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Tag: toe walking

feet forward

Put Your Best Foot Forward!

When to see a pediatric physical therapist for your child’s feet?

How do you know if your child’s little feet are functioning at their very best? Here are 10 clear signs that you should have a pediatric physical therapist screen your child’s feet so they can put their best foot forward!

Pain 

If walking causes pain in your child’s feet this is a concern that should be addressed immediately. There are a number of reasons for pain in the feet and a pediatric PT can assess and address painful walking.  

Asymmetry

Any difference in one foot compared to the other foot should be seen by a pediatric PT. Feet should look and move the same at the other foot. Seek advice if you notice a difference in foot size, a heel lifted on one side, turning in or out of one foot or any other noticeable differences. 

Toe Walking

Toe walking is an abnormal gait or walk at any age at any time! We often see children raise up on their toes when they are very excited, nervous or cold but only for a few steps and then come down to their heels to walk or run. The earlier a child is seen for toe walking, the faster the treatment and the better the outcome. Don’t Wait!

In or Out Toeing (Pigeon or Duck footed)

Toe inning or outing is a common foot alignment deficit. When the feet are not aligned, the knees are not aligned which can lead to pain and inflammation. Often it can be a sign of leg, hip or trunk weakness or all three! It could also be a misalignment of bones within the joints. Seeing a pediatric PTl will determine the root cause and help get those duck feet in a row!

Flat Feet / Pronation

Flat feet is when almost the whole foot makes contact with the floor while standing. Pronation is when the ankle collapses inward when standing. Both flat feet and pronation can cause similar problems. Postural deficits are usually present as well as over use and under used muscle groups. This imbalance causes poor body mechanics which can lead to premature breakdown of joints. Flat feet and pronation cause the body to move inefficiently. It will take more energy to walk, run and jump!  

Tripping

Children are still developing their sensory systems and body awareness which can look a bit messy. It’s common to miss a crack in the sidewalk or move too fast for their feet causing them to trip and fall. Tripping becomes a problem when they are doing it so much they are hurting themselves. Tripping on the same thing over and over, on stairs or ramps, carpets or even nothing at all can be concerning.  A pediatric PT will be able to assess why they are tripping so often and help keep them on their feet!

Fatigues Quickly with Walking

Carry me! Is a phrase often used by a child who fatigues quickly when walking. A child who has good endurance, body mechanics, postural control and strength will want to walk vs being pushed in a stroller or carried. A child who struggles with one or more of these deficits will fatigue quickly when walking and ask to be carried more often. Ask a professional if your child seems to fatigue quickly when walking vs other children their age. 

Aversion to changing shoes

New shoes or any new clothing item can be stressful to a developing sensory system. Our children who are more sensitive to change will often break down their favorite pair of shoes to a thin sole, or wear shoes that lack proper support such as slip-on type shoes. A professional can help get children into good quality shoes that support the foot properly, helping them to move with better posture and efficiency. Let’s make shopping for new shoes fun! 

Sprained or twisted ankles

This painful injury literally stops you in your tracks. It’s common once in a while but abnormal if it happens over and over again, especially when doing everyday activities. Ankle weakness, misalignment or even vision could be the cause of ankle sprains. A PT can assess and address the reason for this very painful problem. 

Abnormal gait / walk

Any abnormality of a child’s gait should be addressed as soon as possible. Sometimes it’s hard to put your finger on it because the smallest thing could be affecting their gait or it comes and goes. Listen for your child’s steps on a hard surface. It should be an even beat most of the time. Rubbing the top of their foot while walking can be a sensory movement that is affecting their gait. Running instead of walking. Gait abnormalities can easily be addressed in PT. 

High Arches

High arches do not always need to be addressed but if your child has any other deficits such as any problems above, then high arches may need extra support. A PT can assess their gait and determine if treatment is necessary. 

Pediatric Physical Therapists assess the cause of these symptoms and use conservative interventions to improve their everyday function on their feet! They will also refer you to the appropriate healthcare professionals when extra attention is required for the best care of those little feet! 

Set up a free screening with a pediatric PT to ensure your child is putting their best foot forward!

Written By: Dana Bukala, PTA

 

Reflex

Primitive Reflexes

Primative Reflexes- The Good, The Bad, The Better!

Have you ever tripped and simultaneously reached out your hands to stop the fall? That is your primitive reflexes at work! They are essential as the first line of defense to protect ourselves but they can also be detrimental to our development.

What are primitive reflexes? 

Primitive reflexes are involuntary motor responses present at infancy that facilitate survival. Pediatricians check these reflexes at wellness visits to ensure the nervous system is working properly. It is important that these reflexes are present but it is just as important that these reflexes mature or integrate in early childhood. 

