| Screen time: Overview | Screen time: Overview | Screen time: Overview | S | English | Prevention | Baby (1-12 months);Toddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | NA | NA | Healthy living and prevention | Caregivers
Adult (19+) | NA | | 2016-07-18T04:00:00Z | | | | | | 10.0000000000000 | 56.8000000000000 | 1097.00000000000 | | Flat Content | Health A-Z | <p>Find out how much screen time your child should have each day and how screen time affects your child’s health and wellbeing.</p> | <h2>What is screen time?</h2><p>Screen time is the amount of time your child spends using a device that has a screen. It includes time spent watching television, browsing the internet, using a cell phone and playing video games. But regardless of the device, most screen time limits a child’s opportunities to get active outside the home. Over time, this low level of
<a href="/Article?contentid=642&language=English">physical activity</a> can threaten their health.<br></p> | | <h2>Key points</h2>
<ul>
<li>Screen time is the amount of time your child spends using a device that has a screen such as a TV, computer, games console, tablet or smartphone.</li>
<li>The recommended amount of screen time depends on a child’s age. Children under two should not have any screen time and those under aged five and under should have less than two hours a day.</li>
<li>Spending too much time in front of a screen can negatively impact your child’s mental health. Signs include feeling sad, overly tired, withdrawn or uninterested in other activities.</li>
</ul> | <p>The technology children have access to today is changing their world and providing them with endless opportunities. The downside is that it is very easy for children (and even adults) to experience an overload of information and forget about other fun and healthy activities.</p><p>Recent research from the Healthy Active Living and Obesity Research Group in the Children’s Hospital of Eastern Ontario indicates that Canadian school-aged children spend 65 to 80 percent of their waking hours engaging in sedentary behaviour. Another study found that Canadian children and youth aged six to 19 spend 62 percent of their waking hours being sedentary.</p><p>Together, these studies show that most young children engage in activities that involve little physical movement or use of energy. This pattern can be partly explained by the increasing amount of screen time in our daily lives.</p><h2>How screen time affects physical and mental health</h2><p>Screen time has been linked to lower levels of physical fitness and problems with mental health and social development.</p><ul><li>Children who spend more time in front of a screen tend to have higher obesity rates than children who spend less time in front of a screen.<br></li><li>Children and teens who watch more than two hours of TV a day have lower scores of self-esteem.</li><li>Higher levels of screen time have been linked to lower school performance, partly because those who watch more TV tend to spend less time on homework.<br></li><li>Screen time can sometimes encourage unhealthy eating habits. For instance, if your child is distracted by a television show or video game while they eat, they may not be able to recognize when they are full. It is also easy for your child to associate screen time with enjoying a favourite food.</li></ul><p>While active video games are advertised as a good way to encourage physical activity, children and teens quickly learn how to play using minimal gestures (for example using wrist movement only). This greatly reduces the amount of energy they use.</p><h2>How much screen time is ‘too much’?</h2><p>Daily screen time recommendations largely depend on the age of the child. The Canadian Paediatric Society and the Canadian Society for Exercise Physiology (CSEP) recommend the following daily limits.</p><ul><li>Children under age two: no screen time</li><li>Children aged two to four: less than one hour a day of screen time</li><li>Children and teens aged 5 to 17: maximum of two hours a day of recreational screen time (watching television, messaging friends or playing computer games)</li></ul><p>Screen time is an important and unavoidable part of your child’s life, especially as they get older. For instance, older children may need to spend more time on a computer to complete homework or on their phone to stay in touch with friends. There are also different types of screen time: using a phone or computer to video call a family member has a different effect on a developing brain than watching a stream of videos.<br></p><p>Associations such as the American Academy of Pediatrics have considered the growing presence of technology from the early years. Rather than set daily limits by age group, its recommendations now focus on the role of parents to set limits, use their judgment about the quality of screen time and model healthy behaviour. It is likely that more research into screen time will be needed as technology continues to evolve.</p><h2>How to calculate your child’s current daily screen time</h2><p>Calculate the time your child spends looking at a screen on a normal day by adding up the time on the activities in the table below from when your child wakes up until they go to bed. When you have the total time, you can decide if you need to
<a href="/Article?contentid=644&language=English">set limits on screen time</a> and encourage your child to spend more time on other activities.<br></p><table class="akh-table"><thead><tr><th>Screen time activity</th><th>Examples</th></tr></thead><tbody><tr><td>Watching television</td><td><ul><li>Watching cartoons, reality shows, sports, documentaries, news, game shows, talk shows, movies</li></ul></td></tr><tr><td>Using the internet</td><td><ul><li>Watching videos</li><li>Watching streamed TV shows or movies</li><li>Instant messaging</li><li>Downloading music</li><li>Playing online games</li><li>Using social media websites and apps<br></li></ul></td></tr><tr><td>Using a computer or tablet</td><td><ul><li>Reading or writing documents</li><li>Playing a computer game</li><li>Creating a drawing in a computer program</li><li>Browsing or editing photos</li><li>Listening to or organizing music files</li><li>Writing computer programs</li></ul></td></tr><tr><td>Using a cell phone or smart watch</td><td><ul><li>Reading and writing text messages</li><li>Playing games</li><li>Using apps</li><li>Listening to music</li></ul></td></tr><tr><td>Playing games</td><td><ul><li>Using a gaming station</li><li>Using a children's camera with built-in games</li></ul></td></tr></tbody></table><h2>How to tell if your child has too much screen time</h2><p>Screen time becomes unhealthy when your child is glued to a screen for most of the day. If your child’s screen time falls outside the recommended limits for their age, you may notice some telltale signs.</p><p>Children and teens who spend too much time in front of a screen may seem:</p><ul><li>lonely</li><li>sad</li><li>overly tired</li><li>stressed or fearful</li><li>isolated from friends or family</li><li>withdrawn</li><li>nervous</li><li>agitated or tense</li><li>aggressive or angry.</li></ul><p>They may also experience emotional outbursts and have difficulties making and keeping friends.</p><p>Some children also have difficulties concentrating and lose interest in school, following rules or doing other activities. The lack of physical activity that results from too much screen time can also cause frequent back pain, headaches or stomach aches.</p><p>Some of these issues may have causes other than excessive screen time. See your child’s doctor if you have any concerns about your child’s physical or mental health.<br></p><h3>What to do about screen time and tantrums<br></h3><div class="asset-video">
<iframe src="https://www.youtube.com/embed/xbfSMpyphAw" frameborder="0"></iframe><br></div><p>For more videos from SickKids experts in collaboration with Youngster, visit <a href="https://www.youtube.com/channel/UCoKMd2cYwegtZX19uHdNLQA">Youngster on YouTube</a>.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/screen_time_overview.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/screen_time_overview.jpg | Screen time | | Main | | |
