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In the morning, the kids and I went to Spaulding in Lexington. T. was born with the same kind of wonky foot (angled, but the shape is right, so not a club foot in the strict sense) that my sister and I were born with. We had been subjected to foot braces, which we believe caused lasting problems for our ankles, knees, hips, pelvic development, etc. Since T. walked very early (8 months) and effectively (walked over a mile at 11 months), I felt that we should just leave this all alone. The weird angle more or less resolved on its own, justifying, in my mind, a wait and see approach.
Over time, people became concerned with his toe walking. Again, I was in favor of letting that be. A large fraction of the adult female population wears heels all the time. They are toe walking. From my perspective, one shouldn’t be selecting my kid for attention to something which is instilled as a semi-mandatory cultural norm for so many others. However, as kids get older, they spend more time with other people in other contexts, and I believe having different rules in different contexts increases flexibility. Plus, if you can’t adapt to that, your adult life _will_ involve institutions who will not go along with my Just Leave It Alone philosophy. I departed the field, recognizing a win here was not possible.
The verbal approach to Hey Dude Heel Strike was, over time, successful, but has led to an increasingly weird looking arch (that actually does bother me) and duck walking (toes angled out — also bothers me a little, more than toe walking, for sure). At his latest physical (well, one of them), he was referred to Spaulding for orthotics. This was that appointment.
The therapist disagreed with the orthotics idea. She felt that the entire history — toe walking, arch reshaping, duck walking — suggested tightness in the quads, gastrocnemius, hamstring, etc., that could be addressed more effectively with a program of stretching. While I am prepared to agree with this theory as an explanation of what has happened to date, I am less prepared to sign up for the idea that stretching will meaningfully fix this. There is a tendency to tell _compliant_ PT patients that they didn’t enjoy good success because they were not compliant. PT people tend to believe that if it didn’t work, it is because you didn’t do the work. They don’t have a meaningful context for understanding that there is actually a limit, and the limit might not be where you think it is. I provided one (my standard, most of us can jump, with effort, we can jump higher, with training, probably higher still — yet none of us can jump to the moon) and asked, what is your process for determining when this isn’t working OTHER THAN saying, hey, it would have worked if you had actually done the exercises. We agreed to do a 4 week assessment after 4 appointments / weeks of doing the home exercises and deciding whether there was any progress and what to do next. Not an answer, but an acknowledgement.
My plan is to get the school PT to take over getting the daily exercises done 5x a week, if at all possible, if this is going to go on for more than a month.
After Spaulding, we stopped at McDonald’s for lunch, then we went to Altitude for a half hour of jumping. I’m going to try to do this a couple times a week for A., because it is a form of vigorous exercise that she actually really likes.
I had a haircut later in the day, because we will be attending a wedding this weekend and it is about time.
Over time, people became concerned with his toe walking. Again, I was in favor of letting that be. A large fraction of the adult female population wears heels all the time. They are toe walking. From my perspective, one shouldn’t be selecting my kid for attention to something which is instilled as a semi-mandatory cultural norm for so many others. However, as kids get older, they spend more time with other people in other contexts, and I believe having different rules in different contexts increases flexibility. Plus, if you can’t adapt to that, your adult life _will_ involve institutions who will not go along with my Just Leave It Alone philosophy. I departed the field, recognizing a win here was not possible.
The verbal approach to Hey Dude Heel Strike was, over time, successful, but has led to an increasingly weird looking arch (that actually does bother me) and duck walking (toes angled out — also bothers me a little, more than toe walking, for sure). At his latest physical (well, one of them), he was referred to Spaulding for orthotics. This was that appointment.
The therapist disagreed with the orthotics idea. She felt that the entire history — toe walking, arch reshaping, duck walking — suggested tightness in the quads, gastrocnemius, hamstring, etc., that could be addressed more effectively with a program of stretching. While I am prepared to agree with this theory as an explanation of what has happened to date, I am less prepared to sign up for the idea that stretching will meaningfully fix this. There is a tendency to tell _compliant_ PT patients that they didn’t enjoy good success because they were not compliant. PT people tend to believe that if it didn’t work, it is because you didn’t do the work. They don’t have a meaningful context for understanding that there is actually a limit, and the limit might not be where you think it is. I provided one (my standard, most of us can jump, with effort, we can jump higher, with training, probably higher still — yet none of us can jump to the moon) and asked, what is your process for determining when this isn’t working OTHER THAN saying, hey, it would have worked if you had actually done the exercises. We agreed to do a 4 week assessment after 4 appointments / weeks of doing the home exercises and deciding whether there was any progress and what to do next. Not an answer, but an acknowledgement.
My plan is to get the school PT to take over getting the daily exercises done 5x a week, if at all possible, if this is going to go on for more than a month.
After Spaulding, we stopped at McDonald’s for lunch, then we went to Altitude for a half hour of jumping. I’m going to try to do this a couple times a week for A., because it is a form of vigorous exercise that she actually really likes.
I had a haircut later in the day, because we will be attending a wedding this weekend and it is about time.