The Good: 

REFLEX

GOOD

Moro Reflex

The startle reflex

A fear response to sudden movements or noise
Hands PullingHead control reflex and the ability to contract our muscles to sit up
Hands SupportingOur falling reflex. Ability to reach out and catch yourself.
Tonic Labyrinthine (TLR)Develops balance and spatial awareness
STNRHead, limbs and balance system connection
Asymmetrical Tonic Neck Reflex (ATNR):  Differentiates our left and right side.
Spinal GalantConnects the trunk and lower body
AmphibianActivates nerves between both hemispheres of the brain
Babinski:Supports mature walking and balance
BabkinTongue and mouth coordination for eating and speaking
PlantarProtective response to provide stability
PalmarAdvances fine motor movements of fingers.
Landau Promotes ability to control head in tummy time

Why do reflexes need to integrate?

We unconsciously use these reflexes everyday, but what happens when we are unable to consciously control them? That’s what happens when reflexes don’t integrate. It’s like being in a self driving car and not being able to take control of the wheel, which can be very scary. Sometimes our reflexes do not mature because of abnormal movement patterns in utero or infancy, neurological deficits, or just unknown reasons. These primitive neuro connections are powerful and can inhibit our ability to voluntarily control our body and mind if they are retained.

How do reflexes affect development?

A retained reflex can present in strange ways causing possible behavioral, emotional, sensory and physical deficts. Not all reflexes present the same way in every person but they do have common patterns. The infant’s movements work together in sequence during development. If one reflex does not integrate it can cause others to also be retained. It is not uncommon to see two, three, or almost all the reflexes present during a primitive reflex evaluation. The following are common traits you might see if reflexes are retained.   

The Bad- Unintegrated Primative Reflexes

REFLEX

GOOD

BAD

Moro Reflex

The startle reflex

A fear response to sudden movements or noise
  • Anxiety
  • Difficulty sleeping
  • Insecure
  • Sensitive to light
  • Sound and/or touch
  • Emotional
  • Common in toe walkers 
Hands PullingHead control reflex and the ability to contract our muscles to sit up
  • Poor muscle tone
  • Poor hand, eye, and mouth coordination
  • Delayed gross and fine motor movements 
Hands SupportingOur falling reflex. Ability to reach out and catch yourself.
  • Clumsy
  • Poor personal boundaries
  • Aggressive
  • Avoids interactions
  • Difficulty processing information
Tonic Labyrinthine (TLR)Develops balance and spatial awareness
  • Motion sickness
  • Poor sense of time and organizational skills
  • Coordination difficulty
  • Spatial and balance problem
STNRHead, limbs and balance system connection
  • Crawling difficulty
  • Low muscle tone
  • Slumps while seated
  • Difficulty copying tasks
  • Poor attention
  • W sits 
Asymmetrical Tonic Neck Reflex (ATNR):  Differentiates our left and right side.
  • Challenged with crossing midline
  • Difficulty catching
  • Focus and memory difficulty
  • Auditory challenges
  • Dyslexia
Spinal GalantConnects the trunk and lower body
  • Postural deficits
  • Hip rotation effecting gait
  • Hyperactive
  • Fatigues with cognitive functions
  • Bed wetting
AmphibianActivates nerves between both hemispheres of the brain
  • Rigid movements
  • Limited stride length
  • Poor coordination
  • No rotational movement
  • No hand dominance
Babinski:Supports mature walking and balance
  • Tripping
  • Stabilizes with tongue
  • Oral motor and articulation deficits
  • Flat feet
  • Walks on toes or sides of feet 
BabkinTongue and mouth coordination for eating and speaking
  • Open mouth posture
  • Poor mouth coordination
  • Lacks facial expression
  • Speech delay
  • Sensory chewer 
PlantarProtective response to provide stability
  • Grasping hands
  • Poor running/jumping
  • One sided crawl
  • Standing delay
  • Fight/flight response to loss of balance.
PalmarAdvances fine motor movements of fingers. 
Landau Promotes ability to control head in tummy time
  • Poor posture
  • Clumsy
  • High tone in legs
  • Visual challenges
  • Depression and fears
  • Poor focus and balance

 

The Better: 

It is extremely common to have one or more reflexes present and you might even identify some of these traits in yourself. That does not mean it needs to be treated unless the reflex is so dominant that it interferes with the ability to learn, be safe and thrive. Reflex therapy helps to identify and create an individualized reflex exercise program to promote integration. The brain responds by taking the wheel and improves control over it’s own mind and body. Now that’s better!

 

If you think your child may have primitive reflexes present we can help! Free primitive reflex screenings are available via Zoom or in person at our Orland Park or Naperville/Aurora locations.