Amanda Wilde (Host): Welcome to Healing Heroes PDX, the podcast series from the Specialists at Shriners Children's, Portland. Today, we are discussing physical therapy at Shriners Children's Portland with Physical therapist, Elena Absalon. I'm Amanda Wilde. And Elena, it is great to have you here.

Elena Absalon: Thanks for having me.

Host: So, you are a dedicated physical therapist within the Shriner Children's Network, and I know you brought extensive experience from an earlier career in Southern California. Now, recently, you were board-certified as a pediatric physical therapist, and that's a distinction, only a few physical therapists achieve. So first of all, congratulations and just glad to have you with us to answer some questions about physical therapy, like what are the most common reasons you see kids and adolescents in your therapy room?

Elena Absalon: For me, I see a wide range of diagnoses and ages. I'll see kids with cerebral palsy. I'm part of the team that treats kids with spina bifida. I also do a little bit of sports medicine with post-op meniscal repairs, MPFL repairs, and quite a few post-operative hip procedures, so labral repairs, PAOs, total hip arthroplasties. And I'm also a part of the inpatient team where I see kids on the inpatient unit for any surgery that any of our surgeons do from spinal fusions for scoliosis to osteotomies and other lower extremity surgeries and help them with those initial first days of mobility. So, I'm fortunate I get to work on the outpatient side of our rehab team and the inpatient side and see just like a wide variety of orthopedic and neurodevelopmental diagnoses.

Host: And you have a broad range of techniques to match that. I'm sure the plans that you do are very individual, but what can families generally expect when coming to see you for the first time with a physical therapy need?

Elena Absalon: Well, exactly that, individualized care. And we'll discuss specific goals, create an individualized approach. I will seek evidence-based care, but also make it family-specific. And one goal that I always have is meeting families where they are, and empowering families to have the knowledge and be able to carry out our therapy plans at home. So, that's what they can expect from me.

Host: And what's important for kids and their parents to know about their participation in physical therapy?

Elena Absalon: Well, this kind of links back to it being individualized, that we are going to work on finding something that works for their specific needs, their family structure, the time that they have during the day, really meeting kids and families where they're at. And I also always want to think about, you know, physical therapy, we think of movement and being able to do physical things. It's really about optimizing movement, whatever form that is, if it's walking, if it's wheelchair use. Just maximizing independence and participation.

Host: So, optimizing movement and maximizing independence.

Elena Absalon: Independence and participation.

Host: Which probably answers my next question, which is what makes it a successful experience for patients to have physical therapy? And it sounds like those are the goals. Keep mobility at its best and participation in activities.

Elena Absalon: Yeah. An individualized mobility, because many people think like physical therapy, the goal is walking. We want to walk. But I have a lot of patients I see who are wheelchair users and maybe the goal is getting really strong in their shoulders to maintain shoulder health. Maybe the goal is getting their wheelchair, fitting them better, and working with our wheelchair vendor so that they are faster and can keep up with their peers better without hurting their shoulders, or maybe it's finding a alternative mode of mobility. So really, just whatever mobility improves and enhances independence, that's the goal that I'm going for.

Host: And when you reach the goal, I mean, is there a point where some patients no longer need physical therapy?

Elena Absalon: Yeah, ideally, we meet the goals and the family and the kids know what to do to self monitor and manage their condition independently and know when they need to come back for care, when they need to follow up with the physician. That's the ideal situation. I would say that in the neurodevelopmental population or kids who are experiencing disability or longer term chronic conditions, it might be more of we've reached a point where family knows what to do, kid knows what to do, and we're going to take a short break from therapy so that they can focus their energy on enjoying their summer or spending time with their family or school and then come back to me in a few months.

So, I am a big fan of these like kind of episodes of care for the kids that are going to be in PT for long, long terms of their life. I like to kind of educate families at the beginning that we may do kind of an episode of care. And if it's appropriate at the end of that episode, we may plan to take a break and have them come back in the future for a little bit more physical therapy. But really, my goal is empowering families and kids to be active participants in managing their care and feeling like they're knowledgeable about what they need to do for their body.

Host: What would you say makes the physical therapy experience at Shriners Children's different than at another facility?

