Physical Therapy

What are the benefits of Orthopedic Physical Therapy?

Physical Therapy is unique to each child/adolescent. Depending on the specific needs of each patient, Physical Therapy can aide in the development of gross motor skills, improve pain, improve independence with mobility, improve strength, aide in the return to activity following surgery or injury, and improve overall health and/or quality of life.

Our experts treat conditions like:

• Pediatric knee
• Amputations/prosthetics
• Toe walking
• Scoliosis and spine
• Cerebral Palsy
• Pediatric Hip
• Juvenile Arthritis
• Leg length disorders
• Spina Bifida
• Developmental and Genetic disorders

How do I prepare for PT?

Please arrive on time for your visit to allow for every minute scheduled to be directed to the care of your child/adolescent. Patients should arrive to their appointment wearing clothing that allows for exercise, play, and activity. Patient should also wear a comfortable, but supportive pair of sneakers with socks. Your Physical Therapist will likely ask you questions about changes in pain, nutrition, medication, sleep, or any information that might impact participation in Physical Therapy. Be prepared to share this type of information and/or any other concerns with your Physical Therapist.

What can I expect during PT?

At your first Physical Therapy appointment, an evaluation will take place. Generally, the evaluation will include gathering all information that is important for better understanding the needs of and goals of the child/adolescent. Following this, the Physical Therapist will assess the child/adolescent’s strength, mobility, posture, range of motion, coordination, and balance, among other things. This will allow the Physical Therapist to work with both the caregiver and the child/adolescent to develop a plan for interventions (i.e. exercise, functional activities) that will best help the child/adolescent reach their goals.

Care Coordination and Communication

Through our MyChart options, you can see your child’s schedule, utilize secure chat for questions you may have any time of day, and attend telehealth visits. MyChart is easily accessible and available to any Scottish Rite for Children patient by asking the patient access team to help set up your account. Access here.

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Our goal in our Mobility and Equipment Clinic is to take a family approach to care. We assess each child’s skill level and functional needs to determine what equipment is appropriate while taking into consideration the child’s environment and family dynamics.

Our Physical and Occupational Therapists who prescribe custom wheelchairs have undergone training and passed the Assistive Technology Professional (ATP) certification, recognized by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). RESNA defines the ATP certification as a way to identify demonstrated competence in analyzing the needs of consumers with disabilities, assisting in the selection of appropriate assistive technology for the consumers' needs and providing training in the use of the selected devices.

Process of Obtaining Equipment:

• The patient is seen by a qualified medical provider and a referral for an equipment evaluation is obtained.
• The patient, therapist, and a complex rehab technology vendor attend the evaluation. and collaborates as a team to determine the most appropriate piece of medical equipment necessary for the patient.
• Documentation is sent to insurance for processing.
• The therapist and vendor will work to obtain insurance approval.
• For complex rehab equipment, the delivery of equipment will be performed in the presence of a therapist to ensure proper fitting and education of any and all devices.

Types of Equipment Evaluations:

• Manual wheelchairs
• Power wheelchairs
• Medical strollers
• Power assist for wheelchairs
• Walkers
• Gait trainers
• Standers
• Forearm crutches
• Scooters
• Bathing and toileting
• Medical beds
• Medical car seats
• Lift systems and other transfer equipment
• Feeding devices

Who Can Benefit?

At Scottish Rite for Children, we provide treatment for children of all ages and with a wide variety of diagnoses. These diagnoses include, but are not limited to:

• Birth defects/congenital anomalies
• Spina Bifida
• Cerebral Palsy
• Amputations
• Muscular Dystrophy
• Spinal cord injuries
• Osteogenesis Imperfecta
• Behavioral Challenges

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At Scottish Rite for Children Sports Physical Therapy, our experts provide skilled and compassionate care to help youth and adolescent athletes recover from injury or surgery. We utilize evidence-based treatments and assessments tailored to each athlete’s individual needs to get your athlete back to the sports they enjoy. Our experts provide rehabilitative services to competitive athletes engaged in middle school, high school, or club-level sports between the ages of 8 to 18.

Benefits of Sports PT?

