Dorsiflexion --Incline Walking

I consider this one of the easiest dorsiflexion exercises. By having a child walk up an incline, dorsiflexion firing is encouraged. The child can substitute with more hip flexion or out toeing so be wary of the possible substitutions. Some children can’t start on an incline and need to start on the flat floor. Obviously the steeper the incline, the more dorsiflexion is likely required. I encourage a heel toe gait on some children. For some of my toe walkers, I feel like I have accomplished something if I simply get heel strike during stance phase. For these kids sometimes I use “Kick Spots” that I can position under the heel. They squeak every time the heel makes contact with the ground. Last I checked "Kick Spots" were no longer being manufactured but you can still pick these up on a few websites. If these are not available then replacement dog toy squeakers can simply be taped to a child’s heel for the duration of the exercise. For my toe walkers, I remind the child that with longer stride lengths, it is a little easier to get the heel to touch down. I can use an angle finder on the incline to get an idea of the angle of inclination for documentation purposes. I can have the child walk independently, 2 hands held, 1 hand held or with a walker. I can document the walking with proper form (according to how you have defined it) by the number of correct steps or amount of time walked with appropriate form. For the never ending incline, a treadmill works great. Just spot your child close by for safety. I like a treadmill because I can position myself low beside the child and watch to see if the heel is hitting before the toe (or if the heel is making contact with the floor). I can increase the speed and the incline angle to document skill at walking heel toe. The treadmill makes it easy to document duration sustained as well. On the treadmill, I can allow the child to walk with 2 hand support, 1 hand support or hands free. I recommend using the safety tether on the child. For my really advanced kid, I have him heel walk using the same criteria as above. I use those same “Kick Spots” but this time I position the squeaker under the toes. I document how long the child can go before the toes come down, and the toy squeaks. If you liked these exercise recommendations, I'm delighted. This exercise will be featured in a future app for strengthening Dorsiflexors. In the mean time, Pediatric Physical Therapy Strengthening Exercises for Abdominals is available now for iPhone and iPad.