Toe Tapping Happy Feet with Dorsiflexion Strengthening

I do a lot of this exercise with children who have weak dorsiflexors. I like the position I am in here in this picture. I can rest the child’s calf on my knees and discourage cheating. I use one hand to provide resistance/assistance to the foot, and the other hand is the target. I tend to position the target hand by having my pinky on the shin, and the child touches my thumb. This ensures that where ever the shin goes, my target hand moves along with it. It is not uncommon for children to try to scoot back in their seat to bring the foot up. This way of providing the target eliminates the effectiveness of that cheat. The target position is important. Usually a child has more passive range than active, so don’t put the target position in an impossible active dorsiflexion range…unless you plan to assist a whole lot at the end of the range of movement. Some children cannot for the life of them motor plan how to pull that foot up. I resort to a little bottom of the foot tickle to see if it will jerk up into dorsiflexion. I may also use electric stimulation to help a child get the feeling of this movement. I perform this activity concentrically but also eccentrically. I allow the child to dorsiflex his foot, and I try to pull it down to a target….usually my nose. If I pull his foot down to my nose before I get to the count of 10, I win. Children are amazingly motivated to win a competition with their therapist. If you provide just the right resistance, it is amazing how little I have to have stinky feet on my nose.