Children, Backpack Pain and Booster Seats
Commonsense Health Care - Dr. Lee DeBlon
Question: At what age should children be checked by a Chiropractor?
The answer is immediately after they are born.
Follow-up question: How does the child’s spine become misaligned?
These misalignments, called “Vertebral Subluxations” by Chiropractors have many causes. These can come from a difficult birth, such as a breech {feet first} birth and extreme stress the whole birth process can place on mom and child. Most health problems early in a child’s life can be traced back to a difficult birth, even caesarian.
As the child grows and explores, many opportunities present themselves for jumping, running, falling and accidents, which are all part of a normal child’s life. These jolts, strains and injuries can cause spinal misalignments and possible nerve damage. This is why we recommend a minimum of 4 examinations per year and teach our patients the warning signs to look for, for both children and adults. This is why we promote FAMILY CARE.
When misalignments occur, they can cause nerve blockages that may cause generalized weakening of your child’s body, lower resistance to disease and cause body malfunction and sickness. Correction of spinal misalignments can have a powerful effect on many areas of a child’s life. Parents will notice behavioral and emotional changes. Sleep patterns will change and improve. Allergies, asthmas, hyperactivity, bedwetting are just a few of the problems that we have seen eliminated. We are always amazed by the number of children and teenagers complaining about headaches and stomachaches. If your child has these or the following conditions bring them into our offices for our “FREE EXAMINATION”
FEVER, COLIC, CROUP, POOR POSTURE, NERVOUSNESS, CONSTIPATION, BEDWETTING, FATIGUE, STOMACHACHES, LOSS OF HEARING, EAR INFECTIONS, ARTHRITIS, NUMBNESS, IRRITABILITY, HEADACHES, EYE PROBLEMS, SORE THROAT, COUGH, SINUS PROBLEMS, SKIN PROBLEMS, ASTHMA, BRONCHITIS, FREQUENT COLDS, POOR COORDINATION, POOR CONCENTRATION, ARM: HAND: SHOULDER PAIN, HIP: LEG: FOOT PAIN, SCOLIOSIS;
Chiropractic is a DIFFERENT APPROACH to health care; it is not a treatment for disease processes but a correctional approach to a malfunctioning body that has lost some or all of the ability to correct these problems itself. Because you and your children may have spinal misalignments and NOT KNOW it, we recommend the periodic check-ups during the course of the year. We also teach our patients the warning signs and a simple check they can do at home to know when to bring their children or themselves into our offices. These WARNING SIGNS CAN INCLUDE CHRONIC FATIGUE, ONE HIP OR SHOULDER HIGHER THAN THE OTHER, SHOULDER BLADE STICKING OUT, HYPERACTIVITY, FREQUENT FALLS, SKIN CONDITIONS, FOOT TURNED OUT, JOINT PAIN, NECK TILT, ONE LEG SHORTER, AND NERVOUSNESS.
If you see these warning signs in your children or yourselves and they have been present more than a few days DON’T HESITATE TO CALL our offices with any questions. Families are finding out that check-ups during the year make a big difference in their overall health. We can be reached at 570-253-0904.
Backpack Misuse,Backpain & Chiropractic
Back pain is pervasive among American adults, but a new and disturbing
trend is emerging. Young children are suffering from back pain much
earlier than previous generations, and the use of overweight backpacks is
a contributing factor, according to the American Chiropractic Association
(ACA). In fact, the U.S. Consumer Product Safety Commission reports that
backpack-related injuries sent more than 7,000 people to the emergency
room in 2001 alone.
This new back pain trend among youngsters isn't surprising when you
consider the disproportionate amounts of weight they carry in their
backpacks - often slung over just one shoulder. A
recent study conducted in Italy found that the average child carries a
backpack that would be the equivalent of a 39-pound burden for a 176-pound
man, or a 29-pound load for a 132-pound woman. Of those children carrying
heavy backpacks to school, 60 percent had experienced back pain as a
result.
The preliminary results of studies being conducted in
France show that the longer a child wears a backpack, the longer it takes
for a curvature or deformity of the spine to correct itself. "The question
that needs to be addressed next is, 'Does it ever return to normal?'"
The results of these types of studies are especially important as more and
more school districts - many of them in urban areas - remove lockers from
the premises, forcing students to carry their books with them all day
long.
