Friday, January 22, 2010

Orthotics?

Yes or no?

A couple of months ago, Dylan's PT mentioned the possibility of him needing orthotics. She told me about the benefits of Sure Steps . Does anyone have any experience with these?

Last week, I called the orthotist she had recommended to make an appointment. It can't just be that easy, though, c'mon! As it turns out, before we can see them, I need to have a prescription from Dylan's pediatrician faxed over there that says something along the lines of "please evaluate Dylan for orthotic need".

It sounded simple enough to me. Yeah. Not so much.

For whatever reason, Dylan's pediatrician will not do that, so I had to make an appointment with an orthopedic doctor. Doesn't sound like that big of a deal, I know, but unfortunately the soonest appointment they have is at the end of March. And this is all for an evaluation! I don't even know if Dylan even needs orthotics at this point. Gr.

So, I was telling my friend this story (Hi Michelle! : ) and she gave me some interesting information. She had just been to the Down syndrome Clinic in Boston that day with her little guy and had specifically asked the PT there about orthotics. Her take on it is that it's actually more beneficial for most of our little ones to not use orthotics, but rather go barefoot for as much time as possible, thus strengthening the muscles naturally and encouraging proper foot placement.

This makes sense to me. It seems to be kind of along the same lines as my running shoe philosophy - using minimally cushioned running shoes to make one's foot placement more efficient.

But as I usually say, "What do I know?!".

Does anyone have any thoughts on orthotics? Does your Little One use them? Are they helpful? Necessary?

Thanks so much! : )

24 comments:

Angela said...

I don't have any experience w/it, as B's PT so far hasn't thought that he's needed anything.

B does walk around either in socks or barefoot 95% of the time, but that is all indoors. (We stay home or go to my mom's a lot, and when we do go out, he is usually in the stroller or being held.)

But when we do put his shoes on, he doesn't do nearly as well walking. He clumps around and trips over them. So at what point will he need to be trained on walking IN shoes? Ugh....

sarah said...

My son Braeden had Sure Steps, it seemed like our PT just assumed he needed them, so we got them and he wore them for awhile, but he walked way better barefoot, so we stopped using them. Thats just our experience, I do know quite a few who use them and they really seem to help.

Anonymous said...

We wish we could help out with this situation but have no answers.You have done fine following your Mother's intuition.

Rachel said...

I haven't heard anything, but will talk with our PT on Monday since she is hear. I don't think that I would use them though. Her delay in walking is not because of a physical problem, really. She is delayed in everything:)

I'll let you know what she says.

Mindy said...

Liam went without orthotics (or shoes) for the first year and a half of his life. His ankles turned in so bad that he would stand on the inside edges of his feet and would curl his toes under to try to grip the ground for stability. He had no confidence in standing or even attempting to walk.

He wore Sure Steps for about a year, and while they didn't fix his problems, he did learn to stand and to walk. He doesn't wear Sure Steps now, but he does wear Cascade Leap Frogs. We made the switch because the Leap Frogs have a toe pad that prevent him from curling his toes under. That has almost totally stopped him from the toe curl even without shoes.

While orthotics were a benefit for us, take your time to look at Dylan. Does he not want to stand or do anything on his feet? With Liam, he wanted to but had no confidence in his ability. The Sure Steps gave him that more than they did anything else.

Cate said...

we do have them, and they have helped.

do his ankles roll in? that was the first thing the PT noticed that sent us on the road to orthotics.

And we saw an orthopedist (doctor) who referred us to the orthotist. Our regular ped wasn't even involved. Maybe try that route?

Jocelyn said...

Hey there! Pat Winders is our PT and she just said this past week that she'll watch Myles' feet/ankles as he gets better at walking to see if he needs orthotics. She said you can't tell until the "fat pad" on the inside of their feet/heels goes away. I think kids also have to be decent walkers before you can tell if they need orthotics, but not all kids with DS need them. Good luck!

Tausha said...

Sam is at that age and I asked his PT about it and she said oh, for now he doesn't need them so I don't really know. Sorry, not much help. I do know that he friend Benson needed them and the early intervention ladies, his PT just gave him a pair.

towandat23 said...

Gabe has orthotics and I really havent seen much of a difference. Its really hard to find him shoes that can accommodate the sure steps correctly, I have found one pair of See Kai Run shoes that seem to work without them having to be a size larger and thus actually too big to be effective. Gabe is cruising and pulling up, standing unassisted every once in a while but he is doing all of that without the sure steps. Of course if you are anything like me you'll get him anything that COULD give him the slightest bit of help and with that being said sometimes it only helps the SLIGHTEST bit. My suggestion is to try them and see if they work even if it helps just a little its better than not at all right? Good luck!

