At-Home Wound Care Tips for Parents

By Ruchi Bagrodia, physical therapist at CHOC Children’s

Did you know that the physical therapy team provides wound care for the kids at CHOC Children’s?

Part of their scope of practice, both physical therapists and physical therapist assistants complete coursework in wound management during their higher level education. Several PTs and PTAs at CHOC have received specialized training in wound care and many have gone on to receive board certifications in wound care. With this training, a therapist is able to evaluate wounds, decide on the best treatment, and create a comprehensive wound care plan in collaboration with the patient, family, and medical team.

Physical therapists are able to use their expert knowledge of anatomy, tissue healing, movement and positioning to develop an individualized plan of care that also aims to improve movement and function. Successful wound healing may allow a child to more quickly return to school, participate in gym class and enjoy a summer trip to the beach with their family.  The ultimate goal of physical therapy is to restore function and allow people to get back to the things they love doing!

How do PTs provide wound care at CHOC?

At CHOC, PTs and PTAs provide wound care services for kids on both an inpatient and outpatient basis. During an evaluation, a PT will decide how to best clean, dress, and protect the child’s wound, and also provide recommendations to the parent to encourage wound healing and to prevent complications.

Here are some tips to remember when caring for your own minor wounds or skin injuries at home:

  • Keep dried scabs moist using a healing ointment or petroleum jelly for faster healing time. While it may be challenging, try your best not to pick at scabs!
  • If a wound is open (appearing wet, bleeding or draining liquid), cover it with some type of bandage. Leaving it open to air will increase the risk of infection.
  • Common signs of infection include redness, swelling, pain and warmth. Call your doctor if you notice an increase in signs of infection that are not already being treated.
  • When using over-the-counter antibiotic ointments for minor cuts and scrapes make sure to follow the dosage instructions. It is not recommended to use many of these ointments for more than seven days unless stated by your doctor. Many people have allergic reactions to triple antibiotic ointments. If you notice a wound is getting worse with an ointment, stop using it and talk to a health care professional.
  • Hydrogen peroxide and rubbing alcohol are commonly used to clean wounds, although both are damaging to your healthy skin cells. Instead, simply use mild soap and water to clean a cut or scrape.
  • Different types of sandals, shoes, plus foot and ankle braces can all cause areas of redness caused by too much pressure to the skin. If the redness does not go away after 15 minutes upon removing the pressure, the fit needs to be modified to avoid further injury to the skin.
  • Nutrition makes a difference in wound healing! Incorporate foods that are high in protein, Vitamins A and C, and Zinc into your diet to help with healing. Learn more by visiting ChooseMyPlate.gov for tips on how to create a balanced diet.

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  • Importance of Stretching for the Young Athlete
    Stretching can often take a back seat to your general exercise routine and sport-related activities, but these are an essential part of any conditioning or physical therapy program.
  • CHOC Physical Therapy Improves Quality of Life
    The American Physical Therapy Association declares the vision of the physical therapy profession as “transforming society by optimizing movement to improve the human experience.” The movement system is complex and ...
  • Olympic Medalist Turned Physical Therapist
    When athletes of any caliber come to physical therapy appointments, they often struggle with emotional hurdles as big as their physical challenges. Working with an expert who understands their struggles ...

Importance of Stretching for the Young Athlete

By Victor Araiza, physical therapy assistant at CHOC Children’s

Stretching can often take a back seat to your general exercise routine and sport-related activities, but these are an essential part of any conditioning or physical therapy program. Stretching decreases the risk of injury or re-injury and promotes wellness.

Why is stretching so important?

Stretching the right way will help improve flexibility and make it easier for you to move. Stretching properly can increase and improve motion in your joints, increase blood flow, and decrease feelings of stiffness. Other potential benefits of stretching can include reducing delayed onset muscle soreness, increasing athletic performance and reducing the risk of tendon or muscle tears.

