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Cerebral Palsy Clinic: Your Child’s Care and What To Expect

Cerebral Palsy Clinic: Your Child’s Care and What To Expect

by | Mar 17, 2023 | Neurology

At Scottish Rite for Children, our experts provide care to the whole child – body, mind and spirit. The Neurology and Rehabilitation Medicine department sees children with orthopedic issues who also have related neurological disorders and neuromuscular diseases. One of the most common conditions seen by this team is cerebral palsy (CP).

Like all conditions, the severity of cerebral palsy can vary depending on the child and requires a multidisciplinary team to determine the best treatment options. With several factors that play into this diagnosis, we understand that as a parent or caregiver it can be challenging to navigate through the care plan for a child with cerebral palsy. Below is what you need to know about our specialized cerebral palsy clinic at Scottish Rite.

Who is part of the CP team?

  • Orthopedic Surgery
    • A pediatric orthopedic surgeon focuses on evaluating and monitoring for operative interventions to address function and pain.
  • Pediatric Rehabilitation Medicine (PRM)
    • PRM focuses on evaluating and monitoring the child for nonoperative interventions, including bracing, casting, tone medications, botulinum injections, equipment and therapies with the goal of optimizing function and reducing pain.
  • Neurology
    • This team treats the active neurological conditions such as seizures.
  • Advanced practice providers (APP)
    • The APPs work with both the neurologists and pediatric rehabilitation specialists to provide holistic care.
  • Nursing
    • This team coordinates and organizes each of the multidisciplinary teams and ensures that education is tailored to the needs of each patient.
  • Orthotics
    • A team of orthotists work with the teams to evaluate, fit and fabricate braces used to help your child’s mobility.
  • Physical Therapy (PT)
    • PT works with the child to improve functional mobility, with or without their needed equipment.
  • Occupational Therapy (OT)
    • OT focuses on activities of daily living, upper extremity function and the use of equipment needed to help your child function.
  • Therapeutic Recreation (TR)
    • TR works with the patient to promote activities and participation through peer interactions and relationships, such as adaptive sports, games and more.
  • Psychology
    • Our team of pediatric psychologists manage the psychological well-being of the child and helps them with strategies to overcome barriers to the treatment plan.
  • Developmental and Behavioral Pediatrics
    • This team optimizes nutrition, feeding and medical comorbidities and manages behavioral differences.

What can a parent/child expect when come to the CP clinic?

  • The child will first be seen by our motor control nurse who will go over medications and safety questions.
  • One of the neurology/rehabilitation medicine APPs will continue the visit.
  • A video recording will be conducted of the child for their gait to be analyzed so the team can compare changes that occur throughout time.
  • The pediatric rehabilitation medicine specialist and the APPs will then complete the visit and explain the plan to the patient and parent/caregiver.
  • Depending on the clinic and specific needs, the patient may also be seen by a pediatric orthopedic surgeon, orthotist, physical and/or occupational therapist, pediatric psychologist or a recreational therapist. When appropriate, referrals are also made to the other cerebral palsy experts.

How often are clinic appointments?

  • Children younger than 5 are typically seen every three to four months. Since this is a period of rapid growth and development, our team of experts want to make sure that they are monitoring the patient’s growth closely and intervening in any way needed to promote healthy and happy development.
  • Children between ages 6 to 12 are seen about every six months but may require visits more often if they are in the middle of a growth spurt.
  • After a child has completed their growth spurt, the team typically sees them between every six months to a year.

Pediatric rehabilitation medicine physician Fabiola I. Reyes, M.D., works closely with this patient population. “I am honored to have the opportunity to provide care to these kids,” Reyes says. “In the CP clinic, we pride ourselves in making sure that both the child and parent/guardian understand and feel comfortable with every step of the treatment plan. Although your child may have several specialists caring for them, which can be overwhelming, our team is here to walk you through the process – making sure the patient remains our priority.”

Learn more about the Neurology and Rehabilitation Medicine department.

