Tuesday, October 10, 2006

My Little Pigeon-Toed Princess: Part II (update)

I just want to add before I go on about the appointment some of what we deal with, besides the notice-ability of the intoeing when she runs or walks. She's great at walking and running and climbing, but she does sometimes fall and trip on her own feet. A slight difference in the ground, such as hardwood flooring to a slightly raised carpet makes her fall. She navigates stairs confidently, but very VERY cautiously. The poor little girl complains at night after running and playing all day that her right foot hurts. As a whole, her foot is sore and in pain. She's also getting little sores, like blood blisters, in the side-heel area where it gets the most pressure due to the intoeing. There are nights I have to give her some Tylenol before bed for that aching to go away enough for her to relax and fall asleep.

We had our appointment this morning, and Anneliese was so good! She didn't like that the NP had to touch her, and when the NP would talk to her, she would cover her eyes with her arms. As if she were saying "If I can't see you, then you can't see me either and maybe, just maybe, you'll go away!"

Anneliese has two conditions, both of which are considered normal for her age group, and *should* resolve by the time she's 7 or 8 years old. She has femoral anteversion, which simply put means that she has sort of hyper-flexibility in her hips where the femoral bone connects. It makes her entire leg turn inward, which makes it appear that her feet are turning inward aka pigeon-toeing. She also has internal tibial torsion, which means that her tibia (from the knee down) is ALSO so flexible that it's turning that part of her leg even further inward.

Essentially, they can't do anything for her right now. They have to allow her to naturally outgrow the natural "over" flexibility on it's own. Adults are no where near as flexible as children to begin with, because we lose our flexibility as we get older. This loss of flexibility will be more noticable in Anneliese as she gets older, and the intoeing decreases. Leg braces and special shoes are NOT proven to work in children this age, so we're going to avoid that for now. She'll have a check-up in a year, and hopefully will show signs of improvement by then, but even if she doesn't, unless I really really push the issue, they'll probably still recommend waiting.

There ARE things we can do. One of her favorite positions for sitting is to rest on her knees as if she's kneeling, but her butt is actually on the floor and her feet splay out. That keeps the hips flexible, so we have to keep her from doing that and try to get her to learn to sit cross-legged. She also tends to sleep on her belly still, with her bum up in the air and her knees tucked under herself, and THAT also keeps the flexibility in her legs. I'm not supposed to worry about that one too much, but if I notice it and she allows it, I should try to pull her legs out straight when she sleeps.

The NP also made sure to emphasize that all children need to learn to walk without wearing shoes. Their feet really need to be able to feel the floor when they're learning to walk, and what she's doing right now, even though she's been walking for 8 months (!!!!) it's still considered "exploratory walking," which pretty much means she's no expert at walking and still learning the how-to's and balance issues, etc. She's also still growing. And for children like Anneliese, it's even more important that they have the freedom to walk without shoes when they're home. When she does wear shoes, they need to be light-weight yet supportive, so clunky shoes will hinder her.

So, I'm a bit relieved, but it's still something I need to watch out for and if it gets worse, I'll be making another appointment.

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