It is important to stretch correctly and know which muscle groups you want to stretch. Often, the muscles that tend to be tight are the hamstrings, hip flexors, quadriceps, calves and chest muscles. If proper technique is used when stretching, it will help improve flexibility and increase range of motion. This will increase blood flow and decrease stiffness, in turn decreasing the risk of injury or reinjury.

When to stretch

It is recommended that you perform static stretches after exercising, engaging in strenuous physical activity or participating in an athletic event. Static stretches target specific muscles based on the position you are in with the intent to elongate just past the point of a moderate pulling sensation. The static stretch should be held in the same position for 30-60 seconds and repeated two to three times. For an athlete, it is common to perform a dynamic warm-up prior to sport related activities and static stretches after activities. The American College of Sports Medicine guidelines recommends stretching activities be done at least two days per week. It is also important to know and understand which stretches would benefit you based on your limitations and desired activity participation.

Stretching is encouraged:

  •  When range of motion is limited.
  • Prior to or after vigorous exercises.
  • As a component of your sport-specific conditioning program, team warm-up/cool down and before/after a participation in a sporting event.

When is stretching not encouraged?

  • When someone has excessive movement in their joint(s)
  • An athlete who has experienced a recent fracture
  • After sudden onset of inflammation or swelling
  • When you feel a sharp pain when attempting to stretch

 Tips on how to stretch

It is important to remember that just because you perform stretches doesn’t mean that you will never get injured. Stretching won’t prevent an overuse injury that is predominant in sports that involve the repetition of similar movement patterns. There are other important factors such as strength and endurance training, essential to reducing the risk of injury. Please consult your pediatrician for a referral to physical therapy if you and your child need assistance with an exercise and stretching program.

Learn more about rehabilitation services at CHOC.

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CHOC Physical Therapy Improves Quality of Life

The American Physical Therapy Association declares the vision of the physical therapy profession as “transforming society by optimizing movement to improve the human experience.” The movement system is complex and includes various conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and integumentary systems and their complex interaction that allows kids and teens to experience their environment and actively participate in the activities they enjoy.

How do physical therapists play into this at CHOC? You may see them addressing a wound care plan, educating a family on developmental play activities after an open- heart surgery, teaching a patient how to use crutches after surgery, helping a child balance and coordinate a multi-step task after brain surgery, or progressing the endurance and strength of a child on chemotherapy. Most of all, you will see them educating CHOC families on self-empowerment and independence.

From working with neonates who are learning to self-regulate, to high school athletes hoping to return to their sports after injuries, CHOC’s physical therapists are involved in improving quality of life for our patients and families.

Meet Amanda Traylor, a pediatric physical therapist at CHOC.

Q: What aspect of pediatric physical therapy are you most passionate about?

A: I love working with kids, and we get to work with a diverse age range. I also enjoy the multi-disciplinary collaboration of the rehabilitation department, which includes not only physical therapy, but also occupational therapy, speech and language therapy, and developmental therapy.

Q: What inspires you most about the care being delivered at CHOC?

A: I am inspired by the constant striving of the care team to provide the best evidenced-based practice for our patients and families. Our staff is so involved in our community with different events, education opportunities, and training of future professionals; we really make an impact on Orange County.

Q: What have you learned from your patients?

A: My patients have taught me to focus on what is important and meaningful. Being a part of the medical field, we often establish a plan of care and goals based off the impairments we see, but ultimately it always comes down to what is meaningful for the patient and their family.

Q: What, if anything, surprised you when you became a pediatric physical therapist?

A: We don’t just treat the child; we treat the whole family. The families are truly our backbones for patient care.

Learn more about pediatric physical therapy being delivered at CHOC.

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Olympic Medalist Turned Physical Therapist

When athletes of any caliber come to physical therapy appointments, they often struggle with emotional hurdles as big as their physical challenges. Working with an expert who understands their struggles can make it easier to cope, especially when that expert is a former Olympian.

Robin Beauregard, a physical therapist at CHOC Children’s and two-time Olympic medalist in women’s water polo, understands the physical challenges that can sometimes stand in the way of achieving athletic goals.

olympics

“Having a career in athletics helps me establish a rapport with my patients, particularly my history with sustaining and overcoming injuries,” she says. “Sincere empathy creates a stronger bond than sympathy.”

