Thursday, May 28, 2009

Back on the P/T Train

We saw Matthew's P/T yesterday, not for an appointment, but chatted with her afterschool (she works one day a week at Matthew's kindergarten). We really hadn't talked since Matthew had his last physio appointment in March.

She took a look at his new AFO and she was impressed with it. It is not that much different then his old one, but different enough. The joint seems higher then the old one and the strapping is crisscrossed around his ankle. She immediately noticed that with the new strapping, it could be tightened to get his foot above neutral. I hadn't thought if it but it does work. Brilliant! She suggested that in the afternoon, when he is looser, we tighten it. And if we find the strap slipping, put some velcro on the bottom. Great ideas!

She was also impressed with how he was walking so soon after casting. I will have to get another video and post it. She said that usually for every week in a cast, it takes 1.5 weeks to get to normal walking. She also feels that he will not take that long.

Notice the hinge on this AFO is cut higher then his last one here.

One thing she said that worried me was night bracing. She asked me if he was wearing a night brace. I told her that Dr. Dobbs had decided that he didn't need it right now but that if he was getting really tight in the mornings, we could get one. She was worried that after doing all we did and traveling so far that he could loose what we have gained. It is my worry too, but Dr Dobbs does not share that concern so I will try to defer to him and see how it goes.

She gave me another stretch to work on at home. She suggested that while in his AFO, I get him to straighten his knee and as he can tolerate, add dorsiflexion. That way we are stretching the long muscle behind the knee which is what has been missing from Matthew's treatment for the past 6 yrs.

I have to admit, I have only been stretching him twice a day. I was told 2-3 times a day. I need to add a third time in. I think the stretch with the AFO will be the one to add.

We start back with physio next Wednesday. She told me to try and prep him for it, he will not be happy as she feels Matthew associates her with pain. He probably does but this is one train we can not miss.


Anonymous said...

Was your AFO made locally or in STL? I like the concept of the strapping. I haven't seen that before. Levi's AFO was made locally. When anyone stretches Levi (Dobbs, PT, etc) they always want to see if they can get his knee straight and then dorsiflex his foot (passively of course since he hasn't had PTTT yet) because with a bent knee ankle dorsiflexion is easier. How's he liking the new AFO so far? Jamie

Heather said...

I'm so glad that you have seen the PT already, even if not officially. Sounds like she'll be working well with him. I really hope that he can learn to associate her with getting better and not with pain. Poor guy's been through a lot.