Monday, April 18, 2016

Just Tell Them, "She Tried."

Before I go any further, I thought it would be appropriate to let everyone know who I am.  Many of you have been so kind to join my Facebook page and read this blog,  You're going to trust me to provide you with valuable information.  So...I thought it would be important to tell you all about me.

Well, I'm originally from Windsor, Connecticut.  Yes, it's cold up there.  Very cold.

I received a Bachelor of Science from Temple University in Community Health Education in 1998.  For a year after college, I taught a health class to at-risk girls at an inner-city middle school in Philadelphia, Pennsylvania.  I decided to go to Rutgers University for physical therapy school and graduated with a Master in Physical Therapy in  December of 2001.

From there I moved down to Baltimore, Maryland and began working at the University of Maryland Medical Center in their Shock Trauma division.  There I learned from the best physical therapists around and treated some of the most complicated patients you can think of.  BUT....

I knew that I could do more.  I wanted to spread my wings and fly.  So, I started a business.  After a 12 week course in business ownership at the Women's Entreupreuners of Baltimore, I launched Rapha Physical Therapy.  That was in 2003. I started out just contracting with facilities that were short on physical therapists.  And it grew.  I gained a wonderful mentor, Rodger Henning, who really taught me about owning a business.

I ended up moving out to California Thanksgiving weekend of 2005.  I had an uncle in Los Angeles and we had always talked about starting a business together.  He was an occupational therapy assistant and very passionate about his profession.  I was all set to move out here and he ended up passing.  I came anyways.  Somehow, I just thought he would want me to.

To make a long story short, I established Rapha Physical Therapy in Montclair, California in December of 2006 and have been here ever since.  I met my husband on a blind date in 2005 and ended up getting hitched in 2007.  We now have two beautiful children.   My background is in neurology and pediatrics.  I have worked in the pediatric ICU's of Cedar Sinai and Kaiser Permanente and have attended tons of continuing education courses.

Today my practice provides physical, occupational and speech therapy services to both adults and children.  Our mission is to provide outstanding services to the ones we serve and I have to say, my therapists do a GREAT job.  (Seriously...check out our yelp reviews. Type in Rapha Physical Therapy. We're one of the best in our area.)

So that is little old me.  I encourage you to ask questions, share your ideas, vent your frustrations and just be yourself.  Let's walk this journey together.  Although I've been practicing for 15 years now, there's still so much to learn.  When all is said and done, I want people to say this about me: "She tried."

Wednesday, April 13, 2016

Saying Goodbye

One of the hardest things about being a pediatric physical therapist is saying goodbye the first and second time.  When treating adults with orthopedic injuries you get to enjoy your patient one to three times a week for approximately six to twelve weeks.  You share some good times, get them better and then they’re out the door.

Not so with the kiddos.

You see the kiddos for longer than six to twelve weeks.  Sometimes for years.  You become intricately involved in their lives.  You know their favorite food.  You get invited to birthday parties.  You witness the huge milestones.  You share recipes and business ideas with the mom.  You hear the daily frustrations.  You make the intermittent hospital visits.  You cheer for every goal met and cry for every set back.

And then one day it’s over.

That wonderful piece of sunshine that occupied the one o’clock slot on your schedule for the past 3 years is gone.  They go off to school, they age out, they move away, they get so good you have to discharge them.  It’s over.  And even though you’re happy they’re moving on to bigger and better things, a piece of you is devastated.  Where did the time go?  Did you do enough?  Did you give them the best?  Did they know that you genuinely loved them and wanted to see them soar?
The other day I was in the grocery store and I happened to see the father of one of my previous patients. I treated his son and it had been two years since he was discharged.  I loved that little boy.  I exchanged pleasantries with the dad and when I turned to look at his cart, there was my sunshine looking curiously at me.  “Well, hello there sweetheart,” I cooed.  “Hello.” He shyly returned.

And then it hit me.  He didn’t remember me. 

My sunshine was polite but appropriately filled with “stranger-danger” fear.  The dad told me he was doing fabulously in school and making great gains.  I was happy for him.  We said a few more words and then I moved on.  I wanted to embrace my sunshine.  I wanted to tell him that I loved him…even after all this time.  That I was proud of him and all of his progress.  I wanted to ask him about his school and that stuffed animal he loved so much.

But he didn’t remember me.

And such is the life of your child’s pediatric physical therapist.   Saying good bye the first time is hard.  The second goodbye is even harder.

Have you ever had to say goodbye to a beloved therapist?  How was it?  What was your experience?  