At Scottish Rite for Children, our child-focused approach prioritizes the patient and family above all else. We share your goal of returning your athlete to their sport, not just according to a timeline, but when they are truly ready. Our care is episodic, coordinated, and supported by research, with a multi-disciplinary team working together. Additionally, our state-of-the-art gym ensures athletes have access to the best facilities for recovery and performance enhancement.

You will find that our experts have key insight into the athlete’s sport, position, and training regimen. We will conduct a thorough assessment to understand the injury and the mechanism. Our experts understand growth patterns for pediatric athletes and the process of restoration of movement to competency to proficiency for release into performance.

Some common sports-related conditions our experts treat include:

• Pre- and post-operative care
• Overuse and stress-related injuries
• Ligament and tendon injuries
• Growth-plate injuries
• Fractures
• Running Assessments

How do I prepare for Sports PT?

Please arrive on time for your visit to allow for every minute scheduled to be directed to the care of your child/adolescent. Patients should arrive at their appointment wearing clothing that allows for exercise, play, and activity. The patient should also wear comfortable but supportive sneakers with socks; no crocs or slides allowed. Your Physical Therapist will ask you questions about changes in pain, nutrition, medication, sleep, or any information that might impact participation in Physical Therapy. Be prepared to share this information and/or any other concerns with your Physical Therapist.

What can I expect during Sports PT?

During the treatment plan, sessions last for one hour and may occur in our gym, outside on our turf or grass, or in our Hydroworx Pool room. We have a patient-viewing area that accommodates the guardians who accompany our patients. Within the plan of care, you can expect frequent check-ins with the provider to ensure there are no questions and that you feel up-to-date on the plan for the athlete.

Care Coordination and Communication

Through our MyChart options, you can see your child’s schedule, utilize secure chat for questions you may have any time of day, and attend telehealth visits. MyChart is easily accessible and available to any Scottish Rite for Children patient by asking the patient access team to help set up your account. Access here.

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Scottish Rite for Children’s inpatient rehabilitation units serve children and adolescents who require intensive rehabilitation and medical management due to neurological, musculoskeletal, orthopedic or other medical conditions following stabilization of their acute medical issues.

What are the benefits of Inpatient Therapy Treatments?

Inpatient therapy services prepare, educate, and train you and your child for your surgery at SRC. You and your child will work closely with our inpatient occupational and physical therapists to give you confidence with your child’s activity and weight bearing restrictions, necessary equipment use, and how to perform daily activities before and after surgery. The major benefit of inpatient therapy services is to provide you and your child with confidence and understanding to recover well at home.

What Can I expect during my stay?

Inpatient physical therapists can work with you and your child to assist with moving around your environment, determining the appropriate walking devices and performing exercises specific to your child and their surgery. Inpatient occupational therapists can work with you and your child to understand how to complete basic daily activities, like dressing and bathing, as well as determine the appropriate equipment, such as wheelchairs and adaptive equipment needed for your child’s surgery. Together these therapies will coordinate and work together to provide you and your child the opportunity to learn and practice all transfers, activities, and exercises needed to safely recover at home.

Frequently Asked Questions

Do All Surgeries Require Inpatient Therapy Services?

No, not all surgeries or procedures will require inpatient therapy services. The potential therapy needs are determined by the collaborative medical team here at Scottish Rite for Children.

What Equipment Might I Need After Surgery?

This is dependent on your surgery and activity restrictions.

Why Do I Need Therapy Services If I Just Had Surgery?

There is strong research evidence that shows early activity supports the recovery process. If recommended by the medical team, inpatient therapists are often involved in the assessment and initiation of early activity after surgery.

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The Scoliosis Specific Exercise (SSE) helps patients with scoliosis and kyphosis (backbones that curve too much from the center to the right or left, or backward). Scoliosis-specific exercises can help limit these curves and keep them from getting worse — without surgery.

What is SSE?

