More on the “little guy”
So, what do we see in these latest pictures?
Top left: neutral view.
- He enjoys flip flops; probably not the best thing for a developing kiddo, in light of the excessive engagement of the posterior compartment (and reciprocal inhibition of the anterior compartment)
- he has some tibial varum (ie bowleggedness) L > R
- he has some developmental genu valgum whnich appears to be improving (need a Q angle review? click here)
- no tibial torsion present on L: for a review on torsions, click here
- still some external tibial torsion present on R (see section below on middle shots)
Top right and bottom: full internal rotation of R thigh: compare with bottom: full internal rotation of L thigh
- he has adequate internal rotation (4 degrees needed) but not as great as left side (see bottom shot); this represents some improvement since we started
- he has generous internal rotation of the left thigh
Middle Left: full external rotation of right thigh
- note the position of the knee and the position of the foot; external tibial torsion is present. for a review of torsions, click here.
- he has limited external rotation of the right thigh (compared with the left. The knee should fall more outside the saggital plane
Middle right: full external rotation of the left thigh
- note the position of the knee and the position of the foot; internal tibial torsion is present.
- he has generous external rotation of the left thigh (compared with the left)
of other significant note: most of his calcaneal valgus has resolved; longitudinal arches are improved.
- He continues to develop normally and continues to improve since his original presentation to the office
- Having the child continue to walk barefoot
- Continue to wear shoes with little torsional rigidity, to encourage additional additional intrinsic strength to the feet
- He should continue to limit “W” sitting, as this will tend to increase the genu valgus present
- We reviewed 1 leg balancing “games” and encouraged continuing agility activities, like balance beam, hopping, skipping and jumping on each leg individually
- added in using a push and pedal bike
- added in heel walking exercises
Ivo and Shawn. Bald. Good looking. Extraordinary Gait Geeks. Taking the world of gait literacy by storm with each and every post.