Get to Know our Staff: Madelyn White, Therapy Services

Get to Know our Staff: Madelyn White, Therapy Services

by | Jan 13, 2023 | Therapy Services

What is your job title/your role at Scottish Rite for Children?  
I’m a sports physical therapist at our Frisco campus.
 
What do you do on a daily basis or what sort of duties do you have at work?
I work with youth athletes with various injuries to get them back to their sports safely. My job consists of examining and assessing athletes and coming up with a plan to get them back to their sports. I spend most of the day in our sports therapy gym, leading patients through exercises tailored to their injury and their sport. 
 
What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
Prior to becoming a physical therapist, I worked at an ice rink teaching young kids how to skate and play hockey. 
 
My first job as a physical therapist was here! I was a student physical therapist at Scottish Rite for Children for my final clinical rotation, and I started working as a full-time physical therapist about a year later in March 2021. 
 
My family lives in this area, and I remember seeing the Frisco facility being built. I thought it was really unique to have such a specialized clinic for youth sports, and I knew I wanted to be a part of it. After having my clinical rotation here, I couldn’t imagine working anywhere else. I feel very lucky to get to work in such a great facility.
 
What do you enjoy most about Scottish Rite?
The people! Whether it’s my patients or my colleagues, it’s always fun to be here. We have such a great staff in the Therapy Services department and beyond, and my patients always brighten my day!
 
Tell us something about your job that others might not already know?
I think most people don’t know how hard physical therapy (PT) sessions are for patients. A lot of people think PT is just massages and stretching, but most patients spend the majority of sessions lifting weights, running and jumping. There is a lot more strength and conditioning involved than people expect.
 
Where is the most interesting place you’ve been?
I went to Europe for the first time last summer and loved it. Paris was the most beautiful place I’ve ever seen. 
 
What is your favorite game or sport to watch and play?
Ice hockey! I grew up in a hockey family, and I played and/or coached ice hockey until I went to college. I’m a big Dallas Stars fan and go to (almost) all the home games.
 
I also had a brief stint as a gymnast/cheerleader, and I ran track throughout high school. 
 
If you could only eat one meal for the rest of your life, what would it be?
Any kind of sushi.
 
What’s one fun fact about yourself?
I am currently on a daily running streak and have run at least one mile a day for more than 450 days in a row. I haven’t missed a day!
Muscle Strain Q&A

Muscle Strain Q&A

by | Apr 22, 2022 | Sports Medicine

Our world-renowned sports medicine experts are ready to help your injured athlete get back in the game. We have unparalleled experience providing nonoperative and arthroscopic care to treat common sport-related injuries including concussions, ligament injuries and cartilage conditions in the knee, ankle, shoulder, elbow and hip in young and growing athletes.

Sports Medicine expert Jacob C. Jones, M.D., RMSK, shares information about muscle strains and how to handle these types of injuries in young athletes.

What is a muscle strain?
A muscle strain is a disruption of the muscle fibers in a certain muscle group. Muscle strains can be mild or they can be severe, causing muscle tearing.

What causes a muscle strain?
Muscles are constantly being pushed and pulled, but when a muscle contracts at the same time that it is being pulled, a strain can occur. This type of muscle movement is called an eccentric contraction. 

What are the symptoms of a muscle strain?
In mild strains or low-grade muscle disruptions, the most common symptom will be pain in the area. Severe disruptions or tears can also cause swelling, more noticeable weakness, and even bruising.

Should you seek medical treatment for a muscle strain?
It is definitely wise to seek medical treatment for muscle strains. In mild cases, a young athlete may want to consult with their athletic trainer for advice and recommendations on reducing the pain. Athletic trainers can also help determine whether the athlete needs to see a physician for the injury.

Relative rest, in combination with muscle rehab, is the best treatments for a strain. It is important to allow the muscle to heal while also building strength and flexibility to avoid further injury. Even in high grade muscle tears, surgery may not be commonly recommended. 

