shallow hip socket+low muscle tone in ds (nearly 4) - advice

[hazeyjane]

Ds is nearly 4 and has a genetic condition which means he has learning disabilities and health issues.

He fell a couple of months ago, and has struggled to walk since - he has always been a very slow walker, with a 'swivelly' gait and struggles to walk any distance, but this reduced to practically no walking after the fall. When he did walk, he would limp, go up on one toe and kind of hitch his leg around.

After several hospital visits and talking to his physio, they finally agreed to xray his hips and discovered that he has a malformed hip - so the socket is too shallow, meaning the ball moves too much in the socket, and the orthopaedic cons thought he must have had a partial subluxation, which has slipped back in. His walking is starting to improve now.

Because of his low tone, I think he is more prone to damage when he falls.

Does anyone have any experience of this? I am speaking to his physio tomorrow, are there any questions I should be asking?

Any experience?

No experience but I have seen a hip harness which is quite lightweight and keeps the legs from splaying open and keeps the hips supported. Only from America, but can't remember what it's called. Specific to hypotonia.

Sorry only just seen your message! Thanks sneezecakesmum. I will have a google and ask his physio.

My DD was in a hip brace for her shallow hip for several months, but the NHS picked up on her malformed hip when she was 9 weeks old!

I do hope there is something that can be done for your DS soon.

Check out Steps charity website for hip dysplasia. My dd was born with shallow sockets and has had operations at 2 and a half to sort them out. She walked with a wobbly gait but is absolutely fine now at 5. There are lots of children who have hip problems and low muscle tone, hypermobility. Swimming and physio etc can help.

Thankyou HangingBaskets. I have a friend whose little girl had to have several operations and wear a hip spica, she also recommended steps. I have just had the letter from the orthopaedic consultant and it is full of mistakes! It says he has a low grade hip dysplasia, and recommends physio and hydrotherapy.

My worry is that such a minor fall left him so immobile for such a long time. He struggles to walk anyway, with a very wobbly gait, and very low stamina, and relies on a sn buggy to get around any distance.

It might be worth getting a second opinion from a consultant who specialises in children's hips. I am in the Midlands so can recommend some consultants here if that helps at all.

My eldest has extreme hypermobility which means dislocations and subluxations are likely (though we've only had 1), and her muscle tone is naturally quite low (part of the same syndrome).

Our paediatric physio advised always wearing supportive shoes with strong heel cups, sometimes special shoes, (no sandles, crocs etc). We were also told that physio for under 5s is difficult so best to do gymnastics and ballet classes. These have made an unbelievable difference to our child's strength, muscle tone, ability to walk without tripping all the time, and confidence.

Thankyou Pollaidh. Ds has only ever worn Piedro boots, due to his low tone, he started walking at 28 months, but has always struggled with walking, and has never been able to run or climb. At the moment we do a lot of soft play as exercise, he used to do weekly hydrotherapy, but hated it and would only cling onto me like a koala bear! We have been re referred so will try that. I tried a gymnastics class but he was again, very clingy, but also unable to access a lot of the things that the other children were doing.

I notice that he is very stiff first thing in the morning, he can barely walk when he first gets ups, then he loosens up a bit through the day, but when he is tired he struggles and becomes very floppy.

We were advised to put ours in snow boots - even in summer!

Softplay sounds like a good solution for now. I know we're v lucky where we are in that we have a superb gymnastics centre which also has soft play for little ones and builds them up slowly. Her early classes were parent-assisted, so I could give her 1:1 help and build her confidence, but now she goes on her own.

My friend's 4 yr old with Downs Syndrome does riding for the disabled to increase her core muscle tone - is there something like that possible?

We also have a sitfit (a sort of flat wobbly thing equivalent to sitting on a yoga ball), it was for me to sit on but my Dd likes to stand on it and wobble, which builds her core strength too.

Ds starts school in a special needs unit within mainstream in Sept, and they do Riding for the Disabled there, his physio says he will need a special harness, but that it will be great for his core strength - he has very low tone in his trunk. The snow boots are a good idea, I'll check with his physio as ds has quite peculiar feet, very small but fat and still bunched up like a smaller baby.