| Acne (acne vulgaris) | Acne (acne vulgaris) | Acne (acne vulgaris) | A | English | Dermatology | Pre-teen (9-12 years);Teen (13-18 years) | Skin | Skin | Conditions and diseases | Caregivers
Adult (19+) | NA | | 2015-01-14T05:00:00Z | | | | | | 8.20000000000000 | 58.5000000000000 | 1522.00000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Acne is the most common skin condition in teens. Discover the different types and causes and how they can be treated.<br></p> | <p>Acne, clinically known as acne vulgaris, is the most common skin disease. It affects 85% of teenagers, some as young as 12, and often continues into adulthood. It is also called "pimples," "zits" or "blemishes".</p> | | <h2>Key points</h2><ul><li>Acne vulgaris is the most common skin disease in teenagers.</li><li>Acne occurs deep within the skin, and severity and outcomes vary from person to person.</li><li>Acne causes comedones (whiteheads and blackheads), papules, pustules or even nodules.</li><li>Picking, squeezing and popping can lead to scarring.</li><li>Acne is manageable with the appropriate treatment. Ask your doctor or your dermatologist about your options.<br></li></ul> | | | <h2>What causes acne?</h2>
<figure>
<span class="asset-image-title">Anatomy of the skin</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_skin_anatomy_EN.jpg" alt="Identification of a hair, sebaceous gland, sweat gland and blood vessels in the skin" />
<figcaption class="asset-image-caption">Acne occurs when the sebaceous glands produce more oil, clogging different parts of skin tissue.</figcaption> </figure>
<p>The skin is formed by many layers of tissue, containing hair, glands, muscles, sensory receptors and blood vessels. During puberty, a group of hormones are released called androgens. Androgens allow the sebaceous glands in the skin to produce an oily substance called sebum. Acne is in part caused by this increase in sebum that naturally occurs during puberty.<br></p><p>Normal amounts of sebum keep skin and hair from drying out. However, excess oil can mix with dead skin cells and clog hair follicles (the tiny tunnels that lead to the root of the hair) and pores (the opening in the skin where the hair passes through).</p><p>A common type of bacteria that lives on the skin, known as
<em>Propionibacterium acnes</em>, sometimes contributes to acne by causing inflammation. The acne signals white blood cells to the area, which damage the tissue and cause an inflammatory response. This causes swelling and infection.</p><p>Acne leads to persistent redness and inflammation, especially on the face, scalp, back and chest, where the most sebum is produced.</p><p>Acne varies from mild to severe, depending on what kind of blemishes appear. The different types of acne include:<br></p><ul><li>comedones</li><li>papules</li><li>pustules</li><li>nodules</li></ul><p>Comedones are pores that are blocked with oil and dead skin cells. They can be open ("blackheads") or closed by the skin ("whiteheads").</p><p>A blackhead is generally level with the skin surface and cannot be removed by normal washing of the face.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Open comedo (blackhead)</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_blackhead_EN.png" alt="Cross section of skin with an oxidized sebum, which appears black at the top, and a surface view of skin with blackheads" />
<figcaption class="asset-image-caption">The pore of a blackhead is open. When the sebum comes into contact with the air, oxygen exposure causes it to appear black.</figcaption></figure>
<p>A whitehead is slightly raised from the skin, but there is no inflammation.</p>
<figure class="asset-c-80"><span class="asset-image-title">Closed comedo (whitehead)</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_whitehead_EN.png" alt="Cross section of skin with a trapped sebum and clogged pore, and a surface view of skin with whiteheads" /><figcaption class="asset-image-caption">A whitehead is formed when pores are blocked with sebum and dead skin cells. The pore in a whitehead is not open at the top.</figcaption> </figure>
<p>Papules are red, small, hard bumps that are slightly raised on the skin. In clusters, they can feel like sandpaper to the touch. White blood cells enter the follicle, causing inflammation.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Papule</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_papule_EN.png" alt="Cross section of skin with inflammation and white blood cells around sebum, and surface view of skin with papules" />
<figcaption class="asset-image-caption">Papules are red, painful bumps caused by inflammation of the hair follicles.</figcaption></figure>
<p>When the white blood cells in a papule make it to the surface of the skin, a pustule is formed. Pustules appear as red, inflamed circles with a central, raised bump that is yellowish or white. The bump is filled with pus. Pus is the result of inflammation and contains white blood cells, dead skin cells and bacteria.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Pustule</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_pustule_EN.png" alt="Cross section of pus under the skin and white blood cells that have moved toward the surface, and surface view of pustules" />
<figcaption class="asset-image-caption">Pustules form a few days after the white blood cells in a papule make it to the surface of the skin. Pustules are typically called "pimples" or "zits".</figcaption></figure>
<p>When a papule or pustule expands, it can cause more severe inflammation in the surrounding skin. This can lead to nodules, which are deep, red, round bumps that can have a diameter of 6 to 20 mm. They are sometimes referred to as cysts.</p><p>Nodules are formed by irritated, inflamed hair follicles that have ruptured deep under the skin. They can be throbbing and painful, even without touching.</p>
<figure class="asset-c-80">
<span class="asset-image-title">Nodule</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_acne_nodule_EN.png" alt="Cross section of pus and inflammation under the skin with large swollen bump on skin surface, and surface view of nodule" />
<figcaption class="asset-image-caption">Nodules are often large, inflamed, red, swollen and painful to the touch.</figcaption></figure> | | | <h2>Psychological impact of acne</h2>
<p>Acne can have a profound impact on a person's quality of life, particularly for teenagers. Reactions can range from minimal distress to more significant depression, anxiety and, less commonly, thoughts of suicide or self-harm. For these reasons, treating acne matters.</p>
<h2>Treatment of acne</h2>
<p>Treatment depends on the severity and type of acne. An effective treatment will help reduce future breakouts and improve the skin's appearance. Keep in mind that up to six weeks of treatment might be necessary to start noticing results.</p>
<p>In most cases, your doctor or dermatologist will prescribe topical treatments (applied directly on the skin). Sometimes the doctor may prescribe an oral treatment (taken by mouth).</p>
<h3>Cleansing skin</h3>
<p>Acne is a process deep within the skin. Washing your face regularly helps remove dead skin cells and excess oil, but does not play a significant role in the prevention or management of acne.</p>
<p>If you have acne, avoid scrubbing your face when washing, because this may worsen inflammation and irritation. Instead, gently wash your face with warm water. You may also use a mild cleansing product if you want.</p>
<h3>Topical retinoids</h3>
<p>Topical retinoids unplug comedones and improve the process of shedding the old cells. They may also help reduce any inflammation.</p>
<p>Some side effects may occur when using a topical retinoid. These include mild irritation, redness (erythema), dryness, peeling and sensitivity to sun. If you are pregnant, or thinking about having a baby, talk to your doctor or dermatologist before using a topical retinoid, as they should not be used during pregnancy.</p>
<p>Avoid skin damage, such as waxing or exfoliation (e.g., facials) when taking retinoids.</p>
