Kid's Health Archives - Elevate Medical

At least 70 percent of America's 30 million elementary school students use computers, according to a recent New York Times article. As a result of this increased usage, doctors of chiropractic are treating more young patients suffering from the effects of working at computer stations that are either designed for adults or poorly designed for children. Many children are already suffering from repetitive motion injuries (RMI) such as carpal tunnel syndrome and chronic pain in the hands, back, neck and shoulders.

A recently published study conducted by a team of researchers from Cornell University found that 40 percent of the elementary school children they studied used computer workstations that put them at postural risk. The remaining 60 percent scored in a range indicating "some concern."

"Emphasis needs to be placed on teaching children how to properly use computer workstations," stated Dr. Scott Bautch, past president of the American Chiropractic Association's Council on Occupational Health. "Poor work habits and computer workstations that don't fit a child's body during the developing years can have harmful physical effects that can last a lifetime. Parents need to be just as concerned about their children's interaction with their computer workstations as they are with any activities that may affect their children's long-term health," added Dr. Bautch.

What can you do?

To reduce the possibility of your child suffering painful and possibly disabling injuries, the American Chiropractic Association (ACA) and its Council on Occupational Health offer the following tips:

f children and adults in your home share the same computer workstation, make certain that the workstation can be modified for each child's use.
Position the computer monitor so the top of the screen is at or below the child's eye level. This can be accomplished by taking the computer off its base or stand, or having the child sit on firm pillows or phone books to reach the desired height.
Make sure the chair at the workstation fits the child correctly. An ergonomic back cushion, pillow or a rolled-up towel can be placed in the small of the child's back for added back support. There should be two inches between the front edge of the seat and the back of the knees. The chair should have arm supports so that elbows are resting within a 70- to 135-degree angle to the computer keyboard.
Wrists should be held in a neutral position while typing - not angled up or down. The mousing surface should be close to the keyboard so your child doesn't have to reach or hold the arm away from the body.
The child's knees should be positioned at an approximate 90- to 120-degree angle. To accomplish this angle, feet can be placed on a foot rest, box, stool or similar object.
Reduce eyestrain by making sure there is adequate lighting and that there is no glare on the monitor screen. Use an antiglare screen if necessary.
Limit your child's time at the computer and make sure he or she takes periodic stretch breaks during computing time. Stretches can include: clenching hands into fists and moving them in 10 circles inward and 10 circles outward; placing hands in a praying position and squeezing them together for 10 seconds and then pointing them downward and squeezing them together for 10 seconds; spreading fingers apart and then closing them one by one; standing and wrapping arms around the body and turning all the way to the left and then all the way to the right.
Your child's muscles need adequate hydration to work properly and avoid injury. Encourage your child to drink four 8-ounce glasses of water a day. Carbonated beverages, juices and other sweet drinks are not a substitute.
Urge your child's school or PTA officials to provide education on correct computer ergonomics and to install ergonomically correct workstations.

"If your child continues to complain of pain and strain from sitting at a computer, see a doctor of chiropractic," urges Dr. Bautch. "A chiropractor can help alleviate your child's pain and help prevent further injury."

The growing awareness of safe driving and state safety laws have alerted the general public and parents to the importance of using car seats for their small children whenever and wherever they are driving. Most states require the use of car seats for children under the age of 4 and weighing less than 40 pounds. However, these safety rules aimed at protecting children may cause serious neck and spinal injuries and can even be deadly if the child car seats are used incorrectly.

The American Chiropractic Association (ACA), its Council on Occupational Health and ACA member Dr. Michael Freeman, trauma epidemiologist and clinical assistant professor of public health and preventive medicine at the Oregon Health Sciences University School of Medicine, have developed the following general guidelines and safety tips to ensure proper car seat safety.

