Skip to content

Archive for

Playground Safety

Kids love to play on the playground and there are a lot of benefits to outdoor play. Playgrounds are an opportunity for kids to get fresh air, sunshine, exercise and make new friends. Marie Crew agrees. She’s the director of Alabama Safe Kids at Children’s of Alabama. “Alabama has a high obesity rate, so we want the children to be active. We want kids playing at least 60 minutes a day,” she said.

It’s important that parents do their part to ensure their child’s time on the playground is fun and injury-free. Each year, more than 200,000 kids are treated in hospital emergency departments for playground- related injuries. Many of these accidents are preventable with the proper supervision.

“That’s the big thing. We want parents to be with their children,” Crew said. “Parents should check the playground to be sure it’s in good repair. We want parents to put their phones down and interact with their children.”

Children should never play on a playground unsupervised. Young children can’t always judge distances properly and can’t foresee dangerous situations while older children like to test their limits. It’s important for an adult to be there to help keep them safe.

In addition to supervision, before children play on a playground, an adult should always check it for safety. Make sure the playground equipment is in good shape. If it has instructions on it, be sure to read them. Many playgrounds indicate the recommended age range for children.  Toddlers should be on a separate playground with special equipment that is lower to the ground.

Crew said a proper playground surface is important as well. “It’s best to have a soft, spongy surface that can cushion falls. Shredded tires, pea gravel and and mulch are options as well,” she said. Concrete, asphalt, grass and packed earth surfaces are not safe.

Modern playgrounds are often made of plastic instead of metal, which can get too hot. Even still, Crew recommends parents think about the heat of the day and check the equipment before their child plays on it to make sure it isn’t too hot.

Children love for their parents to engage with them when they’re playing on the playground. A good recommendation is for the adult to be close by, encouraging and watching their child while they play. Play is an important part of kids physical, social, intellectual and emotional development. By taking a few extra precautions, they can learn and grow through play while being more likely to stay safe and injury-free.

Juvenile Arthritis Awareness Month

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood and affects about one in 1,000 children. It is a chronic autoimmune disease which does not go away because it is a result of the person’s own immune system.

An autoimmune disease is one in which white blood cells cannot tell the difference between the body’s own healthy cells and germs like bacteria and viruses. The immune system, which is supposed to protect the body from these harmful invaders, instead releases chemicals that can damage healthy tissues and cause inflammation and pain.

“Each year more than 1,000 patients are treated in our rheumatology clinic,” said Dr. Melissa Mannion, pediatric rheumatologist at Children’s of Alabama. “It is our goal to provide patients with resources and treatments to develop growth and development.”

Dr. Melissa Mannion

Signs and Symptoms

The first signs of arthritis can be subtle or obvious, so an early and accurate diagnosis is key to effectively managing JIA. According to Dr. Mannion, the criteria for diagnosis includes age less than 16 at the onset of symptoms, symptoms present for at least six weeks, symptoms including the presence of arthritis on exam, and no other explanation for the arthritis-like cancer or infection.

Understanding the symptoms and characteristics of each type of JIA is crucial. Some of the common symptoms include:

  • Limping
  • Warm joints
  • Sore wrist, finger or knee
  • Sudden swelling of joins that remain enlarged
  • Stiffness in the neck, hips or other joints

“If someone’s disease stays inactive for a long time, usually at least six months, they are said to be in remission,” she said. “Remission means that the disease is quiet, but the disease itself is not gone since there is no cure. Sometimes remission can last for months, years or a person’s lifetime.”

Diagnosis

If a parent is worried that their child has arthritis they should talk to their pediatrician. The pediatrician will evaluate the duration of the symptoms, what hurts, when it hurts, where the swelling occurs, how long it lasts, what makes the pain or swelling better or worse, and if there are any other symptoms like fever or rashes. They will also help determine if your child needs to see a rheumatologist.

To diagnose JIA, the rheumatologist will ask questions about the child’s symptoms, find out whether other family members have had similar problems, and do a thorough physical examination.

It is important that the doctor identifies any additional signs or symptoms to classify or describe the type of JIA, as there are multiple. In some cases, the doctor will use imaging, like musculoskeletal ultrasound or MRI, to look for inflammation inside the joints. The doctor may also order X-rays or blood tests to rule out other conditions or infections, such as Lyme disease, that may cause similar symptoms or occur along with the arthritis.

Treatment

The health care providers, including the primary care physician, rheumatologist, and physical therapist, will work together to develop the best method of treatment for each child.

“Medications are used to control the immune system to stop the symptoms and prevent damage from the disease,” she said. “Some patients can be treated with a steroid injection into the joint, but because the immune system is not only located in one joint most patients will need systemic medications to control their disease.”

The goals of treatment are to relieve pain and inflammation, slow down or prevent the destruction of joints, and restore use and function of the joints to promote optimal growth, physical activity, and social and emotional development.

Facilities

Children’s division consists of five board-certified pediatric rheumatologists, one pediatric rheumatology fellow (in-training), and three nurse practitioners who see patients with the faculty members. Patients can be seen at the Children’s of Alabama main campus, Children’s South on Acton Road, and in satellite clinics in Huntsville, Montgomery, and Mobile.

For more information, visit childrensal.org/rheumatology.