Are certain muscles more at risk for strains?
Yes, muscle groups that are at the highest risk for strains are those that cross multiple joints. For example, some hamstring and quadricep muscles cross both the hip and knee joints and calf muscles cross the ankle and knee joints. Any muscle can be strained, but those groups are more likely to be injured.

How can you avoid muscle strains?
Muscles are less likely to have a strain if they are flexible and strong. Stretching daily can help provide your muscles with more flexibility and strength. Additionally, it is important to also warm up your muscles before working out or playing a sport. Muscles are less likely to strain or tear when they are warm, so it is important to not skip warm-ups before practice.

What does recovery from a muscle strain look like?
Once pain allows, it is important to do some rehabilitation to the muscle before returning to regular activity. In mild strains or low-grade disruptions, recovery time may take weeks. In more severe cases that lead to muscle tears, recovery time may take months. We look for good range of motion, minimal to no pain, and good strength prior to return to sport.

What happens if an athlete returns to sports or activity before the strain is healed?
The biggest risk of returning to athletics or sports too soon is re-aggravating the muscle and extending the recovery time. Additionally, having a strain may cause you to favor one leg or arm and could lead to further injury.

How can ultrasound be used to diagnose and treat muscle strains?
Specially trained experts can use musculoskeletal ultrasound to evaluate injured joints, ligaments, tendons, muscles and bones. Ultrasound can visualize soft tissues like muscle well with a high level of detail. When looking at a muscle using ultrasound, a low-grade strain may show some edema, swelling caused by fluid in tissue, while a more severe strain that has already torn will clearly be visible. Using ultrasound can also allow physicians to determine where additional treatment or care is needed in treating muscle strains. Ultrasound can also be used for treatment of chronic muscle tears not improving with other conservative measures.

Sports medicine is a medical and surgical specialty that considers the comprehensive needs of athletes and provides management for sport-related injuries and conditions. Young and growing athletes are highly competitive and have unique conditions that require care by a pediatric team of experts. Learn more about our Center for Excellence in Sports Medicine and how board-certified pediatricians, pediatric orthopedic surgeons, physical therapists, athletic trainers, psychologists and other sports medicine specialists work side-by-side with each athlete, their parents and coaches to develop the best game plan for treatment, rehabilitation and safe return to sport.

In Strong Hands: Meet the Strength and Conditioning Coaches at Scottish Rite for Children

In Strong Hands: Meet the Strength and Conditioning Coaches at Scottish Rite for Children

by | Mar 4, 2022 | Sports Medicine

Meet the coaches of our Bridge Program. This program is designed to improve movement quality, strength, speed, and other measures in young athletes to simultaneously boost performance while reducing the risk of injury.

Certified Strength and Conditioning Specialists® (CSCS®) are professionals with special training and expertise. Standards set by the National Strength and Conditioning Association (NSCA®) are designed to ensure that these coaches have the proper training and skills to promote safe participation in these activities.

As the Bridge Program coordinator, Matt Schiotz, M.S., CSCS, brings experience as an elite-level sports performance coach with more than 20 years of experience coaching diverse groups of athletes. Schiotz’s coaching journey began with the Kansas City Chiefs before moving to the head strength and conditioning coach role at the University of Southern California. He then returned to the NFL as a strength and conditioning coach for more than a decade.

Schiotz’s most recent coaching role was at Baylor Scott and White Sports Performance Center at The Star in Frisco, where he was also the Director of Performance. He has also worked as a performance coach, providing virtual training sessions using app-based programming and data analysis. Schiotz received his Master of Science in Exercise Physiology from the University of Kansas.

“I am very excited to join the team at Scottish Rite,” Schiotz says. “I believe the continuum from physical therapy to performance training is a model balancing safety and maximum outcomes. Though I have worked with athletes of all ages, my true passion is working with young athletes to help them achieve their sport and performance goals. Seeing them return to a sport or activity they love is my reward, especially as a parent myself. Combined with an athlete’s hard work, I am confident that lessons learned in this program will help each participant optimally develop and be set up for a future of athletic success.”