Elena Absalon: We have just an amazing team here, from our physical therapists, occupational therapists, speech therapists, recreation therapists. People are very specialized. We have therapists who specialize in things that, like when I worked at other clinics, I maybe saw one child with this diagnosis. And we have therapists who have years of knowledge about a specific group or specific diagnosis. So, very specialized care from our therapists and our physicians, our nurses. I think that makes it different than somebody's experience would be at a different clinic.

Host: Sounds optimum, the team approach. I mentioned earlier that you are board certified as a pediatric physical therapist and only a few PTs are certified in that way. You also have special training. Can you talk about that in neurodevelopmental disorders? And you also host a Spanish language group for the therapy services team. So, can you talk about the specialties you bring in? You just described how other people are bringing really specialized areas in and you have many of your own.

Elena Absalon: Yeah. My first two jobs were in early intervention where I specialized in the zero to three age group. And then, the next clinic was, again, kind of the younger children. Zero to seven was most of the age range I saw. I saw some continuing education specifically in torticollis because that was a diagnosis I saw a lot of.

Host: Can you describe what that is really quickly?

Elena Absalon: Yeah. So, torticollis is tightness in the neck muscles, often noticed early after birth with kids having a head tilt and preference to look to one side or the other. It's really common in infants. Oftentimes it resolves on its own, as kids are doing tummy time and strengthening their neck muscles. For some kids, it does not resolve. And they need a little bit of extra specialized care and focus, stretching and intervention. So, that's what torticollis is.

Host: Thank you because that is one that you said it's quite common, but I didn't recognize the name.

Elena Absalon: Yeah. Yeah. it's quite common. And in PT school, we learn about it as one neck muscle. And really, it affects so much more, especially in infants as they're developing motor milestones and ensuring that they are not doing things asymmetrically on one side or the other. So, I see it as like a much bigger thing than just one neck muscle. I see it kind of more in the whole child and how they are developing. So, I really love working with kids who have torticollis. It's a fun age and it gets better with the right exercises and you get to see them just achieve new milestones and grow. So, I do love working with that population.

Host: You mentioned that you took it upon yourself to learn more, sounds like in that instance and in previous instances. Elena, what is it that drew you to physical therapy? You're obviously passionate about what you do.

Elena Absalon: I had excellent professors in PT school that were specialized in Pediatrics, and I really enjoyed learning from them and being a part of some of their research projects. And my mom is actually a pediatric physical therapist, so I was always a little bit drawn to it in that sense as well. So, I knew about it and I thought I would go more into an orthopedic route. And then, towards the end of my PT school career, I got drawn back into Pediatrics and that's where I landed and continued.

Host: And can you tell us more about the Spanish language group for the therapy services team?

Elena Absalon: The Spanish language group is a group in the rehab department that I host along with our wonderful Spanish medical interpreters here at Shriner's Children's Portland. We review useful words that might be helpful for our therapy session. It's with varying levels of Spanish comprehension in our group. So, we start with simple words, but just anything that could be useful and help therapists kind of gain rapport and connection with families that are primarily Spanish-speaking. And when you're doing a therapy session, sometimes you need to be able to say a word quickly, especially when you're doing like physical things, live queuing, it's really helpful to have some words in your back pocket. So, once a month, we get together and try to learn some new words.

Host: As you keep learning more and more and this field keeps advancing, do you feel like you also have that history behind you with your mom and can see sort of the whole spectrum of development of physical therapy, especially pediatric physical therapy?

Elena Absalon: She works in a different field of pediatrics and it's been great to talk just about how it's changed over the years and also talk about the areas of our field where it overlaps and where it also is very different. And it's actually been great to have somebody else to collaborate and talk to.

Host: Well, she obviously is a huge influence on you as our parents are, but this was in a good way. It's not always. So, thank you for doing something great in the world of healing and thanks for sharing your expertise today.

Elena Absalon: Yeah, absolutely. Thank you for having me.

Host: That was physical therapist, Elena Absalon. For more information, head on over to our website at shrinersportland.org. If you found this podcast helpful, please share it and check out the full podcast library for topics of interest to you. And that concludes this episode of Healing Heroes PDX with Shriners Children's Portland.