Monday, March 24, 2014


This is one problem that hits close to home. In May 2010, First Lady Michelle Obama of the United States was in full swing with her campaign against childhood obesity.
obesity_image_01According to the Centers for Disease Control and Prevention and reports from the National Health and Nutrition Examination Survey, the prevalence of overweight children between 6-19 years of age is between 17-18 percentile in the United States. This is a disturbing global trend; the number of obese children has tripled over the past four decades across the world.
Why is childhood obesity a problem?
There are several medical issues directly associated to obesity:
  1. Hypertension
  2. Diabetes
  3. Respiratory disease
  4. Increased risk of injury
After a child turns 6, the chances that obesity will persist into adulthood increase by 50%. The sooner obesity is treated, the greater the likelihood that the individual can achieve a normal adult weight.
Is Your Child At Risk?
Here are the known risk factors:
  • Season (winter), population density (large urban areas) are associated with higher childhood and adolescent obesity.
  • Both parents happen to be obese (body frame tends to be inherited).  
  • Levels of parental education and socioeconomic class.
  • Dietary fat intake.
  • Time spent watching television. The average American child watches approximately 25 hours of television per week.
So what contributes to childhood obesity?
  • Diet: High-fat diets, irregular meals and inactivity continue to be primary contributors to obesity. Limit/avoid the “empty calories” like sodas, candy and chips.
  • Inactivitygirl_watching_tv_6011989Inactivity is widely recognized as a contributor to obesity. Children aged 6 to 11 years watch 23.5 hours of TV per week and adolescents ages 12 to 17 years watch about 22 hours. A study published in the American Journal of Clinical Nutrition assessed the effects of reducing television watching and video game-playing in obese 3rd and 4th grade students. The results showed that the body fat level of the children who received the intervention for 6 months dropped significantly compared to the controls.
The Emotional Factor
Children, like adults, can eat in response to moods. Emotions that commonly lead to overeating include sadness, loneliness, anger and celebration. Children can learn to identify their feelings before eating and control the “misinterpreted” urges to eat.
Obese children report greater number of life changes (indicative of stress) compared with other adolescents. Depression, anxiety, social and behavior problems are commonly reported by obese children.
Exercise As The Solution
A physical therapist can determine realistic weight loss or maintenance goals and help the child accept his / her natural body frame. Otherwise, he/she will constantly strive for an unrealistic weight, often leading to restrictive dieting, overeating or binging. Weight loss of one-half to 1 pound per week is realistic. If a child you know needs help, seek the services of a physical therapist, who can set goals that are small and attainable so that the child doesn't feel discouraged.
football_dad_with_kidsEncourage daily activity in obese children. Sports participation contributes to improved fitness levels, specifically increased endurance, strength, self-esteem, energy and often, improved mood. Family involvement is crucial.
A physical therapist can identify what (if any) changes family members must make to improve the health and fitness level of everyone in the family—not just the obese member. The parents must become good role models with their eating, exercise and stress management. Strive for an attitude of "we're going to do this together."

Wednesday, February 5, 2014


You know the drill well.  It's been a long day.  You're tired.  They're tired.  You give them a bath, put them in the bed, read a bedtime story and turn out the lights.  You're done.  Finally.  You can take the next hour and relax.  Maybe catch up with the latest happenings on Facebook.  Read some of that book you've been dying to dive into.  Eat uninterrupted.  But then you hear a sound coming from their room.  Someone is jumping on the bed.  You go in, give a firm warning and head down the hallway again. Silence.  But it's short lived.  They're back up again.  This time they're playing with the faucet in the bathroom sink.  You give a pleading speech and they reluctantly head into their room. A few minutes later though, the loud crash of something breaking assaults the fragile silence.  You stomp back into the room to find that the lamp is in pieces on the floor as well as the new toy you bought just the other day.  Why won't this kid go to sleep, you ask?  Exhausted, you grab the broom and dust pan.  Just a typical night.  You know it's going to be at least two hours before they get to sleep.

Sound familiar?  Don't worry, you're not alone.  Many children with Autism and Asberger's deal with insomnia.  Sometimes it's caused by the absence of a consistent bedtime routine, fear of the dark, or long napping during the day time.  Or maybe your child is unable to remain asleep.  Maybe he or she is easily awakened by the slightest noise.  Or maybe he or she just gets hungry in the middle of the night.  Don't despair.  We've adapted ten suggestions from the book, "1001 Great Ideas for Teaching and Raising Children with Autism and Asperger's," by Ellen Notbohm and Veronica Zysk on how to get your little one to fall asleep better and stay that way.  

1.  Document, document, document.  Keep a journal and write down when and how often sleeping issues occur.
2. Look for physical issues that may be hindering sleep
3. Look for behavioral issues that may be hindering sleep
4. Set up a regular bedtime and STICK TO IT!  No if, ands or buts.  This one will be difficult at first but will get easier as you become more firm with your expectations.
5. Don't over-stimulate your little one right before bed.  This means no sugar or chocolate.  And please don't introduce any electronics (TV, computer, or games) within one hour of  bedtime.
6. Allow your child to ONLY fall asleep in his bed.  Make it the only location meant for sleep.
7. Create an environment that encourages sleep.  The room should be dark, quiet and at a comfortable temperature
8. Try your best not to let your child wander.  Install a Dutch door with the top open and the bottom locked.
9. Look around the room and try to eliminate any sensory-disturbing items such as ticking clocks, tree branches that scratch the window(s), or humming appliances such as heating or cooling units.
10. Try to make sure that the environment your child goes to sleep in remains that way for the duration of his sleep.