Shortly before the team was named for the Sydney Olympics in 2000, the first time women’s water polo was to be recognized as an Olympic sport, Beauregard dislocated her knee and didn’t know if a recovery was possible. Distraught but determined, she committed fully to her physical therapy plan, as well as a rigorous conditioning program, and made the team. They’d win a silver medal that year, and a bronze four years later. She was later inducted into the USA Water Polo Hall of Fame.

Beauregard’s experience with physical therapy in the midst of her Olympic career ultimately played a big role in her professional career.

“I was not the perfect patient, but it prepared me for being a physical therapist because it gave me an idea of asking only what is reasonable of my teen and young adult patients,” she says. “I really do understand their worry of not being able to get back to the top level in their sport, but also weighing the risks of not wanting to cause further or permanent injury.”

Growing up in Southern California, Beauregard loved to be outdoors and was always active. Having an older brother who was also athletic made her competitive, too. She started swimming competitively for a local club team on her fourth birthday simply because her brother swam, and she wanted to be as a good as he was. Water polo came into play just four years later, and by age 8 she joined a competitive club team.

But when she got to high school, there was no girls’ varsity team. Instead of giving up on her passion, she simply joined the boys’ team instead. Playing with the boys didn’t faze her, or them, since they’d been competing together for almost a decade by that point. When opponents made comments about playing with a girl, she channeled it into her game and used it as fuel to play even harder.

olympics

After high school, she attended UCLA to play water polo, and originally planned on becoming an orthopedic surgeon. She later changed her path to physical therapy, which would ultimately give her a different kind of interaction with patients and athletes.

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Physical Therapy Increases Independence in Kids

In honor of National Physical Therapy Month, we spoke to Lauren Bojorquez, PT, DPT, who has been a physical therapist at CHOC Children’s for six years. She works with children with neurodevelopmental diagnoses, as well as patients with orthopedic diagnoses, and has expanded her practice to include the post-concussive population, oncology population, aquatic therapy, and inpatient acute coverage. Lauren is mom to two young daughters and enjoys keeping active by competing in sprint triathlons.National Physical Therapy Month

Q: Why did you want to work at CHOC?

A: This is my dream job! I work here at CHOC Rehab because I have always felt like I was called to work with children in my career. I love helping kids get back to the highest level of function they possibly can in order to make them more independent and have a better quality of life, and I love the team we have here in Rehab!

Q: What made you want to become a physical therapist?

A: I had a teammate in softball that tore her ACL [anterior cruciate ligament, a common knee injury] in her senior year of high school while we were playing together.  She received physical therapy and returned to sport in time to get a full-ride scholarship to college. I thought it was awesome that she was able to get back to what she loved to do, so I decided that was wanted I wanted to do for my career, and never looked back.

Q: What part of being a physical therapist are you most passionate about?

A: I’m most passionate about working with the kids with an oncology diagnosis here. They amaze me every day how they can go through such hard times, but when you can find what they are motivated by, they make such quick and fantastic progress here at CHOC, and they are so happy when they find their way back to doing what they love to do.

Q: What is unique to being a physical therapist, as opposed to other specialties?

A: The time we get to spend with each patient and family as a PT here at CHOC is 45 minutes to an hour of one-on-one time, one to two times per week. I think that makes it a really special bond with each child, and therefore it is a great job to have.

Q: What else should people know about physical therapy at CHOC?

A: I think that one thing that people do not know about physical therapists is the knowledge base we have. It is now required to have your doctorate to be a physical therapist. Each one of my co-workers is so smart and digs so deep to ensure that we have a good base of knowledge in neurology, orthopedics, cardiopulmonary, and integumentary systems, so that we can give our kids here at CHOC the best treatment possible. We have an amazing team that truly gives their whole heart to CHOC Rehab, and I’m proud to be a part of it.

Learn more about CHOC Children’s Rehabilitation Services.

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