<p>Common topical retinoids are available in cream and gel form. There are benefits to both creams and gels, depending on the severity of acne and the sensitivity of your skin. Retinoids are also available in many strengths and formulations. Therefore, there is no one better option; your doctor will recommend a retinoid most appropriate for you.</p>
<h3>Topical antimicrobials</h3>
<p>Topical antimicrobials are used to kill bacteria that contribute to inflammation. They also help fight inflammation directly. One option is benzoyl peroxide, which is available over the counter. When benzoyl peroxide touches the skin, oxygen is created. <em>P. acnes</em> cannot survive in the presence of oxygen.</p>
<p>Use caution when applying benzoyl peroxide because it is a potent bleaching agent that can damage fabrics. The pharmacist can answer any questions you might have.</p>
<h3>Oral antibiotics</h3>
<p>An oral antibiotic (taken by mouth) is sometimes used to treat more significant acne, especially in cases where the acne has spread to the back and chest. Such as topical treatments, oral antibiotics reduce inflammation.</p>
<p>Antibiotics can also stop <em>P. acnes</em> from multiplying. However, the use of antibiotics should be limited because bacteria can develop a resistance to them.</p>
<h3>Combined treatment</h3>
<p>A combined treatment can be an effective means of treating acne. In this case, a topical retinoid and an antimicrobial cream or gel can be used together. Sometimes they are combined into one product, while other times they are used separately. For example, a topical antimicrobial may be applied in the morning and a topical retinoid may be used at night.</p>
<p>Oral medications are also used in combination with a topical treatment. Most people taking a pill benefit from a topical cream or gel.</p>
<p>Your doctor or dermatologist will advise you on how and when to use a combined treatment for acne.</p>
<h3>Oral isotretinoin</h3>
<p>Isotretinoin (known as Accutane in North America; Clarus and Epuris in Canada; and Roaccutane in Europe) is a chemical compound related to vitamin A. In most cases, isotretinoin is used to treat severe nodular and scarring acne because:</p>
<ul>
<li>it reduces sebum secretion</li>
<li>it prevents the formation of comedones</li>
<li>it acts as an anti-inflammatory</li>
<li>it stops <em>P. acnes</em> from generating in hair follicles and sebaceous glands</li>
</ul>
<p>However, this type of acne treatment must be closely monitored because isotretinoin has a number of side effects. More common side effects include dry skin, lips, nose and eyes. All side effects will begin to disappear when treatment stops.</p>
<p>However, there are more severe side effects. For example, isotretinoin can interfere with the development of a fetus. If you are pregnant or thinking about having a baby, talk to your doctor or dermatologist about the side effects of isotretinoin. There are also concerns about depression, inflammatory bowel disease and impact on liver.</p>
<h3>Hormonal therapy</h3>
<p>Treating acne with female hormones is an effective treatment option for some female patients. This means taking an oral contraceptive (the birth control pill). This type of treatment limits sebum secretion by reducing androgen levels. Other topical and oral treatments can be used along with oral hormonal therapy.</p>
<p>Treating acne using hormones is not for everybody. For more information, talk to your doctor or dermatologist.</p> | | | <h2>Scar prevention</h2>
<p>If left untreated, some acne can cause scarring. It is not always easy to predict which acne will cause scarring; it is a complex problem.</p>
<p>Handle acne with care. Manipulating, squeezing and popping increases the likelihood of scarring. The best way to prevent scarring is to actively treat the acne. Treatment is not only for those who have severe acne; no matter how little or how much acne you might have, you can seek treatment for your skin.</p> | | | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/acne_vulgaris.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/acne_vulgaris.jpg | | | Main | | |
| Babies: How can you tell if your baby is ill? | Babies: How can you tell if your baby is ill? | Babies: How can you tell if your baby is ill? | B | English | NA | Premature;Newborn (0-28 days);Baby (1-12 months);Toddler (13-24 months) | Body | NA | Healthy living and prevention | Caregivers
Adult (19+) | Diarrhea;Fever;Rash;Vomiting | | 2019-01-07T05:00:00Z | | | | | | 9.00000000000000 | 59.3000000000000 | 728.000000000000 | | Flat Content | Health A-Z | <p>Discover the physical and behavioural signs that your baby may be ill and learn when to take your baby to a doctor.<br></p> | <p>A change in behaviour is often a sign of illness in babies. If your baby is ill, they may cry more or have a change in activity level. </p> | | <h2>Key points<br></h2>
<ul>
<li>Fever is usually a sign that your baby’s body is fighting an infection.</li>
<li>One of the first signs of illness in babies is a change in behaviour such as being more sleepy or more fussy.</li>
<li>In newborn babies and young infants three months of age or under, fever may be the first and only sign of a serious infection. All babies less than three months of age with a fever should see a doctor right away.<br></li>
</ul> | <h2>When to see a doctor</h2><h3>See your child's doctor right away if you notice any of the following symptoms:</h3><ul><li>a
<a href="/Article?contentid=30&language=English">fever</a> (for babies 3 months old or younger) </li><li>cries inconsolably </li><li>listless or limp </li><li>has convulsions (<a href="/Article?contentid=1773&language=English">seizures</a>)</li><li>fontanelle, the soft spot at the top of their head, is starting to swell </li><li>pain </li><li>purple splotches on their skin, or another type of rash </li><li>pale or flushed </li><li>problems breathing </li><li>refuses to breastfeed or drink from a bottle </li><li>appears to have trouble swallowing </li><li>has not peed in many hours</li><li>has constant vomiting or the vomit has become dark green</li></ul><h2>Fever</h2><p>In newborn babies and young infants three months of age or under,
<a href="/Article?contentid=30&language=English">fever</a> may be the first and only sign of a serious infection. If you notice a temperature that is even just slightly above the normal range, bring your newborn baby to the doctor as soon as possible. A normal temperature is less than 38°C (100.4°F).</p><h2>Behaviour changes</h2><p>One of the first signs of illness in babies is a change in behaviour. The baby may cry more or have a change in activity level. Generally, if your baby is active when awake, feeding well, and can be comforted when crying, small differences in activity level or crying are normal. However, if your baby becomes very sleepy or fussy, it may be time to see a doctor. Fussiness and decreased energy may be signs that an illness is present.<br></p><h3>Decreased energy</h3><p>Sleepy or listless babies have little or no energy. They sleep longer than normal, and they may be difficult to wake for feedings. When awake, they are drowsy or sluggish; they are not alert and they do not pay attention to visual stimulation or sounds. Decreased energy can develop slowly over time, and parents may have difficulty recognizing it. </p><p>Decreased energy may be a sign of a common infection such as a cold, or a serious type of infection such as influenza or
<a href="/Article?contentid=761&language=English">meningitis</a>. Decreased energy can be caused by heart conditions or blood diseases such as thalassemia. There are numerous other conditions that can cause decreased energy, and decreased energy is usually one of many symptoms associated with any particular condition. Therefore, if you notice that your baby is particularly lethargic or listless, bring them to the doctor for an examination. Treatment will depend on the particular condition that is making your baby listless. </p><h3>Fussiness</h3><p>Crying is a baby’s only way of communicating. Over time, babies develop different cries depending on what they need: food, sleep, a diaper change, or a cuddle. Parents gradually learn to decipher their baby’s cries and respond accordingly. Usually parents can console their baby by providing what they need and cuddling them. However, some babies may begin to cry inconsolably. This may be due to a condition called