We welcome your comments on this subject and can't wait to hear your thoughts!

Wednesday, January 22, 2014


Torticollis literally means, “twisted neck” in Latin.  Also known as “wry neck” or “loxia,” Torticollis is a fixed or dynamic tilt, rotation, or flexion of the head and/or neck. This is usually manifested by a baby’s head being tilted to one side with their chin towards the opposite side.
The First Thing You Didn’t Know About Torticollis
There are actually three types of Torticollis.  The first type is called, Congenital Muscular Torticollis.  Although not completely clear, it’s most thought to be caused by trauma to the neck during birth or abnormal positioning of the baby while in the uterus (for example, a breech position).
This kind of Torticollis is usually discovered between six to eight weeks after birth when a baby begins to have more control over his head.  The sternocleidomastoid muscle (SCM), a muscle in the neck, becomes excessively shortened and causes the baby to be unable to turn and/or tilt his head.  If the shortened muscle is caused by trauma, the SCM will develop scar tissue as it heals, restricting the baby from turning his head.  The second type of Torticollis is Acquired Torticollis.  This type usually develops after the baby has reached its first birthday.  A child might develop it if he or she sleeps in the wrong position or injures his head.  The SCM and other muscles of the neck may spasm, causing the head to tilt to one side.  This type of Torticollis may also be caused by an upper respiratory infection when the lymph nodes in the neck swell. The third type of Torticollis is Spasmodic Torticollis (ak.a. Cervical Dystonia).  It is caused by a dysfunction of the brain which causes the muscles around the neck to contract intermittently or all the time.   This type of torticollis may be extremely painful and cause the shoulders to be uneven.  This type of Torticollis is mainly seen in adults.
The Second Thing You Didn’t Know About Torticollis
Did you know that Tortocollis is described depending on the position of the neck?  There are four positions:
  1. laterocollis : This is when the head is tipped to the side towards the shoulder. (think this: the ear is trying to touch the shoulder)
  2. rotational torticollis : This is when the head is actually rotated to one side.
  3. anterocollis : This is when the head and neck is tilted forward (think this: chin to chest).
  4. retrocollis : When the head is tilted backwards
The Third Thing You Didn’t Know About Torticollis

Physical Therapy provides treatment of Torticollis!  It is always a good idea to get an evaluation by a pediatric physical therapist if you suspect that your child has Torticollis. This type of therapist is specially trained to handle pediatric diagnoses.  He or she will assess and measure the range of motion of your child’s neck and evaluate any muscle tightness.  S/he will also evaluate your child’s muscle strength and gross motor skills.  Lastly, he or she will check for other conditions that can occur with torticollis such as plagiocephaly (abnormal head shape), hip dysplasia (misalignment of the hip joint), and spine problems. The therapist will then discuss these results with the family and make appropriate recommendations for physical therapy treatment. If it is indicated, the physical therapist will then perform a stretching program to the neck and instruct the family in a stretching and positioning program designed specifically to the child's needs. He or she will also educate the parent in how to perform a daily home exercise program.   

Why is Early Treatment Important?
Receiving early treatment for Torticollis is important.  It can prevent a permanent shortening of the involved muscle, avoid the need for surgery and prevent plagiocephaly (flattening of the head on one side), delayed developmental motor skills and facial asymmetries.
At Rapha Physical Therapy, our pediatric therapists use a hands-on method to treat Torticollis coupled with health education and internet resources.  We typically see significant results between 6 to 8 weeks and complete recovery within 12 visits.  When Torticollis treatment is implemented early, the majority of children recover completely in a short period of time.  Don’t go it alone.  If you see that your child’s head is tilted towards one side, talk to your doctor about treatment and ask for a referral to a pediatric physical therapist.

Thursday, June 2, 2011

Welcome From Rapha

Welcome!  We're glad you're here! 

By reading this blog, you have decided to take an important and wise choice to empower yourself with knowledge!  It's not a mistake you're here.  We are so excited to educate you in the latest information about pediatric neurological and musculoskeletal ailments.  Our aim is to help you as parents, caregivers, friends and loved ones, make smart and informed decisions about your child's condition and therapy needs.   Here, you are free to post questions, leave comments and even make recommendations of your very own. If you have not visited our official website,, please do!  Please subscribe to this blog and make it a point to come back often. We can't wait to hear from you!