Stay the Course

Last summer Amanda was seen for the Spastic Diplegia Cerebral Palsy in her ankles. She has always had less than normal range of motion in her ankles. The low side of "normal" means that when your leg is straight, you can point your toes back towards your nose (at the ankle, not the toe joints) and the angle of your ankle would be around 15-degrees. Amanda has always ranged in the 5-10 range. We have done stretches, we have taken her to physical therapy where they worked with her over and over to walk on flat feet instead of up on her toes. The toe walking will not require medical intervention until/unless she were no longer able to put her heels all the way down on the floor. This is not the case, she can walk with "flat feet" when reminded. The school PT told us to give her verbal prompts in order to accomplish this (nag her) and we decided this was not going to happen. The kid hears enough nagging without being criticized for how she walks...all.the.time.
Our concern has been, as she grows taller the muscles and tendons could get tighter and the range of motion in her ankles could get worse. This could lead to walking problems, knee, hip or back problems in her future could be avoided now if we stay on top of things.  So, last summer we started using splints on her as she slept at night. It took months to get them properly fitted trying this material and then that then changing again to get the right fit so the pressure wasn't too much on the top of her foot (it created terrible red marks which lasted all day long) and they were very uncomfortable for her. We finally got the right fit and have steadily increased the tension on them to work our way up to a 4.5 out of 7. The doctor today said, that even after growing an inch and a half this past year she has not gotten any worse, though no better, in her range of motion. He said if she HAD gotten worse (tighter) he would recommend serial casting, literally a series of casts on her legs pointing her toes higher and higher to the sky forcing the muscles in her calves to stretch. Sounds perfect for an active 7-year-old in the summer, huh? However, since she has grown and maintained her not normal but not horrible angle he is willing to stay the course and watch how she does with the expected growth spurt that occurs around age 7 or 8.
This is good news as we continue to make payments on the thankfully not useless splints we dutifully strap on each night and take off each morning. Also, they still fit her after this year of growth so we won't have to buy new ones to stay the course. *Whew!*