Justin Haser, M.S., CSCS, is an elite-level sports performance coach with experience working with athletes across all sports. Haser began his coaching career at Ohio University before moving on to the University of Pittsburgh, where he worked with the football team.

Before joining the team at Scottish Rite, he was a sports performance coach at Baylor Scott and White Sports Performance Center at The Star in Frisco. He has coached athletes of all backgrounds, from 8-year-olds to professionals in the NFL and NBA. He led the Return to Play Program, designed to serve athletes as they transitioned out of therapy and back to a full return to their sport.

“I am excited to keep things rolling here at Scottish Rite,” Haser says. “I believe the transition period between finishing physical therapy and returning full time to sport can often be overlooked. Having gone through this process twice myself, I know firsthand the challenges an athlete will face. I played Division I football for Ohio University. During my career, I had a shoulder injury that required two surgeries, the second of which ultimately ended my athletic career. After my career ended, I spoke with my strength coach at the time and explained the situation. He invited me to assist in the weight room for my final year and a half prior to my graduation. Ultimately, this experience showed me what I wanted to do professionally and launched my coaching career. I am looking forward to helping these young athletes by providing guidance and support on their journey back to their field of play!”

Scottish Rite for Children in Frisco is offering training classes for young athletes. Sessions begin the first week of each month. Contact our Therapy Services team at 469-515-7150 or bridgeprogram@tsrh.org to learn more.

What is a Bridge Program?

What is a Bridge Program?

by | Dec 22, 2021 | General News, Sports Medicine

Getting back to sports after an injury or surgery can be a long road. From the beginning of rehabilitation, the team is actively considering the best path for the athlete to get back to play safely with the lowest risk of re-injury. Depending on the condition and treatment, the natural course of recovery may take as long as 12 months. Formal physical therapy may last three to six months, but when that is over, what’s next? There are several options to “bridge” the gap between discharge from therapy and safe return to sports. The idea is to continue training in an environment where the instructor is familiar with young athletes and aware of the challenges associated to returning to sports after an injury. For some, a high school athletic trainer may be well-suited to collaborate with the athletic program’s strength and conditioning coach. The best option is to stay with a program that understands your child’s history and goals. One that is led by a qualified professional familiar with post-injury and post-surgical recovery timeframes. We are pleased to introduce this option to our current and former patients. Keep reading to learn more about this program at Scottish Rite for Children Orthopedic and  Center.

Sports Medicine 

Top Things to Know About the Bridge Program 

What is it?    The Bridge Program is specially designed for the young athlete who has completed their physical therapy sessions but is still needing focused training to help them return safely to their sport. Why was the program created?  When therapy ends, patients are often not ready to return to sport, but do not know where to turn. The purpose of the program is to offer additional resources to the patient who completes therapy and is in search of continued training with returning to sports as their main goal. Our team is well-equipped to direct the program development and care in this stage of recovery. What is the difference between physical therapy and performance training?  In therapy, physical and occupational therapists are movement experts who optimize quality of life through prescribed exercise, hands-on care and patient education. Once the patient is pain free and exhibits quality movement, performance training is the natural next stage.  Performance training can be offered in a small class setting under the direction of a certified strength and conditioning specialist (CSCS). It is not covered by insurance, but some guarantors have HSA/FSA funds that may qualify for this program. Learn more about this kind of coach in an earlier blog [here]. Who can participate in the Bridge Program?  This program is open to athletes that do not have an injury or have been cleared from all restrictions except the final clearance by their physical therapist or doctor to return to sport and to be considered for this program. How will the program help an athlete in their sport?  With an overall focus on where your child is in his growth pattern, our coaches can address each athlete individually and customize programs that work on weaknesses which may protect him from injuries in the future. We look to provide a starting baseline, progress and discharge summary for the athlete and family to view results throughout our eight-week programs. How do you sign-up?   Call 469-515-7150 or email BridgeProgram@tsrh.org to request more information. Classes are offered with rolling admission.