Pediatric Rehabilitation Medicine
At Mount Sinai, our pediatric rehabilitation medicine team understands that every child is unique, and so are their needs when it comes to physical rehabilitation and well-being. We see children with a broad range of conditions, from common sports injuries to complex neuromuscular disorders. Under the leadership of David Cancel, MD, JD, our team of rehabilitation specialists, including Physical and Occupational Therapists, are here to provide compassionate and expert care to help your child reach their full potential and well-being.
Whether your child has a sports injury, an accident, or one of the many conditions that affect posture or walking, we can develop a personalized care plan for your child.
Pediatric Sports Injuries | Concussion and Brain Injuries | Musculoskeletal and Orthopedic Injuries
Many injuries, thankfully, aren’t severe and rehabilitation therapy and medications can help your child fully recover. We have special expertise in concussions, their aftermath, and treatment for young patients. For many children, the ability to perform and focus in school is just as important as returning to sports. We pay equal attention to the cognitive effects of injuries as the physical aspects.
Unfortunately, we know that life-changing accidents also happen. While this can be overwhelming, we can help develop a strategy for recovery. At every phase of your child’s progress, you’ll have state-of-the-art pediatric rehabilitation medical treatment working for you and your child. We also can help connect you with other Mount Sinai specialists and outside resources, as needed.
Walking (Gait) Abnormalities
Children can develop a variety of walking abnormalities including intoeing (“pidgeon toes”), bowlegs, or toe walking (“walking on tiptoes”). Sometimes, some muscles may be overly tight or neurological conditions such as autism may affect gait. In many cases, these conditions resolve on their own without intervention. However, a physical exam and diagnostic imaging may be necessary to determine the cause. Close monitoring can determine whether treatment is needed. Non-surgical interventions may range from physical therapy to Botulinum toxin injections. (Botox is a brand name, so we’re probably not allowed to legally call it by that name)
Scoliosis is an abnormal curvature of the spine. There are many different causes, and it can develop over time or be present from birth. It can also be associated with other neurological disorders, such as cerebral palsy or spinal bifida. The most common forms of scoliosis can be treated with physical therapy or bracing. In severe cases, surgery may be indicated.
Torticollis or Wryneck
Stiff or mal-aligned neck muscles can cause a baby’s neck to turn the head to one side. This condition, called torticollis or wryneck, can happen during development or be present from birth. Early treatment can include physical therapy and stretching exercises at home.
Plagiocephaly is a condition where a child’s head becomes flattened in one area. Children’s skulls are very moldable, and sometimes sleeping in one position can cause this condition. Making sure the child varies their sleep position can often let the skull resume its proper shape. In more severe cases, however, sometimes special headwear may be used to allow the skull to reshape itself.
Neuromuscular or Developmental Conditions
Sometimes children are born with or develop neuromuscular conditions that affect the nerves and muscles of the body. The most common symptoms include muscle weakness, tightness of the muscles (spasticity), difficulty with movement or even pain. Treatments for this, as well as the following conditions, may include ultrasound guided chemodenervation (injections with Botulinum toxin or alcohol/phenol), baclofen pump management or physical therapy. If assistive devices are needed, we provide evaluations for braces, orthotics, prosthetics, and wheelchairs.
Cerebral palsy is the most common cause of neuromuscular movement disorders in children. It results from an injury to the infant brain. This affects the neurological pathways that create, control, and coordinate movement and posture. Common issues in cerebral palsy include increased muscle tone (spasticity), hip abnormalities and scoliosis.
There are several types of spinal bifida. What they all share is a defect in the fetal neural tube, resulting in an incomplete closure of the developing spine. At times the brain can also be affected. The severity varies greatly. In severe cases, the spinal cord and nerves exit through the defect. Care as your child grows is complex, and the Pediatric Rehabilitation Medicine team works together with the Comprehensive Neuromuscular Care Clinic, bringing all the needed specialists together at one time.
Muscular dystrophies are a group of genetic disorders which affect the muscles of the body. This can progress as the child grows. Symptoms may be present at birth or appear later in life. This can result in loss or failure to reach developmental milestones. Muscle weakness can progress at different rates. All children with muscular dystrophy should have a multi-disciplinary care team, and the Pediatric Rehabilitation Medicine team is an important partner in this team of specialists.
There are a broad spectrum of genetic syndromes that can cause motor difficulties. These include Down syndrome (Trisomy 21), Autism Spectrum Disorder, Ehlers-Danlos Syndrome, and many others. The complexity of these disorders and the vast array of symptoms require personalized treatment and a team of specialists. Our team has deep expertise in treating these disorders and coordinating with other needed specialists.
Difficulty in speaking or slow development of speech can be due to a wide variety of environmental, neuromuscular or genetic issues. Conditions that can contribute to difficulty in speech include Apraxia, Autism, Cerebral Palsy and hearing loss. Many children with speech delays also have issues with motor skills that affect coordinating movement of the lips, tongue, and jaw to produce words. This can also result in feeding difficulties. Speech and Feeding therapy may be one of the tools we use to treat these difficulties.
Why Choose Us?
Our team of pediatric physiatrists has years of experience treating children with a broad spectrum of physical and developmental challenges. Because we understand that every child is an individual, we tailor our treatment plans to meet the specific needs and goals of your child.
We treat every child and family with compassion, respect, and understanding. Your child's well-being is our top priority. We work closely with other physicians, health care providers, therapists and specialists to ensure your child receives comprehensive care.
We believe in involving families in the treatment process and providing the necessary support and resources for parents and caregivers. We are committed to helping your child overcome their physical challenges and achieve the best possible quality of life.