<a href="/Article?contentid=295&language=English">colic</a>, where babies may cry non-stop for three hours or so each evening. Colic can begin a few weeks after birth and usually tapers off by three to four months of life. </p><p>A baby who becomes very fussy and fretful, with long crying periods, may be ill or in pain. The baby may also become quite jittery or start to tremble. Fussiness may be a sign that your baby has gas, abdominal pain, an earache, or a viral or bacterial infection. The cause of your baby’s fussiness may simply be gas, but it might be something more serious. If your baby is fussy and cannot be consoled, bring them to the doctor for an examination. Treatment will depend on the particular condition that is making your baby fussy.<br></p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | <img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/how_can_you_tell_baby_ill.jpg" style="BORDER:0px solid;" /> | | | | | | | | https://assets.aboutkidshealth.ca/AKHAssets/how_can_you_tell_baby_ill.jpg | | | Main | | |
| Fracture: How to treat a buckle fracture of the distal radius | Fracture: How to treat a buckle fracture of the distal radius | Fracture: How to treat a buckle fracture of the distal radius | F | English | Orthopaedics/Musculoskeletal | Child (0-12 years);Teen (13-18 years) | Lower arm | Bones | Non-drug treatment | Caregivers
Adult (19+) | NA | https://assets.aboutkidshealth.ca/akhassets/PST_splint_wrist_EN.jpg | 2017-02-16T05:00:00Z | | | | | | 6.90000000000000 | 74.0000000000000 | 1067.00000000000 | | Health (A-Z) - Procedure | Health A-Z | <p>A buckle fracture occurs when a bone slightly crushes in on itself. Learn how this common childhood fracture is treated with a splint.</p> | <div class="akh-series"><div class="row"><div class="col-md-12">
<figure><span class="asset-image-title">Buckle fracture of the distal radius</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/IMD_fracture_buckle_EN.jpg" alt="Illustration of arm with buckle fracture in the radius" />
<figcaption class="asset-image-caption">The most common buckle fracture in children occurs in the distal radius. Sometimes a child will also have a minor fracture of the ulna.</figcaption>
</figure>
<h2>What is a buckle fracture?</h2><p>A buckle fracture occurs when a bone “buckles”, or slightly crushes in on itself. The most common type of buckle fracture in children occurs in the forearm, near the wrist, usually after a child falls onto an outstretched arm. The injury affects the radius bone in particular.</p></div></div></div> | <h2>Where is the radius?</h2>
<p>The radius runs from the elbow to the hand. It makes up the forearm along with the ulna, the bone that runs alongside it. The ‘distal’ part of the radius is the part furthest away from the centre of the body, in other words, nearest the wrist.</p>
<p>Buckle fractures occur only in children and are very common. Children’s <a href="/Article?contentid=1938&language=English">bones</a> are softer than adult bones and able to bend and compress without fully breaking. Although the bone does not fully break, the fracture can still cause pain.</p> | <h2>Key points</h2>
<ul>
<li>A buckle fracture of the distal radius is a partial break of the bone and is the most common fracture in children.</li>
<li>Almost all children recover very well within four weeks with the aid of a removable splint for pain control and protection.</li>
<li>Your child should avoid all physical activity that could re-injure the wrist for at least three weeks after the splint is removed (typically six to eight weeks from date of injury).<br></li></ul> | | | | | | | | <h2>When should my child wear their splint?</h2>
<p>Your child should wear their splint during the day but may remove it at bath time. For the first week, most children also wear the splint at night for comfort, but you can remove it at bedtime once it is no longer needed for pain control.</p>
<h2>How do I remove the splint?</h2>
<p>When removing the splint:</p>
<ul>
<li>take your time and pay full attention</li>
<li>make sure that your child is calm</li>
<li>allow your child to gently and slowly move their wrist</li>
</ul>
<h2>Can my child go back to school or playgroup with the splint on?</h2>
<p>Your child may return to school or playgroup while wearing the splint the day after they hurt their wrist. Make sure staff know that the arm is injured so they can take appropriate care.</p>
<h2>When will my child be able to move their wrist and hand normally again?</h2>
<p>Most children start to use their wrist and hand again while still wearing their splint. Your child may use their injured arm as it heals but should rest it if they feel pain.</p>
<h2>When can my child stop wearing the splint?</h2>
<p>Depending on your child’s healing, they can usually stop wearing the splint after two or three weeks. A few children need to wear the splint for up to four to six weeks for comfort.</p>
<p>You should only remove the splint completely when your child’s wrist is no longer in pain. If their wrist is still painful, replace the splint for another week. Repeat this step until the pain disappears.</p>
<h2>What should I do if my child keeps removing the splint?</h2>
<p>For the first one to two weeks after injury, try securing the straps of the splint with sticky tape.</p>
<p>If your child tries to remove the splint after the second week and appears to be pain-free and willing to use their arm and hand normally, leave the splint off and monitor them. At this stage, the buckle fracture has probably healed and is safe from re-injury except during contact sports.</p> | | | <h2>What should I expect when the splint comes off?</h2><p>Your child’s arm may be slightly stiff from being in a splint and your child may be a little unsure with their movements to start with. This should pass as the child uses their arm or wrist more.</p><h2>Once the splint is off, can my child return to all physical activities?</h2><p>For the first six weeks after their injury, or for about the first three weeks after the splint is removed, your child should avoid physical education, sports, climbing or other activities, such as swinging or using slides, where a fall could re-injure their wrist.</p><h2>When should my child see a doctor about their injury? </h2><p>It is not usually essential for a child to see a doctor about their injury after they leave the hospital. Most children with this wrist injury heal very well and return to their usual activities within four weeks.</p><p>If your child needs a follow-up visit to your family doctor or paediatrician, the doctor in the hospital emergency department will let you know.</p>
<h2>What should I do with the splint once it is removed?</h2><p>It is best to keep the splint safe for a few days until you are sure your child no longer needs it.</p> | | | | | | | | | | <h2>How are distal radius buckle fractures treated?</h2>
<figure>
<span class="asset-image-title">Splint</span>
<img src="https://assets.aboutkidshealth.ca/akhassets/PST_splint_wrist_EN.jpg" alt="" />
</figure>
<p>When your child goes to the hospital with an injured arm, they will be examined carefully. Often, the doctor will order an X-ray to check if there is an injury.</p><p>If there is a buckle fracture of the distal radius, the doctor will recommend a splint to treat it.</p><p>A buckle fracture is best treated with a splint rather than a full circular plaster cast. Because the bones are only partially broken, they heal very well within a few weeks with the support and protection that a splint provides. A splint also makes normal daily activities, such as bathing, easier and can often save extra visits to the doctor.</p><p>Once it is treated properly, a buckle fracture does not cause any long-term problems with the movement or appearance of your child’s arm or wrist.</p> | | <h2>What should I expect in the first few days after my child’s injury?</h2>