The problem has become so widespread, in fact, that the California State
Assembly recently passed legislation that would force school districts to
develop ways of reducing the weight of students' backpacks. Similar
legislation is being considered in New Jersey as well.
What Can You Do?
Make sure your child's backpack weighs no more than 5 to 10 percent of
his or her body weight. A heavier backpack will cause your child to bend
forward in an attempt to support the weight on his or her back, rather
than on the shoulders, by the straps.
The backpack should never hang more than four inches below the
waistline. A backpack that hangs too low increases the weight on the
shoulders, causing your child to lean forward when walking.
A backpack with individualized compartments helps in positioning the
contents most effectively. Make sure that pointy or bulky objects are
packed away from the area that will rest on your child's back.
Bigger is not necessarily better. The more room there is in a backpack,
the more your child will carry-and the heavier the backpack will be.
Urge your child to wear both shoulder straps. Lugging the backpack
around by one strap can cause the disproportionate shift of weight to
one side, leading to neck and muscle spasms, as well as low-back pain.
Wide, padded straps are very important. Non-padded straps are
uncomfortable, and can dig into your child's shoulders.
The shoulder straps should be adjustable so the backpack can be fitted
to your child's body. Straps that are too loose can cause the backpack
to dangle uncomfortably and cause spinal misalignment and pain.
If the backpack is still too heavy, talk to your child's teacher. Ask if
your child could leave the heaviest books at school, and bring home only
lighter hand-out materials or workbooks.
Although the use of rollerpacks - or backpacks on wheels - has become
popular in recent years, the ACA is now recommending that they be used
cautiously and on a limited basis by only those students who are not
physically able to carry a backpack. Some school districts have begun
banning the use of rollerpacks because they clutter hallways, resulting
in dangerous trips and falls.
Consider the Samsonite Chiropak, a school bag designed to
ease much of the stress that carrying books can place on one's body.
Among other features, the Chiropak offers comfortable body-contact
surfaces and an adjustable hip/waist belt. For more information on the
Chiropak, visit www.chiropak.com or www.samsonite.com.
Chiropractic Care Can Help...
If you or your child experiences any pain or discomfort resulting from
backpack use, call your doctor of chiropractic. Doctors of chiropractic
are licensed and trained to diagnose and treat patients of all ages and
will use a gentler type of treatment for children. In addition, doctors of
chiropractic can also prescribe exercises designed to help children
develop strong muscles, along with instruction in good nutrition, posture
and sleeping habits.
Any questions call Dr. Lee DeBlon in Honesdale @ 253-0904 or in Lords valley @ 775-6656.
We have always offered a NO OBLIGATION EXAMINATION and CONSULTATION for the past 23 years.
Children and Back Pain
Lower back problems may be a more common disorder with children than
chiropractors realize. One large-scale survey of 1,178 school children
revealed a cumulative predominance of back pain in 51.2 percent of the
surveyed population. The most common back pain recorded was lumbar,
thoracic and leg. The survey concluded that contributing factors to back
pain included: previous back injury; age; female gender; volleyball; and
watching television.
Adolescent athletes are more predisposed to low back pain. Excessive
spinal loading that typical accompanies many sporting activities increase
the risk for acute low back injuries during the growth spurt. This
occurrence is more harmful to the lower back.
From the textbook Pediatric Chiropractic, Dr. Dan Murphy addresses lower
spine injuries in his chapter, "Children in Motor Vehicle Collisions." In
approximately half of those involved in vehicle injury, lumbar spine
injury is present. The lumbar injury is often attributed to the belt
fulcrum trauma.
In the recent issue of the ICPA Research Update, three studies were
reported:
1) "Disc disease may start in adolescence"
Disc disease begins as early as age 15, according to a study in Spine.
Investigators in Finland reviewed 12,000 cases of possible lumbar disc
disease. All subjects were 28 years old or less. Investigators found that
the men were twice as likely as the women to be hospitalized for LBP. In
general, researchers determined: "Symptomatic low back pain leading to
hospitalization first appeared around the age of 15 years, and the
incidence rose more sharply form the age of 19, especially in men with
other low back diseases."
2) "Acute trauma associated with Schmorl's nodes"
Scientists used radiographs and pathological examination to evaluate 70
thoracolumbar spines. Investigators found nine Schmorl's nodes; the
majority were in spines of young people (11-30 years old). All nodes were
located in the T8-L1 region. Men had nine times the risk of developing
acute Schmorl's nodes than the women. Trauma analysis indicates that axial
loading plays a pivotal role in node formation, according to the study.
