
  • WCR Brace Fitting Evaluation
  • For PTs/Orthotists
  • WCR Measurement Order Form
  • Masterclass Conferences
  • Careers
    • Front Desk - ACSM