Friday, January 29, 2010

Physical Therapy for Hip Spica Cast Patients

When a young child suffers a broken hip or thigh bone and must wear a hip spica cast, this can be a very trying time for the toddler and his parents. The child may not understand why he has to put up with so much pain and be confined to the hip spica cast. All he wants to do is get up, run around and play with other children.

The best way for parents to deal with a child’s injury of this sort is to explain as best you can the treatment that is being provided, and make him as comfortable as possible. When your child is in a hip spica cast, you need to ensure that:

• The cast does not pinch his skin or cause him pain or discomfort in any way.
• The cast is dry and fresh at all times.
• Your child is turned over at least once every six hours to prevent the onset of bed sores.
• Your child’s bedding is absolutely clean and changed regularly.
• Your child does not stand or bear weight on the cast.
• There is no rash due to itchiness caused by the cast.
• You child has normal feeling in his toes and lower limbs and that blood flow to the lower extremities is normal.
• The cast does not develop any cracks or dents.
• Your child is comfortable and entertained at all times.
• Your child does not put any object down the cast.

When your child has recovered and it’s time for the cast to come off, his limbs will be stiff and unresponsive after the prolonged period of immobility. While some doctors may skip physical therapy altogether, others prefer to provide a set of exercises that will help your child regain full range of mobility in his limbs. Each physical therapy program is tailored to the child’s particular injury and the treatment needed. In general however, doctors recommend that:

• The thigh muscles are strengthened with leg lifts – your child should lie flat on a bed or hard surface, and lift each leg alternately as high as he can without bending his knees, hold the position for a few seconds, and then slowly bring it to rest on the bed. A few repetitions with both legs should be done every day.

(NOTE: Your child may be very afraid once the hip spica cast comes off. Having gotten used to the heavy cast, it can be quite traumatic for a 2 to 5 year old to suddenly have all that weight disappear. Take a pillow with you and have it ready to put on top of his legs immediately after the cast is cut off. This will help calm him. Also, do not do any of the leg-lift or other exercises until after your child's fear has subsided. This may take a few days.)

• Your child should walk as much as he or she is able to once the cast has come off. (But let the child let you know when he's ready to do this. Don't push him.) Some children are wary of putting their feet on the ground because they are numb initially and may have no balance. (One way to encourage him to get up is to have him watch other children his age at play. Bring friends or relatives over, or visit a local park or playground.)

• Once he's able to walk straight without any help, get him to walk sideways and then climb up and down stairs. (Start slowly and be very patient. Your child will most likely complain, loudly.)

IMPORTANT: Talk to your doctor before you have your child do these exercises or any kind of at-home therapy. It is also highly recommended you consult a physical therapist, as such a professional will be able to suggest and tailor exercises to your child's specific needs.

Be careful, as pushing your child too much, having him do improper exercises, or improperly doing correct exercises may result in further injury or harm to your child.

This article was written by Shannon Wills, who writes on the topic of Physical Therapist Assistant Schools. She welcomes your comments, and can be contacted at

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