Make sure the child safety seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
Car seats for infants should always be rear facing as the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with air bags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.
The lap harness should be fastened low, as close to the hips as possible; the harness should never be fastened around the waist.
Make certain the shoulder harness is fastened securely and the straps lay flat against the body. Twisted straps can cause additional injury that might prevent the seat from working properly.
Use a retention clip (if provided by the manufacturer) when securing a child safety seat with the shoulder harness. The retention or shoulder harness clip is an added safety feature and must be fastened close to the armpit of the infant or child.
Borrowing or purchasing a used car seat can be dangerous; there is the possibility of unknown or undetected damage. Car seats that have been in a serious accident should never be used again.
Be sure the seat meets federal motor vehicle safety seat standards. Consult the owner's manual or contact the manufacturer for that information. All car seats should have an owner's manual and instruction booklet.
Be sure the clip between the legs of the child is fastened snugly.

While car accidents can be dangerous for all passengers, small children are especially at risk, according to Dr. Scott Bautch, past president of ACA's Council on Occupational Health. "The weight of the head of a child makes the cervical spine much more vulnerable to injury," Dr. Bautch explained. "The infant has little control in the muscles of the neck, and the head can bounce from side to side and fall forward, which can cause serious spine and neck injuries. Children have more flexible upper bodies and shoulders. Make sure the harness comes up, way up, over the shoulders."

Underscoring the importance of proper car seat use, a recent article in Nation's Health reported the findings of a study conducted in Kentucky by the Centers for Disease Control and Prevention. The study found a 37 percent drop in infant fatalities since the 1982 enactment of the state law mandating the use of child car seats. "To continue this decline, prevention efforts now must focus on the proper use of the seats to maximize their life-saving potential," the researchers said.

The key when traveling with small children is to be aware of and follow these rules and tips to ensure proper car seat safety. And remember everyone: Buckle up!

If you or one of your children have been involved in a serious automobile accident and have experienced neck and back discomfort, you should consider a visit to a chiropractor.

Kids get hurt all the time. They're running, they're jumping, they're crashing into things. Kids want to have fun, and when they play, they play full-out.

So, when kids play real sports, stuff happens.1,2 Whether your kid plays soccer, baseball, football, or studies karate, a broken bone, sprained ankle, or twisted knee is just the natural fallout of learning new skills and having a good time.

The treatment for most childhood sports injuries is straightforward and standard.3 For strains and sprains that involve only mild to moderate swelling and pain, the time-honored RICE protocol is followed - rest, ice, compression, and elevation.

Pediatric orthopedists get involved when the injury is more severe or when an arm or leg bone is broken.

But there are other issues, and every parent needs to be aware of these possibilities. In one of the unusual chains of circumstances that make the practice of medicine and the practice of chiropractic so interesting, a physical trauma (like a sports injury) can reveal an underlying serious problem.

In other words, various disorders of bone may not show themselves in terms of symptoms until a physical trauma makes them apparent. Such problems include metabolic disorders, growth and development problems, and even benign and malignant tumors.

What would make a parent suspect such an issue? First, if the child's pain seems out-of-proportion to the degree of injury. A mild knee sprain - for example, caused by tripping over second base while trying to stretch a double into a triple - should not be causing significant pain.

Also, mild-to-moderate injuries should not be warm to the touch. A parent can evaluate this. And, a child should not be running a fever after an activity-related injury.

It would also be suspicious if the pain did not improve daily. For the majority of injuries, pain that lingers beyond several days suggests an underlying problem. Children are resilient. Healthy kids heal quickly. They want to shrug off an injury, forget it happened, and get back to playing.

If your child isn't getting better in a few days, seems lethargic, or feels ill following an injury, warning bells should go off.

Your family chiropractor is familiar with all such conditions and scenarios. He or she is always alert to unusual situations and will recommend the appropriate steps to take, including a complete physical and x-ray examination. If necessary, your chiropractor will be able to recommend appropriate specialists for follow-up, including hematologists, endocrinologists, and pediatric orthopedists.

These more serious problems are uncommon. And, of course, well-informed parents help their kids grow up healthy and strong.