Scoliosis-specific exercise is a treatment for scoliosis or kyphosis provided by a trained physical therapist to teach proper form for exercises and progress the movements over time. Below are the two methods offered by our therapists:

• BSPTS (Barcelona Scoliosis Physical Therapy School) Schroth-based method
• SEAS (Scientific Exercise Approach to Scoliosis) method

Follow your physician’s advice for brace wear and recommendations for surgery. Curve-specific exercises improve posture but do not take the place of surgery or a brace. Physical therapy for scoliosis can be a part of a patient’s treatment plan for those with or without a brace.

What are the Benefits of SSE?

Scoliosis-specific exercises can improve uneven posture, increase body awareness and work to limit curve progression. Some patients may also experience back pain or other muscular imbalances. SSE and outpatient physical therapy can also help in improving back pain and function.

How do I prepare for SSE?

Your back needs to be visible during treatment as you learn to hold yourself in your new posture. For girls, please wear a sports bra or bathing suit top and shorts. Boys, please wear shorts and preferably no shirt. You will be in a private treatment space with you, the therapist and a caregiver.

What can I expect during treatment?

You will learn exercises and positions to hold yourself straighter. Your therapist will evaluate you and provide an individualized plan of care based on your curve and clinical presentation. You will be expected to perform a home exercise program outside of your therapy visits per the recommendation of your therapist. Typically, we ask patients to perform exercises for 15-30 minutes, 5 days a week. Changing your posture is hard work, and you must be dedicated to the exercises. No one can change your posture while sitting, standing or eating, except you.

Frequently Asked Questions

Is there a minimum age?

No; however, children should be old enough to have the concentration & coordination required to participate in each session.

If I do my exercises, does this replace my need to wear my brace?

Follow your physician’s recommendations for brace wear or for surgery. Scoliosis-specific exercises may improve posture, and research has shown bracing is effective in limiting curve progression during growth. Exercises should not take the place of surgery or a brace.

How long will I need to come for physical therapy and how often?

The duration and frequency of visits will be determined by your physical therapist, as each patient may present at a different stage of growth and with a unique clinical presentation. We will consult with the referring provider and determine a plan of care based on your curve, growth, and other clinical factors. Typically, we start with an increased frequency of 1x/week or every other week before spacing out visits based on each patient’s progress and presentation.

How do I know if SSE based method is right for my child?

The following points are helpful to consider:

• A provider at Scottish Rite has indicated this treatment may be appropriate for your child's condition
• Your child is self-motivated to perform the exercises at home and in therapy
• Your child can concentrate and follow instructions for treatment session lengths
• Your child is willing to commit to performing daily exercises for a minimum of 4-6 months

Research

• Scoliosis-specific exercises (SSE) may reduce curve progression, but the research is limited. Click here to learn more.
• We are researching the effectiveness of SSE at Scottish Rite. Click here to learn more.

What does the PT plan look like for my child who needs SSE?

A Scottish Rite for Children Physical Therapist will provide instructions in the Physical Therapy Evaluation. We have several options for follow-up appointments including an intensive program held onsite in Dallas, regular outpatient visits at our locations, or telehealth. The amount and length of time of treatment are determined on progress and needs. On average, our patients who receive SSE are seen periodically for six months to monitor the patient, adjust exercises, and assist in further coordination if other services are determined.

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Aquatic Therapy, or pool therapy, is a treatment technique used by physical or occupational therapists to complement a patient’s plan of care. The natural buoyancy and resistive properties of water provide an environment safe and effective for exercise and its benefits. Read below to learn more about our pools and services.

What type of pools do you have in your clinic?

Hydroworx 1200

HydroWorx 1200 Series resistance pool technology is a quantum leap forward in aquatic therapy equipment. Its high-tech design allows clinicians with limited space to enjoy the same benefits of our 2000 Series physical therapy pools, in a more compact package. The HydroWorx 1200 Series contains a moveable floor and underwater treadmill technology to better care for our patients. The pool is always a therapeutic 94 degrees.