<p>Your child may have some pain in their wrist. If your child is in pain at home, give them <a href="/article?contentid=153&language=English">ibuprofen</a> or <a href="/article?contentid=62&language=English">acetaminophen</a> according to your doctor’s instructions.</p>
<p>Your child’s wrist might also be slightly swollen due to the injured tissues and bones. This usually settles within the first one or two weeks. You can help ease swelling by elevating (raising) your child’s injured arm above their chest for the first two or three days. To do this, have your child lie down and place their injured arm on a large cushion or pillow.</p> | | | | | | | | | | | | | | | Buckle fracture of the distal radius | Learn about buckle fractures and how to treat them. | Main | | |
| Vaccines: Concerns about immunizing your child | Vaccines: Concerns about immunizing your child | Vaccines: Concerns about immunizing your child | V | English | Infectious Diseases | Child (0-12 years);Teen (13-18 years) | NA | Immune system | Healthy living and prevention | Adult (19+)
Caregivers | NA | | 2019-07-12T04:00:00Z | | | | | | 10.7000000000000 | 48.8000000000000 | 1264.00000000000 | | Flat Content | Health A-Z | <p>Many parents have questions about vaccines. Find information about how many diseases vaccines protect children against in Canada. Also learn about the safety of vaccines and what side effects your child may experience. Finally, learn about how vaccines are given and what you can do to make it less stressful for your child.</p> | <p>As a parent, do you have concerns about vaccinating your children? You are not alone. One in three parents in Canada have said they have some minor doubts and concerns about vaccinating their child. For example, in Ontario, the average vaccination rate for seven year olds for measles was 88% for the 2017-18 school year. Areas such as Toronto, however, only had a 74% vaccination rate for measles for seven year olds. The reasons why people choose not to vaccinate their children are complex.</p><p>In addition to all of the questions you might have, you may not be sure what and who to believe or where to get your information. You hear about vaccines from your child’s primary health-care provider, in the media, from friends and family, or by reading information on the Internet. Often, the information seems to conflict.</p>
| | <h2>Key points</h2><ul><li>All diseases that children are vaccinated against are serious and can cause illness, complications and even death.</li><li>Children who are not vaccinated are at risk in their own communities, when travelling or when infections are brought into the country.</li><li>Vaccines are very safe and thoroughly tested before being approved for use, and most provide over 90% protection against the disease. </li><li>There is a lot of scientific evidence that vaccines do not cause autism and none to support the belief that they do.</li><li>Receiving multiple vaccines at a single time is safe for your child and most side effects are minor and temporary.</li></ul> | <h2>The truth about vaccines</h2><p>To get the information you need, it is beneficial to have a good relationship and open communication with your child’s health-care provider. <a href="https://www.aboutkidshealth.ca/Article?contentid=1144&language=English">Tips for preparing for your child’s visit with their health-care provider</a> include writing down any questions or concerns about vaccines that you have beforehand to make sure you do not forget anything and talking to your health-care provider about what is on your mind.</p><p>Vaccination programs in Canada currently protect children against 15 diseases. In most cases, these vaccines provide over 90% protection against the disease. Globally, vaccination currently prevents two to three million deaths each year.</p><p>All diseases that children are vaccinated against are serious. All vaccine-preventable diseases can cause illness, complications and even death. For example, measles complications include <a href="https://www.aboutkidshealth.ca/Article?contentid=7&language=English">diarrhea</a>, <a href="https://www.aboutkidshealth.ca/Article?contentid=8&language=English">ear infections</a> and <a href="https://www.aboutkidshealth.ca/Article?contentid=784&language=English"> pneumonia</a>, and happen in about three out of 10 cases. One to two in every 1,000 cases of measles also result in death. Between one and four babies in Canada die every year from pertussis (whooping cough); and about one in 400 babies who survive pertussis will have permanent brain damage.</p><p>Outbreaks of vaccine-preventable infections continue to happen. When immunization rates drop, more people are likely to get the infection; and what used to be a rare illness can become more common in the population. Vaccine-preventable infections that are uncommon in Canada still occur in other parts of the world. Any child who is not vaccinated is at risk when they are travelling or when infections are brought back to Canada.</p><p>The best protection for a population is when most or all people are fully immunized. The fewer vulnerable people there are in a population, the less chance an infectious disease will have to spread (herd immunity).</p><h2>Safety of vaccines</h2><p>Vaccines are very safe. Before vaccines are approved for use, they are thoroughly tested. They go through many steps to demonstrate they are safe and effective. Even after a vaccine is approved for use, it is still monitored for any possible side effects.</p><p>Most side effects from vaccines are minor and temporary, such as a sore arm or mild fever, and babies are no more likely to get side effects than older children. Because many infectious diseases are more common in babies and young children, delaying vaccines leaves them at higher risk of the diseases and the complications of disease.</p><p>Most vaccines do not have live bacteria or viruses and cannot cause infections. Live vaccines have weakened bacteria or viruses that are unable to cause disease in healthy people. With live weakened vaccines, very rarely, a mild form of infection may occur that is not harmful.</p><p>It is recommended that your baby start to receive their vaccines starting at two months of age. This will help protect your baby as early as possible against diseases such as whooping cough (pertussis).</p><p>It is not better to allow your child to get sick from a disease and acquire natural immunity instead of being vaccinated. Natural infection comes with the risks of serious complications related to that infection. With vaccines, the immune system is stimulated to develop protection against future infection without making your child sick.</p><h3>Vaccines and autism</h3><p>All routine childhood vaccines in Canada use single-dose vials and do not contain preservatives such as thimerosal, with the exception of multi-dose vials of influenza vaccine. Preservatives such as thimerosal are used in multi-dose vials to prevent microbial contamination.</p><p>Vaccines (including the MMR vaccine) do not cause autism. There is no scientific evidence to support the belief that vaccines cause autism, but there is a lot of scientific evidence that shows that vaccines do not cause autism. For example, a study published in March 2019 followed 650,943 children and, again, found no link between the MMR vaccine and autism. The study took into account numerous subgroups of potentially susceptible children and found that the MMR vaccine did not cause autism, nor did it trigger autism in susceptible children.</p><p>Signs of autism sometimes appear around the same age that children receive the MMR vaccine, and some people believed there was a connection between the two. One of the reasons the number of children diagnosed with autism has increased is because children with milder symptoms are now being included in the diagnosis. There is also now more awareness of autism, so more parents are seeking help.