Starfish Therapies

May 22, 2017

The Power of the Calves

star jumps

I don’t know about you, but I have had many children over the years that really struggle to use their calf muscles in an efficient and effective way. This could be due to many reasons but there is probably some underlying weakness and coordination challenges. I have seen this a lot in my kids who are toe walkers. Now I’m sure some of you are saying ‘wait but they walk on their toes, doesn’t that mean they use their calf muscles and they should be nice and strong?’

Not necessarily. Because they tend to walk on their toes (this may look like they are up high on their tip toes or it may look like a shuffling walk with the foot mostly flat but never getting a heel strike first) they aren’t moving through the full range of motion at their ankles and so their calves are only working in a very small range. For the kids up on their tip toes they are really strong in that one position but they would fatigue pretty quickly if you were to ask them to do multiple heel raises in a row. For kids whose feet look flatter but they are still not hitting with their heels first, they are tending to constantly stop a ‘fall’ forward by catching themselves on their foot and then ‘falling’ forward onto the next foot. They aren’t using their calves to help them push off to lead into the step, but rather ‘falling’ into the step.

So as you can see calves work in two ways, they help to control your step forward by supporting your body weight as the muscle slowly lengthens, and they also help to push off by shortening the muscle to give you power to go into the next step. These are also helpful for jumping and running activities to name a few.

Hopefully all this is making sense. I really started this post to give you some ideas for how to work on the calf muscle to help your kiddos use them more effectively and efficiently!

  • Scooter Board Push – I was inspired when I came across this post. I have a few kids that I have been trying to get creative on ways to work on their calves. I actually tried this one out and the kiddo I was working with loved it! He loves to do puzzles so we put the puzzle pieces on one side of the room and were assembling it on the other side of the room so he had to push me back and forth to get all the pieces. Because of the size of the room we had some extra challenges because he had to turn a corner as well causing him to work on his motor planning. In the beginning he had some trouble and would try to go down on his knees to push or I would help him too much so he was just walking and not pushing through his feet but he eventually got it and was so excited when we would get going fast and when we could turn the corner without running into the crash pad! I completely recommend this activity. Just an FYI, carpet causes them to work harder!
  • Wall Push Offs – You can do this one on a scooter or a swing. With a scooter you can have competitions to see how far you can push each time and if you can get further than your last time. Or you can set up bowling pins that when they push off the wall they have to try to knock them over and see how many tries it takes before they’ve knocked them all over. You could also use an exercise ball and have them push off of that and see how many pushes it takes to get down the hallway, and then try to get fewer pushes on the way back! Obviously you would have to move the exercise ball to them each time and hold it stable while they push.
  • Furniture Gliders – With the smooth side down on the furniture gliders, have them put their hands on the top side. Then create a course with painters tape and have them push their hands all along the path. The key is to make sure they are pushing with their feet and not dropping down onto their knees. You can change up the course and make it straight lines, curved lines, zig zag lines, or have it be a treasure hunt/maze where they have to follow the lines to get to bean bags or puzzle pieces and then they bring them out of the maze before going back in to collect the next one! If you don’t have furniture gliders you could do this with bear walking but its definitely more fun with being able to push yourself around! You could also try putting their hands on a scooter and pushing that way if you don’t have furniture gliders!
  • Step Downs – Stepping down slowly really helps to work on having the calves control the body weight as it lowers down. That being said, this is often hard for kids to control. We have tried putting a stomp rocket on the ground below the step so they have to step onto the stomp rocket to get it to go. If possible I recommend doing this without rails. You can change the height of the step to make it easier or harder. And the kids love to shoot the stomp rocket. We generally have targets that we aim for. You can give points to each target and have them try to get a certain number of points by hitting them with the rocket.

What are some ideas you have for calf strengthening with kids?