Adjustable Floor With Variable Water Depth:

• Entire therapy pool floor is fully adjustable in height for safe access without ladders or steps
• Patients simply walk or are wheeled onto the floor and lowered to the desired depth
• Entire entry and the lowering process takes only 30 seconds

Variable Speed Underwater Treadmill:

• The entire 6’x9’6″ floor doubles as a variable-speed treadmill
• Treadmill smoothly increases from 0 to 8.5 mph in safe .2 mph increments
• Treadmill surface has a cushioned low-impact design with excellent traction

Resistance Therapy Jets With Massage Hose:

• Resistance jets are essential for orthopedic therapy, rehabilitation, sports performance training, and swimming or deep tissue massage
• Jet speeds adjust to a wide variety of water speeds with the remote control

Underwater Cameras & Monitoring System:

• The 1200 Series resistance pool’s cameras and viewing monitor enhance your therapeutic capacity
• Five cameras, two in front, two side views, and one rear view with a flat-screen monitor for viewing and optimal visual feedback for coaching

Hydroworx Hot Plunge

Revitalize Muscles With Warm Water Therapy

These warm-water aquatic therapy pools are filled with innovations designed to create an environment ideal for muscle recovery and revitalization. HydroWorx’s hot pools are equipped with thermal heating units to distribute warm or hot water (94° — 104°) to relax tight muscles and stimulate the release of endorphins. Powerful massage hoses easily attach for specific deep tissue therapy.

Clinical Benefits Of Hot Water Therapy:

• Heats muscle and tissue to increase circulation and restore blood flow to the body
• The warmth of the water promotes a transient reduction in joint stiffness, pain, and muscle spasms
• Reduce inflammation
• Increase internal body and muscle temperature for priming functions related to exercise
• Best used in combination with our Polarplunge to flush soreness-causing by-products from your body systems.

Hydroworx PolarPlunge

Revitalize Muscles With Cold Water Therapy

The PolarPlunge line of HydroWorx pools offers clinicians the ability to provide cold water therapy to their athletes and patients. Proven to offer a number of benefits — particularly when alternated with hot water therapy. These cold-water aquatic therapy pools are filled with innovations designed to create the ultimate muscle recovery and revitalizing environment. HydroWorx’s cold plunge pools keep water temperatures at a therapeutic 50°.

Clinical Benefits Of Cold Pool Therapy

• Suitable for use in sports performance training, general fitness, rehabilitation, and recovery applications
• Effective for rapid muscle recovery due to chiller technology
• Capable of deep-tissue massage for a range of speeds and directional combinations with resistance therapy jets
• Reduces the inflammation and perception of general fatigue and leg soreness

Who is appropriate for the pools?

• Patients with weight-bearing restrictions
• Patients who are seen after surgery
• Patients who are trying to return to impact activities
• Patients who have poor balance or need help walking
• Patients who require edema management or have stiff and swollen joints
• Patients who have increased muscle tone and decreased flexibility
• Patients who are not afraid of the water

What diagnoses are safe for the pools?

• Post-operative diagnoses such as:

  • ACL Reconstruction
  • Meniscal Repair
  • MPFL Reconstruction
  • Hip Labral Repair
  • OCD Cartilage Graft Repair
  • Rodding or pinning of bones in the leg

• Non-operative diagnoses include but are not limited to:

  • Stress Fractures
  • Tendinitis
  • Apophysitis
  • Patellofemoral Pain Syndrome
  • Sever’s Disease
  • Back injuries

What type of condition is not appropriate for the pools?

The general rule is if you cannot be submerged in a bathtub, you should not be in the pool for treatment. Your provider will make the decision if you are appropriate for aquatic therapy.

• Contagious disease
• Tracheostomy or gastrostomy
• Serious Epilepsy
• Urinary or Bowel Incontinence
• Open wounds
• Skin conditions

What are the guidelines for your pools?

• We follow strict procedures for the safety of our patients. Pool temperature, chemistry, and clarity are tested and recorded before the first individual enters the pool for the day.
• All staff operating the pool are required to complete training and sign off on pool operations before treating individuals in the pool.
• Patients participating in the aquatic therapy program will be supervised by staff and must be clear of infections, have no open wounds, or have any symptoms of incontinence.
• Everyone must rinse off in the locker room before entering the pools.
• Proper bathing attire is required with the torso skin covered for all participants who enter the cold tub, hot tub, or the 1200 Pool.

Who can use the pools?

Only patients or therapy services and participants of our Bridge Program can utilize the pools.

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