Starfish Therapies

February 3, 2012

Getting a Leg Up – Improving Foot Clearance

Sometimes kids have a hard time picking up their feet when they are walking.  I won’t get into all the components of walking but one thing that helps some kids is to be able to actively clear their foot so either they aren’t dragging their feet, they don’t catch their toes, or they bend their knees and hips a little bit more.  By being able to pick up their feet better when taking a step they improve their overall balance, their ability to take longer/bigger steps, and potentially make walking more energy efficient (to name a few benefits).  Obviously working on strengthening the muscles that help with this is important but here are some other ideas that can help a child get used to having to pick up their feet.

Dragging weights behind them – If you take a string or some sort of rope and attach a weight to the end of it and then wrap it around the kiddos ankle it will naturally encourage them to pick up their feet more.  Be careful not to make the weight too heavy or you may encourage poor movement patterns, such as increased internal hip rotation rather than increased hip flexion.  Also, if the child already has a hard time maintaining balance while taking a step this may be too challenging for them although its great to start trying it out as it does challenge the balance as well.  Also, play around with the length of the rope that will give you the best results.  Try it out on yourself to see if you get more ‘encouragement’ for hip and knee flexion with a longer or shorter rope.  Also feel the difference in weights.  I just used cuff weights and wrapped the weight through them.  In addition the kids think its funny that they are dragging weights behind them.  The first time I saw this done someone called it ‘walking the dogs’ and that has stuck with me so I usually tell the kids, ‘its time to walk the dogs’ and it cracks them up!

Velcro – A few years ago at a conference there was a company selling something called a tib trainer.  I haven’t seen them again and am not sure if they are still in business but I am actually really glad I bought their product because it’s been useful for several things.  Basically its a contraption that hooks onto your shoe so that there is velcro on the bottom of your shoe.  I’m sure you can make this for your kids for pretty inexpensive but I already have these so I try to get use out of them.  If you walk on carpet (you have to find the right kind that sticks to the velcro), there is some increased resistance so you have to use your hip flexors more to pull your foot off the carpet to take a step.  This also works on balance as you have to brace yourself for the increased pull.  Again, if there is too much resistance for some kids you may encourage poor movement patterns so make sure you are watching.  The velcro on the carpet makes a fun noise as well so the kids get the auditory feedback of taking steps.

Cuff Weights – For kids that don’t have ataxia you can try just wrapping cuff weights around their ankles (I think dragging them behind them works a little more effectively though).  Play with the amount of the weight to see what gives you the best response.

Walking in water – This is when I wish I had a wading pool in my clinic because putting a person in ankle deep water (or a little higher) encourages them to pick their feet up to take a step.  Think about when you are walking in the water at the beach, you really pick your foot up to avoid the resistance of the water as well as to make sure you don’t trip and fall.  This is a great activity for warm weather when you are looking to change up your routine a bit.

What other ideas do you have for improving foot clearance when a kiddo takes a step?

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3 Comments »

  1. This is a new idea to me with dragging the weights. Looks like it provides nice proprioceptive feedback to lift and clear the foot. I find obstacle courses where the child has to step over objects encourages hip flexion. I have done a few You Tube videos on putting velcro on the bottom of feet for activities – great way to practice eye foot coordination skills and crossing midline. Here is one example – http://www.youtube.com/watch?v=3HmHjKpYeHM.

    Question – why do you say do not use cuff weights for children with ataxia? I have found that ankle weights sometimes “quiets” the ataxic movements.

    Comment by Your Therapy Source — February 3, 2012 @ 5:48 pm | Reply

  2. […] like walking then you can reverse some of the activities I listed or you can also try some of the ideas I talked about for improving foot […]

    Pingback by When all things aren’t equal – Legs « Starfish Therapies — February 6, 2012 @ 12:09 pm | Reply

  3. I haven’t see “walking the dog” before either. Nice idea! I love using the treadmill to get more repetition for changing walking patterns. You can play around with incline, walking backwards, stepping on and off. I combine it with visual/cognitive work to test that changes in walking patterns are becoming automatic and also to work on the visual-motor system at the same time. I also like walking in swim fins, on dinosaur stomps, and stepping over things.

    Comment by Joni — February 7, 2012 @ 3:32 pm | Reply


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