What is Erb’s Palsy (Obstetric Brachial Plexus Palsy)?

Erb’s palsy is muscle weakness in the arm or shoulder normally occurring as a result of an injury sustained during the birth process. It can happen when the nerves in a baby’s neck get stretched during the birth and is usually identified soon after birth when a baby shows reduced movement range in an arm. It often occurs following shoulder dystocia, or if they needed ventouse or forceps assistance during their delivery.  

Some babies will recover spontaneously from this condition, whereas some babies will require specialist intervention to recover. In New Zealand, this is often covered on ACC. 

How can physiotherapy treat Erb’s Palsy?  

Physiotherapy for Erb’s Palsy is designed to protect and support a baby’s arm while those stretched nerves recover. Physios can provide a treatment programme that assists with maintaining a baby’s muscle flexibility and joint range of motion in their arm while providing parents and caregivers advice on positions and activities to promote their baby’s development.

How can we help? 

At Auckland Children’s Physiotherapy, we offer a holistic approach to your baby’s Erb’s Palsy treatment. As each baby’s recovery is unique, we start with an assessment and will design a personalised treatment plan from here. Our Erb’s treatment plans are designed to treat while maintaining your baby’s flexibility and joint range of motion in the affected arm. In more severe cases of Erb’s Palsy, we can work in parallel to other medical specialists to enable recovery. We can also offer additional treatment modalities such as functional electrical stimulation if your baby is older or support them post interventions such as botox. 

While intervention and treatment of Erb’s Palsy as an infant is key, we can offer assessment and input at any stage of your child’s journey regardless of their age. 

If your baby has been diagnosed with Erb’s Palsy or you have concerns they might have sustained an injury, we can help.


Written by Ruth Buckman


Are you concerned about the shape of your baby’s head?

Auckland Children’s Physiotherapy is now providing helmet therapy using Serkel helmet’s to treat babies between 4 and 12 months of age for asymmetrical head shapes, such as positional plagiocephaly and brachycephaly. 
Babies are often born with a misshaped head which normally corrects within the first six weeks after birth. However sometimes babies go on to develop ‘flat spots’ which if not identified and managed early can be difficult to correct. 

Auckland Children’s Physiotherapy provides a range of assessment and treatment services for babies with a misshapen head, which now includes Helmet Therapy using Serkel Helmets. Our services start with an assessment of your baby’s head, from which we aim to provide you with comprehensive information about your baby’s head shape and allow you to make an informed decision about treatment choices.

What is a Serkel Helmet and how do they work?

Serkel Helmets are 3D printed, providing an accurate mould of your baby’s head with space for the flattened area to grow. The Serkel helmet works by artificially relieving pressure over the flat spot. Once the pressure is relieved from the weight of the head being in the same spot, the bone starts to grow rounding the head out. The helmets don’t squeeze the skull back into shape, rather they redirect the growth to fill out the flattened area.

Serkel helmets are unique in that they are lightweight allowing them to be used on baby’s from 4 months of age upward, increasing the opportunity to correctively treat during the peak growth period of your baby’s skull. The helmets are breathable with improved ventilation and use changeable inserts that also can be adjusted rather than recast to compensate for growth. Serkel helmets therefore require fewer changes than the traditional helmets used in NZ and Australia, making them significantly less expensive as a treatment option. 

We see Serkel helmets as similar to teeth braces. They help improve your head shape for the future. The future of wearing safety helmets (bicycle helmets), sunglasses or reading glasses. They future proof your child’s three dimensional depth perception  and help ensure an even jaw alignment.  

What’s the Helmet Therapy process?

If you are concerned about your baby’s head shape, the first step is to book an assessment with us at Auckland Children’s Physiotherapy. Our comprehensive assessment process is designed to provide you with all the information about your baby’s head shape and to enable you to make an informed decision about your treatment choices.

If your baby meets the criteria for a Serkle helmet and you want to proceed, we complete a referral to Auckland Orthotics. 

Once your child has been accepted for a Serkle helmet, then the process is very quick. A 3-D image is taken by Auckland Orthotics, which is sent to Australia. In a few weeks, the completed custom fit mould will be returned from Australia and fitted by our specialist Orthotist at Auckland Orthotics. 

Once your baby has been fitted, the helmet will be worn for 23 hours per day for 3-4 months until the treatment is no longer required.  Regular follow-up will be recommended to ensure the therapeutic benefits and adjustments are made as needed in response to your baby’s improvements. 

The benefits of Serkel Helmets

  • Light-weight helmets enable earlier treatment at a younger age

  • Adjustable to improve comfort and allows for growth

  • Breathable materials and interchangeable liners help improves your baby’s comfort

  • More affordable as fewer Helmets are required than traditional Helmets

Our partners


Future Fit is a specially designed 30-minute fitness program to help kids who find exercising a challenge but want to work on “getting stronger”, have “better coordination”, be “faster” at running.  We know kids who find running hard often opt out of sports and games that they would otherwise love to do, this, in turn, makes the gap in their physical fitness greater. Over time this sets them up for unhealthy lifestyles in their teenage and adult years. Often all they need is a short burst of targeted training to close this gap and keep them active.
The kids fitness program has been specifically tailored to provide an all-over body workout but addresses underlying balance, strength, endurance, power, cardiovascular fitness, and coordination deficits that are often holding them back. The class format allows each child to work at their own pace whilst meeting others with the same focus. It allows them to celebrate their improvements with similar ability classmates.  The program is run as a six-week block and it can be accessed virtually or in the clinic to make it easier to fit.
For more information and future dates, contact us on 0221551677.