</p><h2>Getting a vaccine</h2><p>Getting vaccines can be painful and cause stress for both you and your child. There are things that you can do to reduce the pain of vaccination in your <a href="https://www.aboutkidshealth.ca/Article?contentid=989&language=English">baby</a> or <a href="https://www.aboutkidshealth.ca/Article?contentid=990&language=English">child</a>, such as using numbing creams, comfort positions and distraction techniques.</p><p>Most vaccines are given using a syringe. These syringes are single-use syringes and are not reused. This eliminates any risk of transmitting infections through needles. Some vaccines are given using other methods that also eliminate risk of infection. The rotavirus vaccine is given in a liquid form by mouth, and the flu vaccine can be given using a nasal spray.</p><p>Many vaccines are given in combination, providing protection to your child for several different diseases with just one injection. For example, the MMR vaccine provides protection against measles, mumps and rubella. Getting more than one vaccine at once also means there is no delay in protection, fewer medical visits and fewer needles for your child.</p><p>Your child’s immune system is able to respond to multiple vaccines given at a single time. The immune system produces antibodies that respond to antigens (substances that resemble parts of bacteria or viruses). It is estimated that children are exposed to thousands of antigens every day from the moment they are born. In their first two years of life, if a child gets all of the recommended vaccines, they will only be exposed to about 320 additional antigens through vaccination. Receiving multiple vaccines at a single time that contain a handful of antigens is safe for your child and their immune system.</p><p>For more information on immunization schedules for your child, visit:</p><ul><li><a href="https://www.aboutkidshealth.ca/Article?contentid=1986&language=English">Immunization schedule</a> – types of immunizations that are recommended during a child's first year of life and onward.</li><li><a href="https://www.aboutkidshealth.ca/Article?contentid=1985&language=English">Immunization "catch-up" for children who have not been fully immunized</a>.</li></ul>
| | | | | | | | | | | | | | | | | | | | | | | | | | | <h2>References</h2><p>Caring for Kids. (2016, November). <em>Vaccine safety: Canada’s system</em>. Retrieved from <a href="https://www.caringforkids.cps.ca/handouts/vaccine_safety">https://www.caringforkids.cps.ca/handouts/vaccine_safety</a></p><p>Caring for Kids. (2016, November). <em>Vaccines: Common concerns</em>. Retrieved from <a href="https://www.caringforkids.cps.ca/handouts/vaccines-common-concerns">https://www.caringforkids.cps.ca/handouts/vaccines-common-concerns</a></p><p>Caring for Kids. (2016, November). <em>Vaccines: Myths and facts</em>. Retrieved from <a href="https://www.caringforkids.cps.ca/handouts/vaccines-myths-and-facts">https://www.caringforkids.cps.ca/handouts/vaccines-myths-and-facts</a></p><p>Centers for Disease Control and Prevention. (2015). Measles. In Hamborsky, J., Kroger, A., Wolfe, S. (Eds.), <em>Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th ed.</em> (pp. 209-30). Washington D.C. Public Health Foundation. Retrieved from <a href="https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html">https://www.cdc.gov/vaccines/pubs/pinkbook/meas.html</a></p><p>Centers for Disease Control and Prevention. (2018). <em>Multiple Vaccines and the Immune System</em>. Retrieved from <a href="https://www.cdc.gov/vaccinesafety/concerns/multiple-vaccines-immunity.html">https://www.cdc.gov/vaccinesafety/concerns/multiple-vaccines-immunity.html</a></p><p>EKOS Research Associates. (2018). <em>Survey for the Development of the Childhood Vaccination Campaign Findings Report Prepared for Health Canada</em>. Retrieved from <a href="http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/022-17-e/report.pdf">http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/022-17-e/report.pdf</a></p><p>Hviid, A., Hansen, J.V., Frisch, M., Melbye, M. (2019). Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study. <em>Annals of Internal Medicine</em>, 170, 513–520. doi: <a href="https://annals.org/aim/fullarticle/2727726/measles-mumps-rubella-vaccination-autism-nationwide-cohort-study">10.7326/M18-2101</a></p><p>Public Health Agency of Canada. (2016, September 1). <em>Canadian Immunization Guide: Part 1 - Key Immunization Information</em>. Retrieved from <a href="https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information.html">https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information.html</a></p><p>Public Health Agency of Canada (2018, October 18). <em>Vaccines for children: Deciding to vaccinate</em>. Retrieved from <a href="https://www.canada.ca/en/public-health/services/vaccination-children.html">https://www.canada.ca/en/public-health/services/vaccination-children.html</a></p><p>Public Health Ontario (2019, May). <em>Immunization Coverage Report for School Pupils in Ontario: 2017-18 School Year</em>. Retrieved from <a href="https://www.publichealthontario.ca/-/media/documents/immunization-coverage-2017-18.pdf">https://www.publichealthontario.ca/-/media/documents/immunization-coverage-2017-18.pdf</a></p><p>Statistics Canada. (2019). <em>Childhood National Immunization Coverage Survey, 2017</em>. Retrieved from <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/190326/dq190326d-eng.htm">https://www150.statcan.gc.ca/n1/daily-quotidien/190326/dq190326d-eng.htm</a></p><p>World Health Organization. (2019). <em>Ten threats to global health in 2019</em>. Retrieved from <a href="https://www.who.int/emergencies/ten-threats-to-global-health-in-2019">https://www.who.int/emergencies/ten-threats-to-global-health-in-2019</a></p> | | | | | | | | | | Vaccines: Concerns about immunization | Learn about the safety of vaccines, their side effects, how they are given, and what they protect your child against. | Main | | |
| Limb lengthening and reconstruction: Exercises to manage edema and improve range of motion with a tibial frame | Limb lengthening and reconstruction: Exercises to manage edema and improve range of motion with a tibial frame | Limb lengthening and reconstruction: Exercises to manage edema and improve range of motion with a tibial frame | L | English | Orthopaedics/Musculoskeletal | School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years) | Legs | Bones | Procedures | Caregivers
Adult (19+) | NA | https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnklePlantarflexion_Assisted_DSC7845.jpg | 2019-10-08T04:00:00Z | | | | | | 4.60000000000000 | 82.9000000000000 | 1774.00000000000 | | Flat Content | Health A-Z | <p>Learn about the exercises your child can perform to help minimize swelling and maintain their range of motion and muscle strength after limb lengthening and reconstruction with a tibial frame.</p> | <p>Following surgery, your child will experience some edema (swelling) and stiffness. Regular exercises will help your child minimize swelling and maintain range of motion and muscle strength.</p> | | <h2>Key points<br></h2><ul><li>It is important to keep your child's leg elevated above their heart when resting and for them to perform regular ankle pumps and circles to manage edema.</li><li>It is very important to ensure your child performs range of motion exercises to help maintain movement in their joints and prevent stiffness.<br></li></ul> | <h2>Managing edema</h2><p>It is important to keep the leg elevated above the heart when resting and to perform regular ankle pumps and circles.</p><h3>Ankle pump and circles<br></h3><p>Starting position: Sitting on a bed or a chair with leg extended straight</p><ol><li>Move the ankle to bring the toes and foot towards the face.</li><li>Move the foot back down like it is pushing on a gas pedal.</li><li>Move the ankle in circles in both directions. It might help to imagine drawing a circle with the big toe.</li></ol><p>Do _____ pumps and circles (each direction) every hour or if your child is sitting for a long time.</p><div class="asset-3-up">
