Working with Physical Therapy

Working with Physical Therapy

If you’re lucky, your insurance covers PT. If you’re human, you are prescribed exercises for your child and you are diligent for the first week, maybe the second. More than likely, after that life takes over and there is little time to remember these exercises. Perhaps it just doesn’t seem “worth it.”

Does your child really need PT? In short, YES. PT is a crucial part of the treatment plan for Perthes. The cornerstones of treatment include containment and range of motion and PT can help with both.

Here are some examples of what may be recommended by your medical-surgical team. It’s important to note Legg Calve Perthes Foundation offers this information as representative information only and recommends following the treatment guidelines set forth by your child’s specific team.

Goals
Contain hip by maintaining 25 degrees or more of hip ABD (abduction, or legs spread from midline).
Protect from excessive hip joint forces
Remodel contained femoral head with low load / high repetition exercise

Precautions
NWB / TTWB / FFWB
WBAT in brace or cast for transfers and supervised HEP (home exercise program)
NO SLR (straight leg raise), HIP HYPEREXTENSION, ABD AGAINST GRAVITY

Mobility
Crutches in home
Wheelchair at school / long distances
NWB / TTWB / FFWB
WBAT in brace or Petrie cast for transfers and supervised HEP
A-FRAME BRACE: 23 hours / day

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