The study's authors concluded: "Schmorl's nodes do occur acutely as the
result of a single traumatic episode, and are almost always associated
with other acute spinal injury."
3) Prevalence of pediatric musculoskeletal pain in children
How prevalent is musculoskeletal pain (MSP) in children who seek pediatric
care? Researchers in Spain set out to answer the question in a four and
one-half month prospective study of 1,000 consecutive visits to an urban
clinic. All subjects were age 3-15 years.
Sixty-one children (6.1%) sought treatment for MSP. Trauma was the most
common cause of MSP (30%). Overuse also accounted for a sizable portion of
complaints (28%). Children with knee and joint pain made up roughly
two-thirds of the total cases. Soft tissue pain caused 18% of all
complaints. The author pointed out that because the clinic studied does
not typically evaluate fractures, patients with fractures were unlikely to
visit the clinic, and consequently, were not included in the study.
So When Do We Begin to Evaluate for Back Pain?
Two factors should be considered: rapid spinal column growth and
micro/macro trauma.
At birth, the length of the spinal column is approximately 24 cm; by the
end of the adolescent state, the length will have increased to 70 cm. The
spine will experience the largest growth period during the first five
years of life. During the first year, the spine will grow 12 cm; by age 5,
a total of 27 cm. Spinal growth of 10 cm will occur from age 5-10. With
the onset of puberty (10-18 years old) the spine will lengthen 15 cm in
females and 10 cm in males.
During childhood, micro and macro traumas are expected to the pediatric
spine. This occurrence cannot be controlled or eliminated. The thoracic
and lumbar regions like the entire spine, will be subjected to childhood
trauma. Trauma to the pediatric spine may result in vertebral
subluxations.
The research community in now paying attention to the pediatric population
and back pain. Back pain is a leading health complaint in the adult
population. This complaint contributes to loss work time and decreased
quality of life. The adult population is often managed by invasive
approaches (i.e., surgery, drugs and therapy) that are not always
successful.
The chiropractic profession has been recognized for its positive results
in approaching back pain in the adult population.
It is not uncommon for the chiropractor to evaluate the adult patient with
acute or chronic back pain (often associated with spinal degeneration).
Maybe the ideal time to evaluate and render care for the vertebral
subluxation (a noninvasive approach to back pain) would be the pediatric
population. Once again, like dentistry, children would benefit if
chiropractic would actively partake in the prevention of disease
processes.
If one has any questions call Dr.Lee DeBlon @ 253-0904 or in Lords Valley @775-6656.
What follows is a complete reprint of an article that appeared in the Dynamic Chiropractic publication.
I felt that this article was extremely important and had to be brought to the attention of my readers.
This article was written by Dr. Arthur Croft the director of Spine Research Institute of San Diego and a leading authority on automobile accidents and spinal injuries.
Booster Seats: Why Go on Killing Our Children?
Automobile seats are designed to comfortably contain adult occupants. Of
more critical importance, these seating systems, which include, inter
alia, the seat belt and shoulder harness, were designed to optimally
protect adult occupants in the unhappy event of a high-velocity crash. Are
children at a disadvantage? Yes, for two reasons.
One reason is that the lap portion of the safety webbing is designed to
distribute high-acceleration loads across the bony pelvis in the event of
a frontal collision. In youngsters, this belt will typically ride up over
the pelvic brim such that the child bears all of the force over the soft
abdomen, with viscera being crushed between spine and belt. In more severe
loading, spinal injuries can occur. Often these occur in collisions that
adults, riding restrained in the front seat, do not perceive as severe.
Because of the resiliency of the pediatric spinal column, gross
dislocations and spontaneous reductions can occur, which are difficult to
find later without very careful attention to MRI details. For the sake of
trivia, this has been termed “spinal cord injury without radiographic
abnormality” (SCIWORA).
Are these injuries uncommon? In one small study, the authors reported that
in children with abrasions over the abdomen from the seat belt (the
so-called “seat belt sign”), nearly 50 percent of the children had
life-threatening bowel lacerations requiring emergent resection.
The other reason kids are at a disadvantage in high-velocity crashes is
related to the shoulder sash or shoulder harness. Whereas in adults, it
crosses safely over the shoulder in the region of the midclavicular line,
in children sitting lower in the seat, it crosses dangerously across the
neck, threatening both the spine and vital vascular structures in the
neck.
