Staying Flexible Through Puberty


Most of us remember the years of our youth as being very physically flexible.  Many of us could do splits, do a perfect backbend, and some of us could even look like a human pretzel.  On the other hand, some of us report that we could barely touch our toes, but I am sure you were far closer than you are today!  Kids are generally known to have a lot of flexibility but throughout their youth, that flexibility can sometimes come and go, so it is important to have flexibility on your kid’s to-do list.

Throughout the years of puberty, kids will tend to have extreme growth spurts.  According to Dr. Keith Dominick (Pediatrics Specialist in Hampton & Portsmouth, NH), most girls will start puberty by age 13 and most boys will start puberty by age 14.

Dr. Dominick reports that flexibility should be a topic of concern for children throughout puberty.  As kids grow, some will grow at a nice steady pace making the transition physically seamless while others will be driving with a heavy foot on the gas and then come to a sudden halt on and off throughout their childhood.  This sudden fast growth spurt can cause many problems physically such as coordination issues, weight struggles, and flexibility restrictions leading to injuries.

How is coordination affected?

Coordination, you can imagine will be a bit of a struggle for the kid that has a heavy foot on the growth spurt pedal.  According to the Magic Foundation, most kids grow on average 2inches/yr. from age four until puberty.  During puberty, a growth spurt of 2 ½ -4 ½ inches/yr. for girls and boys average 3-5 inches/yr.  This can be very frustrating for many kids.  Perhaps they have been a great athlete and all of a sudden, they are dropping the ball, tripping over their feet, and every game or practice seems like they are in a constant funk.  It is very important to educate your child on growth spurts and how this can affect their ability to play.  They need to be reassured that they just need time to adjust to their new playing tools.  Practice and time will allow them to get use to their new size.  They must understand that they may have a bad season one year and the next they could be at the top of their game.  This will prevent the child from deciding to give up on a certain sport all together.  The best thing you could do for your child is keep them physically involved in sports, help them get through these ups and downs that are beyond their control.

Flexibility Restrictions and Injuries:

Flexibility restrictions occur because during growth spurts kid’s bones grow so fast that the length of their muscles are unable to keep up.  Suddenly your limber child that you referred to as Gumby suddenly is complaining that they are tight and are complaining of knee pain or heel pain.  Two of the most common conditions that many kids will have secondary to their bones growing too fast for their muscles and often in combination with increased activity are Osgood Schlatters (knee pain caused by tightness in quad muscle) and Sever’s Disease (heel pain due to tightness in Achilles Tendon).  Both these conditions occur because of a traction injury to the cartilage and bony attachment of the tendons.  These are both apophysitis injuries, which is an inflammation or stress injury to the area on or around the growth plates in children.  Other less common apophysitis’s locations:

Little league Elbow (Medial epicondyle apophysitis) is common in kids that throw or bat. Stretching should target the tightness in a child’s wrist flexor muscles since these muscles attach on the medial epicondyle.

Pelvic/Hip Apophysitis -The location on the hip may be in 7 different locations! Common in dancer’s, soccer players. Take a look at this picture as it shows the points of pain.  Muscles to target: Sartorius, rectus femoris, hamstrings, abdominals, abductors, iliopsoas, and adductor longus.

Iselin’s Disease (5th metatarsal apophysitis) Pain located on the Outside foot- Muscles to target: peroneals/gastroc muscles (outside of ankle and back of calf stretch) most common in soccer, basketball, gymnastics and dance.

What flexibility stretches should all kids do?

In order to be proactive and try to avoid the areas that kids commonly have apophysitis’s, have your child routinely do these stretches at least 3 days/week. If your child is involved in sports, try and make it a habit for them to do the attached exercises after every practice or game once they get home.