¹Caine D, et al: Incidence and distribution of pediatric sports-related injuries. Clin J Sport Med 16(6):500-513, 2006
²Emery CA: Risk factors for injury in child and adolescent sport: a systematic review of the literature. Clin J Sport Med 13(4):256-268, 2003
³Demorest RA, Landry GL: Prevention of pediatric sports injuries. Curr Sports Med Rep 2(6):337-343, 2003

Kids can get checked, too. Do kids need regular blood pressure check-ups or regular tests of their blood glucose levels? Probably not - these simple procedures can be done during a child's annual physical. But kids are very active and more frequent chiropractic check-ups are usually a good idea. Most of us were introduced to chiropractic care when we were adults - and we had to play catch-up for however long a period of time before we really began to feel healthy again. If we began chiropractic care as a younger adult, it probably didn't take too long to restore good health. If we were older - well, the process probably took more time.

If chiropractic care is valuable for you, imagine how valuable it is for your children. Kids are natural explorers - they run, jump, climb things, fall down, and bounce around. And, kids are resilient - this ability to recover quickly is one of the great benefits of being very young. Occasionally, one of these activity-related injuries impacts a child's spine. Nothing obvious has happened and nothing hurts. But there may be subtle injuries to spinal muscles and spinal ligaments that have a long-term effect on spinal nerve function.

Spinal nerve function depends on mechanical integrity of the spine itself. If spinal muscles and ligaments are inflamed or irritated, spinal nerve function is compromised to a greater or lesser extent. In a child, the short- and long-term results may include muscle pain and stiffness, loss of full range of motion in the neck or lower back, frequent colds, headaches, gastrointestinal problems, allergies, and asthma. Of course, when it comes to good health for you and your family, preventing a problem is much easier than treating a problem. In the long run, prevention also costs much less. We all want our kids to be healthy and well. We want them to play full-out, to engage in all kinds of sports, and to have a lot of fun. In order for children to continue to enjoy optimal health, regular spinal check-ups are as important as an annual physical exam. Your local chiropractor is the spinal health expert in your community. She will be glad to help you ensure your child's continued good health.

¹Barkley JE, et al: Reinforcing value of interval and continuous physical activities in children. Physiol Behav April 16, 2009
²Fecteau D, et al: The effect of concentrating periods of physical activity on the risk of injury in organized sports in a pediatric population. Clin J Sport Med 18(5):410-414, 2008
³Spinks AB, McClure RJ: Quantifying the risk of sports injury: a systematic review of activity-specific rates for children under 16 years of age. Br J Sports Med 41(9):548-557, 2007

American kids are under tremendous pressure to perform well in school. Every year they're required to take more and more standardized tests, and every year they fall further behind children around the world, particularly in science and mathematics.More is required to do well in school beyond sitting in the classroom and managing to stay awake throughout the day.

Kids by nature want to learn, but somehow this love of new knowledge and new experiences is sucked out of them early on. Many teachers no longer teach to broaden the skills and abilities of their students. Instead they teach to the standardized tests. There's no longer much room for exploring new territory, and kids get bored easily and stay bored if they're not challenged.

How can we help our children when the educational system does not provide the formula to engage many kids? Making sure our kids are healthy and well is a very good start. One of the most interesting developments in cognitive science (how people learn) in the last ten years is the importance of physical activity in relation to human performance. The results are in - research proves that physical activity is highly correlated to learning and academic achievement. Active kids are explorers. Active kids are alert and interested in what's going on around them. Active kids have an instinctive desire to grow and develop.

What kinds of exercise should our kids be doing? The great news is that the specific type of exercise doesn't matter. It's all good, whether a kid is playing soccer, running track, or riding around the neighborhood on her bike. It's the amount of exercise that counts, not the format of the exercise. Federal agencies recommend that every child get an hour of physical activity each day. This hour can be broken up into small segments or done all at once. What matters is the amount and consistency of the exercise.

Chiropractic care can play a big role in a child's development. Periodic chiropractic treatment can improve the functioning of a child's musculoskeletal system, and thus help improve their physical performance. And, chiropractic care can help a child recover quickly from activity- and sports-related injuries.

