Eversion Sitting with Manual Assistance/Resistance

I do a lot of this exercise with children who have weak evertors. 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 thumb on the other hand is the target. I start the child in extreme inversion and cue them to bring their foot into eversion. If a child can get any eversion, it is usually from the extreme inverted position back toward midline. I tend to position the target hand by having my pinky on the shin, and the child everts to touch 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 move their leg laterally to bring the foot over. This way of providing the target eliminates the effectiveness of that cheat.The target position is important. Usually I check a child’s range first to see what a reasonable target end position is. You don’t want an impossible end position of eversion…unless you plan to assist a whole lot at the end of the range of movement. Some children have no idea how to move their foot into eversion, so I may have to help them move their foot through the entire range. I find this very common in my children with cerebral palsy. I find plantarflexion control develops first, then dorsiflexion, then eversion/inversion. Sometimes I use electric stimulation to help a child get the feeling of this movement. I perform this activity concentrically but also eccentrically. I have the child to evert his foot, and I try to pull it in inversion to the target on the opposite side. If I pull his foot into inversion touching my thumb on the inverted side before I get to the count of 10, I win. Children are amazingly motivated to win a competition with their therapist.