Zane started serial casting today to correct his extreme toe walking. He’s been a toe walker since we adopted him and I assume it dates before that. It is worse now than it was a little over two years ago. The first time he saw a neurologist, she suspected he had CP from the waist down and prescribed AFOs for him to wear 24/7. What a nightmare that was! They were horrible for him and we were not strict at all with making him wear them. He went without them for many months until one day I realized just how bad his toe walking had become. I put the AFOs back on him and posted a picture on FB. Ha!
Several of my friends made some comments and it made me start thinking and researching treatments for toe walking. I am so thankful because I learned that AFOs like this do not necessarily correct toe walking. In these, his feet did not have the range of motion they needed to “learn” how to walk correctly. These AFOs just held his feet down in a fixed position. As soon as they came off, he was right back up on his toes.
I made an appointment with a pediatric orthopedic doctor at TCH where he goes for all of his other medical issues. That doctor prescribed serial casting for six weeks. I learned that day that the cast will allow his muscles and tendons to weaken and lengthen. Once the casting is done, he will have PT to learn to walk correctly.
Today, the PT who put the casts on said his calf muscles were very underdeveloped (short) and that his left foot was worse than his right. Poor little guy!
You can see the natural position of his foot in the first photo below — pointed, with his toes bent up. This is what his feet look like when he is standing bare-footed. If he tries to stand flat with his bare feet together, he falls forward. He can stand flat as long as his feet are apart with toes pointed out, like second position. Even then, he has a hard time not falling forward. In shoes, he usually rocks back and forth on his feet. He is always in constant motion on his feet. He can put his feet down when we say “feet down” but only for a few seconds before he is up on his toes again. His legs and buttocks are so tight that he just cannot keep his feet down.
While the PT was casting his legs, he wiggled so much he cracked the first one. That’s my Zane-boy! They gave him a snack and changed to a room where he could watch a DVD and they were able to finish. When he stood up to walk out, he was so wobbly that he almost fell forward. You can see in the photo where he is standing against the wall that when his feet are flat, he must have them apart and pointing outward. By the time we got to the parking lot, he could walk. I’m so glad he figured it out. :-)
I let him choose his lunch and he chose pizza. Little brother was happy with the pizza too! Once he was home, we gave him a “prize” for being so still (eventually) at PT. We have some little prizes for the remainder of his visits. Our kids hardly ever get tangible prizes or rewards, so when they do, it’s a BIG deal.