Orthopedics: Terms for Children with Musculoskeletal Weakness

Children with musculoskeletal diseases such as cerebral palsy will be no strangers to orthopedics therapy. Parents tend to do more worrying than the children who are undergoing therapy and intense orthopedic supervision, so knowing a few of the terms that may be thrown at you during exams or sessions is a good way to feel empowered about your child's condition.

Spasticity is a term that is thrown around quite a bit in the profession of orthopedics from orthotists, to surgeons, and physical therapists. Because of the connotation of the 1980s use of the word spastic, parents are often frightened by the diagnosis or description of spasticity. However, it is strictly a medical term. It deals with skeletal muscles, and is a typical condition for those with nervous system disorders. This term may be used in congruency with the word "hypertonio" which means "tightness of the muscles. These conditions may be hindering gross motor abilities, but with therapy, spasticity can go away or significantly decrease to an unnoticeable disability.

Some of most common misunderstood terms in the field of orthopedics have to do with conditions of the legs and feet. Terms such as pigeon toes, bowlegs, flat feet, and knock-kneed are non-medical terms connected to many wives' tales and pre-medical knowledge family folklore that scare parents for no reason.

Toe walking may be a condition due to spasticity, and it usually is nothing to worry about. Babies will usually grow out of toe walking unless it is due to spasticity, under which circumstance physical therapy can be very effective. Having flat feet is another condition that children outgrow. In fact, it has been said that all babies have flat feet. They develop arches later, some sooner than others.

In-toeing, medically called femoral anteversion, is the common term to which being pigeon toed describes. A few decades ago, parents and doctors alike would rush to put braces on or ankle foot orthotics (AFOs) on children who showed this condition, but the opinion of late is that there is no evidence that braces make any corrections. Like toe walking and flat feet, most children grow out of what is usually just a genetic anomaly. It can be a condition of hyertonio or spasticity due to a condition like cerebral palsy, but, again, therapy and progressive use of the muscles that are contracting will usually correct the problem or at least modify it so that it does not interfere with daily activities.

Genu varum, which is the official term for bowlegged, is the exaggerated outward bending of the legs and is not worrisome until after the age of two. Many parents worry that forced walking, the wrong shoes, or another decision has caused the condition, but it is usually just a genetic anomaly that a child will outgrown in the first few years of life.