The booster seat exerts its main effect by simply elevating the youngster
in the seat, so that both the lap belt and shoulder harness fit the child
more like they do an adult. Studies have demonstrated that youngsters
using booster seats and standard restraints are much safer than youngsters
using the restraints without the booster. You can find more information on
the Web site of the National Highway Traffic Safety Institute (NHTSA).
However, as it turns out, you can’t trust everything you read, even from
the government.
There are two kinds of booster seats. The most basic kind is a simple seat
booster: the so-called backless booster seat. The other type
is a seat bottom/back combination: the high-back booster. Most of these
also have a back high enough to serve an additional important function as
a head restraint. Most also have lateral head protection to prevent
lateral flexion excursions in the even more unhappy event of a side-impact
collision.
If you visit the NHTSA Web site, you will find that it informs visitors
(unless it has changed recently) that both types of booster seats are
equally effective at reducing injuries. But as it turns out, that is not
actually the case. A recent study demonstrated that the high-back booster
reduced injuries by a very commendable 70 percent, while the backless
booster was shown to be no more effective at reducing injuries than seat
belts without the booster.1
How can we explain this extreme disparity? My guess would be that the
original researchers included both the high-back and the impotent,
backless type in the study, and compared their lumped, safety-enhancing
effect in a direct comparison with children of the same age and sex in
comparable crashes who had no booster seats. The reported combined
effectiveness was 59 percent; this is a frequently cited figure. Thus, the
ineffectiveness (zero percent) of the backless booster would have been
obscured by the high (70 percent) effectiveness of the high-back type. My
advice would be to exhort your patients to replace those useless backless
boosters with high-back boosters immediately.
How Many Parents Use Boosters Correctly?
In another recent survey, it was reported that about 33 percent of parents
did not use booster seats at all, while 33 percent of those who did use
them used them incorrectly.2 The proportion of backless types was not
reported, but I would consider these “inappropriate” as well, in light of
the above-mentioned study, so this number is probably conservative.
We might ask, what motivates the proper use of booster seats? Is it
parental concern for the safety of their darling children? Not exactly. In
a recent survey, 70 percent of adults said that the motivating factor for
them was a law requiring booster seat use.3 This observation was confirmed
in a before-and-after survey conducted in Indiana. The authors of the
study reported a 50 percent increase in the use of booster seats after
enactment of laws requiring them.4 As heartless as that may seem, we
should not be too surprised. In the U.S., before laws went into effect,
seat belt use hovered around 12 percent. Now seat belt use is about 70
percent or a little higher; however, we still lag well behind most other
industrialized nations, where compliance is better than 95 percent. It
seems unlikely that 82 percent of Americans were unaware of the safety
offered by seat belts.
Rules of Thumb for Booster Usage
There are a few simple ways to determine whether the child should be using
a booster seat. Children should ride in a booster seat until they are at
least 57 inches tall. Once they have reached this height, if the child
cannot sit all the way back against the vehicle’s seat back and bend the
knees over the edge of the seat, he or she should remain in a booster. If
the seat belt rides up over the abdomen or if the shoulder portion rides
over the neck, the child needs to remain in a booster seat. Also, check
state laws: Some states require children to remain in a booster until 6 or
8 years of age.
Who said chiropractors don’t routinely save lives?
References
Arbogast KB, Kallan M, Durbin DR. “Effectiveness of High Back and
Backless Belt Positioning Booster Seats in Side-Impact Crashes.” 49th
Association for the Advancement of Automotive Medicine Conference.
Massachusetts, 2005:201-213.
O’Neil J, Meritt S, Talty J. “Observed Frequency of Misuse of Booster
Seats.” 50th Annual Meeting of the Association for the Advancement of
Automotive Medicine. Chicago, 2006.
Bingham CR, et al. Factors influencing the use of booster seats: a
state-wide survey of parents. Accid Analysis Prev 2006;38:1028-1037.
O’Neil J. “Observed Frequency of Booster Seat Usage After Legislation.”
50th Annual Meeting of the Association for the Advancement of Automotive
Medicine. Chicago, 2006.
For further information please call Dr. Lee DeBlon in Lords Valley @ 775-6656 or
in Honesdale @ 253-0904
