LE internal rotation in child (Full Version)

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yankeept -> LE internal rotation in child (March 29, 2004 9:34:00 AM)

I have a question for the pediatric PTs. A parent is concerned regarding her 15 month old child who began walking independently at about 13 months. He currently tends to internally rotate on the left lower extremity, but not the right. It's noticeable often during walking.

Anything we should be doing for it at this point?

Thanks.



IN-PT -> Re: LE internal rotation in child (March 30, 2004 10:57:00 AM)

Good question. I have seen children with similar descriptions. I would be concerned (now and as they mature)if there is functional limitations with their balance, walking, running, etc. Also, I would continue to monitor their ease and range of movement in the lower extremity. I'll be interested to read other comments from clinicians who treat more peds than me.



tlhpedspt -> Re: LE internal rotation in child (April 3, 2004 5:44:00 PM)

I have personal and professional experience with internal rotation in a child. Orthopedics do not recommend treating this type of internal rotation unless a serious, underlying amount of bony rotation, foot deformity, or hip problem is found. I personally prefer to check for any muscle tightness, make note photographically and with goniometric measurements on the child's lower extremity position and range of motion, give any recommendations to the parent for stretching, strengthening if needed, and avoiding floor sitting positions such as "W" sitting. Small differences can be present due to en utero positioning of the child or positions that they prefer over time. One of my own children has had significant internal tibial rotation and metatarsus adductus bilaterally that affected his early balance and walking development, shoe wear ,etc. He still (age 11) trips frequently and has significant shoe wear. Orthopedists refused to treat him as an infant in spite of his metatarsus adductus--they felt he would "grow out of it". It is not debilitating in any way but it definetly affects his shoe wear.



IN-PT -> Re: LE internal rotation in child (March 30, 2004 10:57:00 AM)

Good question. I have seen children with similar descriptions. I would be concerned (now and as they mature)if there is functional limitations with their balance, walking, running, etc. Also, I would continue to monitor their ease and range of movement in the lower extremity. I'll be interested to read other comments from clinicians who treat more peds than me.



tlhpedspt -> Re: LE internal rotation in child (April 3, 2004 5:44:00 PM)

I have personal and professional experience with internal rotation in a child. Orthopedics do not recommend treating this type of internal rotation unless a serious, underlying amount of bony rotation, foot deformity, or hip problem is found. I personally prefer to check for any muscle tightness, make note photographically and with goniometric measurements on the child's lower extremity position and range of motion, give any recommendations to the parent for stretching, strengthening if needed, and avoiding floor sitting positions such as "W" sitting. Small differences can be present due to en utero positioning of the child or positions that they prefer over time. One of my own children has had significant internal tibial rotation and metatarsus adductus bilaterally that affected his early balance and walking development, shoe wear ,etc. He still (age 11) trips frequently and has significant shoe wear. Orthopedists refused to treat him as an infant in spite of his metatarsus adductus--they felt he would "grow out of it". It is not debilitating in any way but it definetly affects his shoe wear.



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