Toddlers and kids are so busy exploring and challenging their bodies that they are often accident-prone. I can’t think of the last time I jumped off something the height of me! They get muscle strains, torn ligaments, and broken bones although often the mechanism and type of injury is different from adults. They do also have the benefit of youth on their side with a remarkable ability to heal. But sometimes, they need physio to help get them back to their happy and active selves.
Think of the last time you went to physio for a sprained ankle. You would hope that they physio treating you would:
  1. Reduce the pain
  2. Help your get back to your normal activities
  3. Build you back up to your pre-injured ability
Children are no different and deserve the same treatment approach rather than the ‘they will be alright’.
If your child is complaining of an injury secondary to an accident then they are entitled to ACC. No GP or Doctor referral is required. If you have an existing ACC claim number from their injury we can use this or we can help complete a claim application at their appointment.


Intensive Therapy provides the burst that our children need to help them reach the next level in their movement and play.  We are fortunate to have great publicly funded therapy services in New Zealand. However, the frequency and duration of therapy may not always be enough to maximise your child’s potential. We know the timing of therapy is also very important as young brains have a greater ability to adapt and learn which is known as neuroplasticity. Utilising this window of opportunity to teach them new skills and prevent them from developing poor movement patterns that need unlearning is supported by current research and is a fundamental principle of intensive therapy. Programs are specially designed to provide 2- 3 hours of therapy, 4-5 days per week over a two to three-week period.

Our intensive therapy goal:
To drive motor learning by creating permanent neural pathways that lead to lifelong skill development.

What type of therapy is used ?

At Auckland Children’s Therapy, we utilises a number of different treatment methods and approaches.

  • Physiotherapy & Occupational Therapy (Speech Language Therapy on request)
  • Task-specific training
  • Bobath approach
  • Neuromuscular facilitation
  • TheraSuit® Method – Therasuit Method Intensive Program (TMIP)
  • Universal Exercise Unit (spider cage)- full and partial body weight suspension
  • Resisted weight training
  • Electrotherapy- EMG feedback & Neuromuscular facilitation
  • Manual therapy techniques- soft tissue and joint mobilisation
Therasuit® Method Intensive Program and Universal Exercise Unit

TheraSuit® Method Intensive Program is suitable for children older than two years of age. It is used internationally in leading paediatric rehabilitation centers such as John Hopkins All Children’s Hospital with recent changes to public funding within Australia to support the packages (for Australians). Trained therapists utilises a suit system to improve joint alignment and modify underlying muscle tone to promote movement and improve sensory stimulation. The Universal Exercise Unit is often referred to as a ‘Spider Cage’ due to its bungee attachments and is used as part of the Therasuit program.  It allows children to feel what it is like to experience movement on their own if they usually need help to sit or stand. As a therapy tool, it allows the therapist to facilitate or challenge them building strength and sensory experiences in a number of different positions. It can also be used to isolate specific movements to target areas that need special attention. Auckland Children’s Physiotherapy is the only clinic to have a permanent Universal Exercise Unit available locally to New Zealand children. Contact us if you would like to know more about how our intensive therapy program can help your child.

Post-operative Selective Dorsal Rhizotomy rehabilitation 

Selective dorsal rhizotomy (SDR) is a permeant (irreversible) procedure to help reduce lower limb spasticity in children with Cerebral palsy. The goals of the procedure is to; reduce spasticity, prevent the progression of orthopaedic impairments, improve function (sitting balance, standing, transfers, walking ability), or improve care and comfort (GMFCS IV, V).

In children who stand and walk (ambulant children), post-operative rehabilitation is a vital element to maximise the benefits of the surgery. International best practice recommends 24-months outpatient therapy following an SDR with improvements in function continuing to be seen beyond two years post-op.  Within New Zealand, if you have self-funded the surgery abroad and not completed pre-operative assessments through The Child Rehabilitation Service then it is unlikely that you will receive publically funded post-operative therapy.

At Auckland Children’s Physiotherapy, we understand this important need to receive timely, appropriate, and specific therapy for your child. We have worked with a number of children and their family’s who have completed their self-funded SDR journey.  We look forward to the possibility of helping your child post this milestone surgery.



Prolonged toe walking can make their calf muscles tight but also weak.  This makes learning to balance, run, jump and hop difficult for your child. 


Physiotherapy is effective in helping control the negative changes that can occur and helps to promote movement through muscle strengthening, learning optimal movement patterns, balance and maintaining muscle length.


Our practice philosophy is to promote strength and development through play and exercise. We provide a holistic and comprehensive approach that is backed by clinical experience. We can create a tailored individual program to be implemented at home, childcare or school to help meet your child and family’s goals.

Copyright by Auckland Childrens Physio 2020. All rights reserved.