Physical Therapy has returned!
Most children with multiple disabilities see their therapies come and go over the years. There is a variety of reasons why this happens. To mention a few that I understand: insurance/Medicaid budgets and changes, caregivers should learn therapy throughout the course of sessions and learn to continue the therapy independently, and a very large demand on the therapy resources. The reason that usually ends the course of therapy for Riley: he cannot demonstrate measurable improvement on an ongoing basis.
As a mother and caregiver it does help to return for a refresher course of my own. Yesterday, the lovely Miss Emily reminded me to pay more attention to Riley's feet. Oh, those poor little tense feet. In actuality, it is quite easy to give attention to Riley's feet. He sits in my lap and they are an easy reach. are also amazing. Since Riley does not use his feet, they are amazingly soft. Unfortunately, they are also very tense... his toes are always curling... a little more all the time especially after tonic posturning. They do not receive the input and pressure from general use and it shows in the narrowness and lack of callous. He can barely where shoes because in no time the pressure points will begin to break down. Generally I simply move them around and stretch out his toes. Yes, reminders are always a good idea.
There are quite a few demonstrations online. It really does not seem to need anything so complicated as I am finding. Any few moments available will do. As I remember it.... being no expert, just a caregiver needing to apply useful information. Begin at the bottom of the heel with your thumb. Apply a little pressure moving upward along each tendon. Continue on to lengthen the toes and gently stretch each toe back without reaching the point of overstretching. Next put your thumb under one of the long bones in the foot and the index finger above the same bone and gently wiggle it up and down. One at a time repeat this with each of the long bones. Another helpful move is to move the whole foot back and forth from the ankle only as far as remains comfortable. Over time, more motility will be gained here. Foot rotations and gentle toe pressure is also welcome.
More suggestions welcome! Stacie Wiesenbaugh