By helping a child continue with fun, enjoyable, and rewarding physical activities, chiropractic care is also helping them improve their academic performance. The result is a much more well-rounded young person, one whose interests may extend from the ball field to the science lab to the music room.

¹Hillman CH, et al: The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent chiildren. Neuroscience 159(3):1044-1054, 2009
²Ploughman M: Exercise is brain food. The effects of physical activity on cognitive function. Dev Neurorehabil 11(3):236-240, 2008
³Davis CL, et al: Effects of aerobic exercise on overweight children's cognitive functioning. Res Q Exerc Sport 78(5):510-519, 2007

We are constantly searching the landscape for heroes. This is not to fill in a missing piece in ourselves, but rather represents an ongoing search for inspiration, stimulation, and motivation. Even those of us who are self-starters need coaches and mentors to cause us to reach ever-higher levels of achievement. In this, we all need support. We all need guidance. We all need fresh perspectives.

Children, in particular, need guidance. Kids need rules. Kids need structure. Usually, a child's parents are her leaders or role models. Other relatives, teachers, peers, and older kids may also fill these roles.

Let's consider parents, relatives, and teachers - the adults in a kid's environment. In America, one-third of all adults are obese. An additional one-third of adults are overweight. Almost one-half of American adults do not do any vigorous physical activity. Three-quarters of adults do not get enough physical activity to meet public health recommendations.

The awful bottom line is that the majority of Americans are out-of-shape and overweight or obese. These adults are the role models for their kids. The result is that one-third of American children are overweight or obese.¹ Juvenile diabetes is an epidemic that is getting worse every year. Type 2 diabetes, previously rare in young people, is now a commonly recognized diagnosis in kids. Hypertension is increasing in prevalence in teenagers.

We're in the midst of a healthcare disaster. Diabetes and obesity are twin raging epidemics endangering the health and welfare of our nation's young people. In New York City, by the age of 4, there is a one in three chance that the child will be obese. More than 40% of children are at an unhealthy weight at ages 2 and 3. National statistics are similar.²

Type II diabetes, long known as "adult-onset diabetes", is now being recognized as a significant juvenile disorder. Up to 45% of the children diagnosed with diabetes have the type II form. And the numbers keep increasing. Additionally, studies demonstrate that almost two-thirds of American kids aged 9 through 13 do not participate in any organized physical activity during non-school hours. Twenty-five percent do not engage in ANY free-time physical activity.

Kids mimic the habits of their parents or other significant adults. If the adults eat cheeseburgers and fries three times a week, so will the kids. If adults don't eat fresh fruits and vegetables, neither will the kids. Also, if kids see their parents putting on more and more weight, they will put on more and more weight. If adults spend no time exercising, neither will the kids.

Luckily, the converse is also true, and this is where parents can become heroes to their kids - literally, saving their kids' lives. If kids see their parents choosing healthy behaviors and being positive and supportive about doing so, kids will begin to choose those healthy behaviors, too. Let's start to teach our kids that exercise can be fun.^3,4 Strength training, aerobic exercise, core exercises can all be incorporated into family games and fitness activities. Also, let's start to teach our kids that healthy eating can be fun - nurturing as well as nutritious. Shopping, cooking, and mealtimes can all become key components of a healthy family lifestyle.

All children need the love and support and guidance of the important adults in their lives. It's up to us, those important adults, to really BE the role models kids so desperately need and want.

¹Berman LJ, et al: Physical activity is related to insulin sensitivity in children and adolescents, independent of adiposity: a review of the literature. Diabetes Metab Res Rev

2012 March 2 [Epub ahead of print]

²Fagot-Campagna A: Emergence of type 2 diabetes mellitus in children: Epidemiological evidence. Journal of Pediatric Endocrinology and Metabolism 13(Suppl 6): S1395-S1402, 2000.

³Feda DM, et al: Effect of increasing the choice of active options on children's physically active play. J Sci Med Sport 2012 February 16 [Epub ahead of print]

⁴Ekelund U: Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. JAMA 307(7):704-712, 2012

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