<figure><span class="asset-image-title">Ankle pumps (1)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnklePump_Up_DSC7829.jpg" alt="" /></figure><figure><span class="asset-image-title">(2)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnklePump_Down_DSC7827.jpg" alt="" /></figure><figure><span class="asset-image-title">Ankle circles</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnklePump_Circles_DSC7827.jpg" alt="" /> </figure> </div><h2>Range of motion exercises</h2><p>Range of motion exercises help maintain movement in your child’s joints throughout your child’s leg lengthening process. It is very important to do them to prevent joint stiffness and any related complications.</p><p>Notes about the exercises</p><ul><li>Not all the exercises shown here may be necessary for your child. If your child’s foot is bound to their frame, ankle exercises will not apply to them. Your child’s physiotherapist will explain which exercises your child should do and how to modify them if needed.</li><li>Some exercises require you to handle your child’s leg to further a stretch or support the weight of their frame. Depending on the location of your child’s frame and pin sites, your handling may vary a little from the descriptions below. Your child’s physiotherapist will assist you with this.</li><li>As a general rule, try to place your hands as close as possible to the joint you are stretching to avoid added stress through the bone.</li><li>Your child should do the recommended exercises three times a day or as often as instructed by the physiotherapist.</li></ul><div class="akh-series"><div class="row"><div class="col-md-12"><h3>Ankle dorsiflexion (DF) while sitting</h3>
<figure><span class="asset-image-title">Ankle dorsiflexion while sitting</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnkleDorsiflexion_Sitting_DSC7837.jpg" alt="" /> </figure>
<p>Starting position: Sitting on a bed with leg extended straight</p><p>Warm-up: Move the ankle up and down slowly 10 times to warm up the muscles and make the stretch more comfortable</p><ol><li>Wrap a towel or thick band around the middle of the foot and hold one end in each hand.</li><li>Keeping the knee as straight as possible, have your child slowly pull their foot towards their face using their own muscles.</li><li>Use the towel to bring the foot further into a stretch. Your child should feel this in the back of their calf.</li><li>Hold for ______ seconds.</li></ol><p>Do exercise _____ times. Repeat _____ times a day.</p><h3>Ankle DF while sitting (assisted)</h3>
<figure><span class="asset-image-title">Ankle dorsiflexion while sitting (assisted)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnkleDorsiflexion_Sitting_Assisted_DSC7841.jpg" alt="" /> </figure>
<p>Starting position: Sitting on a bed with leg extended straight </p><ol><li>Have your child bring their toes and ankle towards their face as much as they can on their own, without raising their leg off the bed.</li><li>You (the parent or caregiver) can gently further the stretch, making sure the leg remains straight. Your child should feel this in the back of their calf.<br></li><li>Hold for ______ seconds.</li></ol><p>Do exercise _____ times. Repeat _____ times a day.</p></div></div></div><h3>Ankle DF standing (runner's lunge)</h3><p>Starting position: Standing facing a wall with feet and knees pointed straight ahead</p><ol><li>Have your child step back with the leg they are stretching.</li><li>Keeping hips level and the upper body straight, have them lean forward with their hands out to touch the wall. The front knee may be bent, but the back knee should remain straight.</li><li>Your child should stay in this position until they feel a stretch at the back of the calf on their back leg. Both heels should stay on the floor throughout the exercise.</li><li>Hold for _____ seconds.</li></ol><p>Do exercise _____ times. Repeat _____ times a day.</p><div class="asset-2-up">
<figure><span class="asset-image-title">Ankle dorsiflexion standing (1)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnkleDorsiflexion_Standing_Side_DSC7908.jpg" alt="" /> </figure><figure><span class="asset-image-title">(2)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnkleDorsiflexion_Standing_Back_DSC7894.jpg" alt="" /> </figure></div><div class="akh-series"><div class="row"><div class="col-md-12"><h3>Ankle plantar flexion</h3>
<figure>
<span class="asset-image-title">Ankle plantar flexion</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnklePlantarflexion_Assisted_DSC7845.jpg" alt="" /> </figure>
<p>Starting position: Sitting or lying down</p><ol><li>Slowly move the toes downwards like the foot is pushing on a gas pedal. Your child should feel the stretch on the front of the ankle.</li><li>If they do not feel the stretch, you can help by bringing the ankle further into the movement. You should put one hand over the top of the foot and another hand just above the ankle if the frame allows.</li><li>Hold for ____ seconds.</li></ol><p>Do exercise ____ times. Repeat _____ times a day.</p></div></div></div><h3>Ankle inversion and eversion</h3><p>Starting position: Sitting or lying down</p><ol><li>For inversion, bring the big toe in towards the midline.</li><li>For eversion, move the baby toe away from the midline.</li><li>Make sure only the foot and ankle are moving. Keep the rest of the leg still. It might help to imagine that the foot is moving like a windshield wiper. </li></ol><p>Do ____ inversions and eversions. Repeat _____ times a day.</p><p>
<em>*Note: If your child’s ankle gets tight, you may be asked to help them stretch it further towards or away from the midline. Your therapist will help with this.</em></p><div class="asset-2-up">
<figure><span class="asset-image-title">Ankle inversion</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnkleInversion_DSC7853.jpg" alt="" /> </figure><figure>
<span class="asset-image-title">Ankle eversion</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_AnkleEversion_DSC7848.jpg" alt="" /> </figure> </div><h3>Toe flexor stretch</h3><p>Starting position: Sitting or lying down</p><p>Warm-up: Wiggle the toes up and down approximately 10 times to warm up the muscles</p><ol><li>Holding your child’s big toe (as shown below), gently bring it towards the face until a stretch is felt along the bottom of the foot.</li><li>Hold for ____ seconds.</li><li>Repeat steps 1 to 2 with the remaining toes together.</li></ol><p>Do exercise _______ times. Repeat ____ times a day.</p><p>
<em>*Note: Sometimes the wires near the toe will block full extension, so just move it as far into extension as the frame allows.</em></p><div class="asset-2-up">
<figure><span class="asset-image-title">Big toe stretch</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_GreatToeFlexor_%289431%29.jpg" alt="" /> </figure><figure>
<span class="asset-image-title">Toe flexor stretch</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_ToeFlexorStretch_%289443%29.jpg" alt="" /> </figure></div><h3>Knee flexion and extension (active assisted)</h3><p>Starting position: Lying down on a bed or other smooth surface (to allow the heel to slide)</p><p>Warm-up: Slowly bend and straighten the knee 10 times as much as possible in each direction</p><ol><li>For flexion, bend the knee and slowly slide the heel up towards the bum, as far as it can go. If the heel cannot touch the bed because of the frame, you can support your child’s leg and help them move it to make sure that they have a full range of motion.</li><li>When your child feels a stretch over the front of their thigh, hold the position for five seconds.</li><li>For extension, slowly move the heel back down the bed until the leg is straight again.</li></ol><p>Do exercise ____ times. Repeat ____ times a day.</p><p>
<em>*Note: Some children may require the adult assisting them to perform most of the movement. This will be determined by your child’s physiotherapist.</em></p><div class="asset-2-up">
<figure><span class="asset-image-title">Knee flexion</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/KneeFlexionExtension1%289352%29.jpg" alt="" /> </figure><figure>