The goal for them during a warm up is to do more of a dynamic warm up with their team (dynamic stretching is more movement-based stretching such as walking lunges with a twist) and then when they come home; they should do these exercises – (see and/or print out Flexibility Stretching Exercises pdf)

*Parent Tip for avoiding these conditions: An important factor to discuss is the huge push kids are getting to specialize in single sport participation despite the recommendation against it from the American Academy of Orthopedic Surgeons (AAOS).  Early sport specialization is defined as intensive training or competition in an organized sport by prepubescent children for eight or more months out of the year. The AAOS attributes lack of sport diversification with a significantly higher incidence of repetitive injury. Bones, muscles, ligaments, and joints do not have enough time to heal and can lead to maladaptive mobility and a decline in flexibility. (AAOS, 2019).  I encourage you to do your best and try to not cave with the constant pressure from sports organizations.  The more sports you expose your kids to the less incident of repetitive injury they will have.

At Hampton Physical Therapy, we treat these conditions regularly.  All of our therapists hold Doctorate Degrees and have advanced certifications to offer the latest treatments while using Evidence Based Medicine as their guide.  Please feel free to reach out and speak directly with a skilled Therapist regarding your individual concerns.


I have a painful neck and back, should I see a Physical Therapist or go to a chiropractor?


Many people at some point in their lifetime will encounter a situation where they experience neck or low back pain. Neck and low back pain can significantly impact quality of life and make activities that were once enjoyable debilitating and unfulfilling. When someone experiences spine related pain the question to ask is “who do I see that can make my back and neck pain go away”? Two of the primary options for conservative treatment of low back pain and neck pain include seeing your local chiropractor or local physical therapy. So, who should you see?

It is important to first understand the similarities between both of these conservative treatment options for your spine pain. Both PT’s and chiropractors primarily focus on the reduction of your pain patterns through use of manual interventions to restore function and mobility to allow you to be able to do the daily activities that you enjoy. PT’s and chiropractors also go through extensive schooling requiring doctoral level entry to deliver optimal care to each patient they treat.

So, how does physical therapy and chiropractor differ, and which treatment option should I seek?

First, chiropractors primarily perform spinal manipulations often called “adjustments” on patients with goal of restoring alignment and your spines self-awareness, known as proprioception. Often individuals with back pain go to their chiropractor, get seen for ten minutes, and go home feeling great. However, after a few days, their pain often returns, and they need to go see their local chiropractor again.

Physical therapy will focus on identifying the limitations and dysfunction in the musculoskeletal system that may be contributing to your spine pain patterns. PT will perform a thorough evaluation of how your spine moves, including identifying any dysfunctions in muscle flexibility, joint mobility, strength and neuromuscular deficits including sensation and reflexes. From there, PT will work with you on how to properly gain segmental mobility through your spine with the goal of restoring functional mobility to get you back to doing the activities that you enjoy. Physical therapists in the state of NH are permitted to perform spinal manipulations, similar to that of a chiropractor.

Cervical manipulation by a physical therapist for neck pain and stiffness

However, with PT we use these adjustments as a compliment to other interventions with the goal of addressing the dysfunctional movement patterns and changing the way you move, which over time will lead to long term pain relief. These additional interventions include use of manual therapy and soft tissue mobilization to improve tissue pliability and reduce joint and muscle inflammation, therapeutic exercises specifically targeted towards your goals and your pain patterns to provide support to your spine, dry needling to address deeper muscle binding and pain and electrical stimulation to block your bodies pain signals to get you feeling better before you leave.

Physical Therapists don’t want you to have to come back every 2 weeks if we can educate you on techniques to get you feeling better ALL the time!

Physical Therapist applies instrument assisted soft tissue work for muscle pliability

Physical Therapist applies electrical stimulation for pain modulation

At Hampton Physical Therapy, our skilled licensed physical therapists are able to perform many of the skills that chiropractors use to get their patients feeling better, however that is just one component to the treatment services we provide. You get the benefits of feeling better leaving PT, like you would going to a chiropractor, with the goal of attending PT for 4-8 weeks and then not having to keep coming back to address your pain!

If you’re experiencing any low back, neck or mid back pains and are looking to get evaluated by one of our skilled doctors of physical therapy, give us a call today! 603-929-2880


Go-to Sleep Positions… How to Combat Injuries While Sleeping

Adjust Your Sleep Position For Better Quality Sleep & Life

By Kate Dulac Serodio, DPT, OCS

As a Physical Therapist, I see a lot of sleeping injuries. Sleeping injuries? Yes, literally sleeping injuries!