August 16, 2013

‘Lazy’ Feet

Filed under: Developmental Milestones — Starfish Therapies @ 7:00 am
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Feet

One of the things I love being a pediatric physical therapist is when my friends ask me questions about their kids.  I’m sure many may think that’s odd but I love that it challenges me to think and problem solve.  Added to the challenge is that often, my friends live no where near me so I’m getting their descriptions of what their child is or isn’t doing or I’m getting videos of their kids.  I’m not sure how we ever lived without technology!

A recent question was about running.  My friend noticed that sometimes her son ran ‘fast’ and other times he ran slow and awkward.  I had her send me some videos and while I may not know exactly what is causing the challenges with her son, I was able to relate it to some things we’ve seen with kids in the past.

Now I’m making up this term so don’t try to look it up, but kids can have ‘lazy’ feet.  They aren’t engaging their feet and ankles when they are walking or running.  This can cause toes to drag, or them not to have push off, or any other type of ‘odd’ movement pattern.  Now there are kids that have challenges with this because of a physical challenge and that may be a slightly different story.

For kids that just aren’t engaging their calves when they walk or run, they aren’t getting the push off that initiates the swing phase of their walking or running and they lose the propulsion that can set them up to move quickly or smoothly.  In addition, without activating the push off, often they won’t maintain activity in their ankle muscles causing their foot to look floppy as they walk, and possibly cause their toes to drag or their foot to slap down on the ground.

There is no sure fire way to fix this but we work a lot on leaping from one foot to the next, jumping up into the air and emphasizing push off, and telling them to take longer steps (using spots or markers on the ground is a great way to encourage this).  Each kiddo is going to be different but if you think your child needs a little boost to their running, help them to wake up their calves and other foot/ankle muscles.  They can also walk on their heels, walk on their toes, hop on one foot, etc.  After doing this have them practice running.  Also, if you play ‘chase’ you may see their form improve because they are trying to run faster which can encourage longer strides and an improved push off.

Also, you will see better form on a firm surface than if they are on sand or in long grass.  So start on a track or road/sidewalk and then progress to the more challenging surfaces like the beach or your yard (unless your grass is cut really short).  Also, wearing running shoes or bare feet will potentially show better form than looser fitting shoes like clogs or flip flops.

I just thought it would be fun to share some observations that I’ve noted and see what others think on the subject.

October 4, 2011

Running

I’ve been working with several kids on running skills and since I’m training for a marathon I’ve had ample mileage to really look at and analyze some of the components of running!  When a child goes from walking to running it usually starts as a fast walk.  Its officially termed running when they are able to achieve both feet off the ground at the same time.  Children may often start out running flat footed and progress into a heel strike.  Interestingly enough the Nike Sport Research Lab did a study looking at running in children and found that by age 3 at least 80% of the kids were hitting with their heel as opposed to with a flat foot.

In addition to achieving both feet off the ground, mature running also consists of reciprocal arm swing (one arm and then the other on a different side than the foot that is moving forward) and trunk rotation.  In children with challenges affecting their gross motor development, I often see the reciprocal arm swing and trunk rotation either absent, or very understated.

As I have watched kids running (and been logging in ample mileage myself) I have realized the importance of a good push off.  This helps to propel the child forward and increase the foot clearance.  It is what can make running look smooth and easy as opposed to feet thudding to the ground with every step.

After push off, when their foot is in the air it also helps to be able to actively lift their toes up so they can achieve a nice heel strike.  This helps to prevent flat footed running which is tough on the joints and not very efficient!

Some children will look almost as if they are bending at their hips while they are running.  This is because they have their weight back but they are leaning their head and shoulders forward as if to make themselves go faster.  This can be a result of weaker core and hip muscles so that they don’t feel that they can prevent themselves from falling if they put their weight forward.  Another indication of potential hip weakness is a wide base of support while ‘running’.  By keeping their base of support wide they don’t need to transition into standing on one foot and thereby decreasing their stability.  As these children get stronger in their hips and core muscles you will see a lot more forward momentum for running!

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