🧩 Toe Walking Puzzle: How to Drive the Heel Down & Shin Forward 🦶🏾 | Pediatric PT #39

🎯 Jumping Down with Control for Toe Walking 🎯🦶🏾 Pediatric Physical Therapy | Mykael #40 👋🏾 Meet Mykael Mykael is an 8-year-old child with persistent toe walking. His toe walking tends to increase when he is tired, anxious, sick, or emotionally dysregulated. He also walks more on his toes when barefoot or in less supportive shoes, and less when wearing supportive athletic shoes 👟🦶🏽. Toe walking runs in Mykael’s family — his grandfather and uncle are also toe walkers. Hinged plantarflexion-stop orthotics had been recommended by his therapist; at this visit, his family shared that he has not been wearing them. 🦶🏾 What We’re Working On in This Video In this session, we focus on jumping down with control, which is often challenging for children who toe walk. Specifically, we’re targeting: • controlled knee bend on landing • forward movement of the knees over the feet • keeping the heels down during landing • balance and postural control after impact Many children who toe walk tend to land with stiff legs, heels lifting, or their balance shifting backward. Jumping down from a step is a functional way to expose and work on these patterns. 🪜 The Setup Mykael jumps down from progressively higher steps on a ladder attached to a raised backyard fort: • first step ≈ 4 inches • intermediate steps increase gradually • final step is approximately 3.5 feet We start with the easiest height and build up, watching how his landing strategy changes as the demand increases. 👀 What You’ll See As the steps get higher, you’ll see: • how heel contact changes with increased challenge • moments where balance shifts backward • subtle heel lift when effort increases • improved control with repetition and focused cueing I cue Mykael to bend his knees and “stick the landing,” holding the position briefly to confirm true control — not just a quick touchdown. 💬 A Note on Choice & Safety You’ll hear me jokingly tell Mykael that he can refuse the highest step. While the tone is playful, this also models something important: children should always feel allowed to say no to a movement that feels unsafe or overwhelming. 🏡 Ideas for Home Practice You don’t need a ladder or fort to practice this concept. You can try: • stepping or jumping down from a single stair • low playground steps • sturdy boxes or platforms of varying height Focus on: • slow, controlled landings • knees bending forward • heels staying down • balance before moving again 🕒 Timestamps (Chapters) 0:00 – Intro to Amy and Mykael 0:13 – Toe walking background and family history 0:37 – Why jumping down matters for toe walking 0:58 – First low step attempt 1:15 – Balance strategies and repeat attempts 1:31 – “Stick the landing” with a 3-second hold 1:46 – Higher step and heel control 2:07 – Highest step and increased challenge 2:33 – Who this exercise is for and wrap-up 🦶🏾 Toe Walking Video Series (Mykael) This video is part of an ongoing pediatric physical therapy series addressing toe walking through: • balance • strength • motor control • functional movement practice 🔗 Watch the full Mykael toe walking series here: https://youtube.com/playlist?list=PLAkJbMrHyKjP470frDXaGDv2XrtEqPEUx If you’re new, starting from the beginning is helpful for continuity 📺👨🏾‍🦱👩🏽‍🦱. 📚 Books by Amy Sturkey Children’s Educational Books: “A is for Autism” → https://www.amazon.com/dp/B071F4FFTB “D is for Down Syndro