<span class="asset-image-title">Knee extension</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/KneeFlexionExtension2%289357%29.jpg" alt="" /> </figure></div><div class="akh-series"><div class="row"><div class="col-md-12"><h3>Knee flexion (assisted)</h3>
<figure>
<span class="asset-image-title">Assisted knee flexion</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_KneeFlexion_Assisted_%289379%29.jpg" alt="" /> </figure>
<p>Starting position: Sitting at the edge of a chair or bed so the frame is off the surface</p><ol><li>Straighten the knee. You should help by holding your child’s lower leg to support the weight of the frame.</li><li>Slowly bend the knee. You should let your child bend their knee by themselves. Use one hand to support the frame as it lowers and use the other hand to support the knee.</li><li>Keep bending the knee until your child feels a stretch in the font of their thigh or until the frame stops them from bending any further. You may need to have your child move forward on the bed to allow more room for the knee to bend.</li><li>Hold for ___ seconds.</li></ol><p>Do exercise ___ times, making sure the leg straightens each time. Repeat ___ times a day.</p><h3>Prone lying</h3>
<figure><span class="asset-image-title">Prone lying</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_ProneLying_%289397%29.jpg" alt="" /> </figure>
<p>Starting position: Lying on the stomach on a bed, with knees and lower leg off the edge of the bed</p><ol><li>Have your child lie like this for 15-20 minutes, making sure that the front of the hips stay flat on the bed. This keeps the pelvis level.</li><li>If the frame is too heavy, you can support your child’s lower leg, or place a stool under it, making sure the knee can stay completely straight. The stool should be lower than the bed to ensure there is no bend in the knee.</li><li>Perform this stretch once daily.</li></ol><h3>Assisted knee extension</h3>
<figure>
<span class="asset-image-title">Assisted knee extension</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_KneeExtension_Assisted_DSC7889.jpg" alt="" /> </figure>
<p>Starting position: Sitting</p><ol><li>Place one hand above your child’s knee and one hand around their lower leg, as close as possible to the knee to support the joint. Depending on the frame, you may use your full forearm to support the lower leg.</li><li>Gently press downwards above the knee and upwards against the lower leg. This is to extend (straighten) the knee.</li><li>Hold for ____ seconds.</li></ol><p>Do exercise ___ times. Repeat ____ times a day.</p><p>
<em>*Note: Due to the shape of the frame, you will likely need to place a small roll under your child’s ankle/frame to allow for full extension of the knee during the stretch.</em></p><h3>Knee extension stretch (standing)</h3>
<figure>
<span class="asset-image-title">Knee extension</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_HamstringStretch_Standing_DSC7916.jpg" alt="" /> </figure>
<p>Starting position: Standing with the leg extended straight on a stair or on the floor, depending on flexibility</p><ol><li>Have your child stand with their heel on the floor, or a block, and their toes against a wall.</li><li>Keeping the knee as straight as possible, have them lean slightly forward. Your child should feel a stretch through the back of their thigh and knee.</li><li>Hold for ____ seconds.</li></ol><p>Do exercise ___ times. Repeat ____ times a day.</p><p>
<em>*Note: Depending on how flexible your child’s hamstrings are, they may not be able to bend as far forward as shown. Your child’s physiotherapist will assist you with this.</em></p></div></div></div><h2>Strengthening exercises</h2><p>Strengthening exercises help maintain the strength of your child’s muscles throughout the leg lengthening process. It is important to do them to maintain your child’s mobility.</p><div class="akh-series"><div class="row"><div class="col-md-12"><h3>Isometric quadriceps (static contractions)</h3>
<figure><span class="asset-image-title">Isometric quadriceps (static contractions)</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_HamstringStretch_LongSitting_DSC7927.jpg" alt="" /> </figure>
<p>Starting position: Sitting up with back supported and a small roll under the heel</p><ol><li>Have your child tighten their thigh muscles and push their kneecap down into the bed. They should make the knee as straight as they can. Make sure the kneecap and toes point straight up towards the ceiling throughout the exercise.</li><li>You will likely need to place a small roll under the ankle to allow the knee to fully straighten.</li><li>Hold for 3-5 seconds.</li><li>Relax.</li></ol><p>Do exercise ____ times. Repeat ____ times a day.</p><p>
<em>*Note: If the frame prevents your child from fully straightening the knee on the bed, your child’s physiotherapist will show you how to modify the exercise.</em></p></div></div></div><h3>Quadriceps setting over roll</h3><p>Starting position: Lying down or sitting up with back supported on a bed, knee slightly bent over a rolled-up towel</p><ol><li>Have your child tighten their thigh muscles and push their knee down into the roll.</li><li>Lift the lower leg and foot up off the bed. Keep the knee on the roll and make sure the kneecap and toes point straight up towards the ceiling throughout the exercise.</li><li>Try to hold the leg up for 3-5 seconds.</li><li>Slowly lower the leg back down.</li></ol><p>Do exercise _____ times. Repeat ____ times a day.</p><div class="asset-2-up">
<figure><span class="asset-image-title">Quadriceps setting over roll – Starting position</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_QuadsOverRoll_StartingPosition_%289480%29.jpg" alt="" /> </figure><figure>
<span class="asset-image-title">Quadriceps setting over roll – Lifting the lower leg</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/TibialFrame_QuadsOverRoll_LiftingLeg_%289487%29.jpg" alt="" /> </figure></div> | | | | | | | | | | | | | | | | | | | | | | | | | | <h2>Print all exercises</h2><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbReconstruction_Tibial_FINAL.pdf">Exercises to manage edema and improve range of motion with a tibial frame</a></p><h2>Print individual exercises<br></h2><h3>Managing edema</h3><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_AnklePumpsCircles.pdf">Ankle pump and circles</a></p><h3>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_Summary.pdf">Range of motion exercises</a></h3><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_AnkleDFSitting.pdf">Ankle dorsiflexion (DF) while sitting</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_AnkleDFSittingAssisted.pdf">Ankle DF while sitting (assisted)</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_AnkleDFStanding.pdf">Ankle DF standing (runner’s lunge)</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_AnklePlanFlex.pdf">Ankle plantar flexion</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_AnkleInvEve.pdf">Ankle inversion and eversion</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_ToeFlexStretch.pdf">Toe flexor stretch</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_KneeFlexExtAA.pdf">Knee flexion and extension (active assisted)</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_KneeFlexA.pdf">Knee flexion (assisted)</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_ProneLying.pdf">Prone lying</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_KneeExtAssi.pdf">Assisted knee extension</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_RoM_KneeExtStretchStand.pdf">Knee extension stretch (standing)</a></p><h3>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_Strength_Summary.pdf">Strengthening exercises</a></h3><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_Strength_IsoQuad.pdf">Isometric quadriceps (static contractions)</a></p><p>
<a href="https://assets.aboutkidshealth.ca/AKHAssets/LimbRecon_Tib_Strength_QuadSetRoll.pdf">Quadriceps setting over roll</a></p> | | | | | | | | | | | Exercises with a tibial frame | Learn about the exercises your child can perform to minimize swelling after limb lengthening and reconstruction with a tibial frame. | Main | | |