The Lehnick Family said...

Laurie...our leap frog orthotics come in next week...I posted some pics on my blog...he is cruising everywhere without them and usually wears Robeez right now, but our PT is worried a little about the amount of pressure he puts solely on his heels at times and his feet turn in just slightly from time to time...when we went to the clinic to determine what was best for him, the owner of Leap frogs was there and made soooo much sense in correcting the feet in walking/ standing at a young age because if you don't the damage will already be done...harder to correct at an older age and our little ones bones are so soft...don't think I made much sense...it is really complicated and really depends on each individual child. We don't have to get a very high orthotic, but this will keep him even more stable until he is good walking on his own. He didn't mind them at all , and they are really comfortable and he was practically RUNNING in them by the time we left.

So check with your PT...his PT...lol

Katie said...

While I agree with most "let it be methods," you definitely want to correct any incorrect foot rotation now. Jack's foot rotates inward, so I have no worries or problems using SMO orthotics. They are the low ones that just support the ankles. My PT mentioned she doesn't recommend orthotics unless they are truly truly necessary. I will trust her judgment. I wish I could have fixed my permanent duck walk! =)

Ladybird said...

Laurie, My sister is a chiropractor (well she will be one come September)and she is focussing her work on feet and hands. She always insisted that Silvia walk around barefoot when she was learning, it was very important for the muscle development, but more importantly the balance. Dylan needs his feet to feel where there are going, to be able to adjust to every slight change in balance. I would be letting him go barefoot as much as possible.

But you might want to look into the orthotics for when he is not at home. I just question how often he will wear them, and how soon he will outgrow them. Obviously you know how quickly they outgrow shoes at this age. Talk to someone and find out how long they will last.

Love Ya!

Hector and Jennifer Varanini Sanchez said...

Our PT recommended them and I am of the belief of natural is better but her argument was that although Joaquin didn't need them, she wanted to use them to prevent his arch from falling (as so often does with children with low tone) so as he learns to walk he will learn using the proper placement of his foot...by using them now, we prevent future problems. So we got them. I use them occasionally and during his therapy sessions. It's still too early to tell but I'll let you know. We too got the sure steps and yes they are really hard to fit into shoes. We found that the Robeez booties work well with them and I'm glad it's winter because I don't think I'll be as inclined to use them in the summer when it's hot.

Cathy said...

I was really interested to read everyone's comments. Wow...they are all over the place...lol. Lily's PT mentioned that she was going to put them on Lily's IFSP when we work on it this coming week. I guess she thinks they are a good thing. I think that if our insurance will pay for them, we will try them out. And even if it doesn't pay...we'll still probably try them.

Karly said...

We were evaluated about a year ago as K has slight pronation. But she didn't need anything super involved like the SureSteps, just little inserts (PollyWogs) which help stabilize her base. The pediatric orthopedist's take was that it was better to have her have level support while her muscles/bones are growing and developing than to have things develop off kilter. That said, they were quite inexpensive ($30ish directly from their website) so I figured it couldn't hurt. Honestly? She goes barefoot at home, but they do seem to help some when she wears them at school. Good Luck!

Rachel said...

My daughter (2.5 years old, walking for about 5 months) has orthotics. They aren't the Sure Steps. I'm not sure what they're called (the PT made them here in our home to fit her foot). For us, the orthotics have been wonderful. Her ankles were bending inward really badly and they said she didn't have the muscle strength to hold her legs up. She was also walking very "bow legged". Witht he orthotics her walk was much more stable and her ankles are gaining strength. Now even when she's not wearing shoes her ankles are straighter and her walk is better. So, that's our experience. :) Good luck as you figure it out.

Tim and Kelli said...

Lindsey's isn't at that point yet but her PT has mention that some kids do need them and it just depends if they need that extra support at their ankles when they stand.

Bethany said...

We used to take Payton to see Pat Winders -- if you aren't familiar, she is the PT/DS Guru. She is now in CO and we don't see her anymore, but it was awesome while it lasted.

Anyway, she is big on "no orthotics" before walking. Think about it -- if you give them support on their feet/ankles, they will always be dependent on that. Now, I understand some kids pronate sooo much when bearing weight that some think it is a problem. But why not let them go barefoot and give them the chance to strengthen their feet/ankles on their own?

That is what we always did. My girls wore Pediped soft soles until they couldn't fit anymore. Each of them have pretty strong ankles ... they might benefit from a tiny little Hot Dog insert in their shoe (are you familiar with those?), but we have never done it.

I dunno ... JMO.

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