Teen Boy With Severe Toe Walking Sees Extreme Improvement

Submitted by KJM, Occupational Therapist

Teen Boy With Severe Toe Walking Sees Extreme Improvement
Before
After
Toe walking so severe that surgery was being considered
Returned to normal walking
Tendency toward hyper-excitability
Extreme reduction in need for behavior management

 

I have the pleasure of reporting on a high school student, who in one month has made gains in self-calming strategies and overall behavior that have not been seen in years of therapy. No one really knows how or why this has happened, but you and I have a good idea...I introduced rhythmic movement to him at the beginning of December.

Until recently, Mondays back at school were very difficult for both student and the staff. I also noted in the past, he was prone to hyper-excitability and toe walking, which seems more pronounced because he is over 6 feet tall.

To combat the severe toe walking, this student had one year of serial casting to minimize plantar flexion and increase the length of Achilles tendon. This had the desired effect for less than six months, then back to toe walking. The next medical step is reportedly surgery, and the grandparents asked for my advice. I suggested that the student may have a retained primitive TLR and he would benefit from daily and rhythmic motion. When I told the grandparents that toe walking is a way for him to bring his center of gravity forward to prevent feeling like he might fall backward, grandfather said when he asks the student why he walks on his toes, the student replies “so I don’t fall backwards!” My insight was a revelation to them, but all in a day’s work for us!

The student participates in daily breathing, yoga, cross crawl, windshield wipers, star/stone, and rocking while he lays on his side. This child has made such an improvement in the past month that the staff can’t believe that it’s simply the exercises. If it weren’t for difficulties due to autism, he would likely be categorized as gifted. It’s amazing to see, even though I have only 30 min/month allocated for him.

Monday mornings are no longer aimed at behavior management by his staff.

And to think the next step was surgery. I will continue monitoring this student who luckily has an attentive aide. (emphasis added)

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