Injuries that occur while you’re sound asleep or are a result of laying in the same position night after night. We often don’t value the time that we’re sleeping because, well, we’re asleep. But even though you’re not consciously aware of what position you’re in, you’re potentially positioned poorly and laying in a position that increases your risk of injury.

We all have a position that is our go-to position. WebMD acting reports that 63% of people sleep on their side, 16% on their stomach, and only 14% on their back. The thought of changing this is not a welcoming thought for most. On a daily basis, I preach the need to modify “your go-to position” and sleep in the ideal position that allows your body to be in the best resting position that doesn’t cause impingements and allows for gravity to actually do something positive for you, stretch you while you’re asleep.

If you have a neck, shoulder, or back condition or just want to make sure you never do its time you address your sleeping habits. I truly believe this is the #1 most basic modification you could ever do for yourself. So, what is the winning position? As you may have guessed is, yes, your back! This means that 79% of you need to make a change. Even the 14% of the back sleepers will need to make one modification as well. Sleeping on your back ensures that your neck is in alignment with your body with minimal rotation. Your shoulders are being pushed back by gravity and actually help open up your chest. Your low back is also in somewhat of a neutral position without any rotation. The low back will also require a little more help to maintain that ideal resting position, you need to put a wedge under your knees. Not only will a triangular wedge open up your spine and allow for proper fluid circulation and disc nourishment but it also prevents you from rolling over!

So, as you can imagine, I often get a kickback on why is it bad to sleep on your side or stomach, let’s take a look at a few sleep methods…

The Side Sleeper:

If you have Shoulder issues and neck issues, this is the worst position of all! Let’s start with the neck, its very unlikely that you’ll keep your head in alignment with your spine, it’s going to be cranked up or down or rotated creating impingement on either side of your neck, possibly resulting in disc pathology or irritation to the facet joint where you wake up and can’t turn your neck. Next, take a look at your shoulder! That is a rotator cuff accumulative injury. Every night laying on that shoulder. What does that do? That makes the muscles in the front of the shoulder really short and elongates the back of the shoulder muscles. That’s 8 hrs in that position! Do you think a little pec stretch that you might be doing daily for 3 min will combat 8hrs of that position, absolutely not.

Now let’s look at the back, your spine is going to rotate and compress on the nerves that come out of the spine and you’ll end of with one side being tight and the other elongated. Again, just adding to the imbalances.

The Stomach Sleeper:

This position is the absolute worst for your neck or if you have TMD! Most likely you’re asleep looking to the same side every night, resulting in muscle imbalances and joint irritation. One morning you’ll wake up and probably have some tingliness in your hand or inability to rotate your neck. Your shoulders won’t have the benefit of having gravity open then up like they do when you’re on your back but instead cont to rotate forward, again, not helping your posture. Your low back will be arched and in extension compressing the disc space and bones, not allowing for the disc to fill back up with fluid while your rest.

So there you have it, you need to sleep on your back! Whether you have back pain, neck pain, or shoulder pain or you simply want to make sure you never do! And if all that isn’t convincing enough, according to the aesthetic surgical journal, sleeping on your back will help prevent wrinkles!

Here is the type of wedge I recommend. This will place your low back in the perfect position. The wedge will also make sure you stay in this position all night, not allowing you to migrate back to you go to position

Buy Yours Here

Rezilient Professional Stretching targets the muscles in your body that have become super tight from years and years of you sleeping on your side or stomach. A side sleeper will often have tightness in their upper trap, pecs, and hip flexors. Also if you’re a side sleeper you’ll often have a tight lateral fascial line and anterior line (the connection of fascia/tissue that connects all the muscles on the side of your body and all the muscles on the anterior Rezilient targets these muscles in ways that most will struggle stretching independently.

Here’s an example of some of the stretches our team can do for you, to alleviate your pain and help you be resilient.

To find out more call Kate at Hampton Physical Therapy, or fill out this contact form.