PT: Take Two

After last week, I had pretty low expectations for physical therapy this week. Maddie's social worker contacted me after the initial session to get my feedback. I was assured that this PT is highly recommended and was having a very atypical day. Still, I was skeptical.

Once again there was a mix-up on the time. Instead of being late, the PT was 20 minutes early. Jackson must have let her in while I hopped in the shower because I came downstairs wearing a bath robe and she was sitting on our couch!  Oh well...at least I wasn't naked. I guess I need to view PT appointment times as a window of time rather than set in stone. 

Despite a strange start, we had a very productive 75 minute session. I naively thought she would just toss Maddie on the ball, but it was so much more complex!  I felt like the PT's little pupil. She followed an "I do. We do. You do." model.  (Not that she used that language. That's just the teacher in me talking.)  She would do different stretches or positions with Maddie, then explain why it was helpful. Then she would have me do the exercises with her hands on top of mine or assist me in balancing the ball. Finally, she let go so I could do it by myself and give me feedback. I asked if I could take pictures to reference for later use. 

Here are some of the things I learned to help Maddie practice each day:

• With my thumbs on her thighs, I can support Maddie in a seated position on the ball.  Keeping her belly button straight and utilizing the movement of the ball, I can rock her from side to side and front to back. This helps stabilize her core. The PT said that even if it feels like Maddie's falling over and losing control, let her feel that movement to help trigger her reflexes. It's also good to bounce the ball the entire time to help loosen her joints and soothe her.  (I haven't mastered rocking and bouncing at the same time yet.)

• Another exercise that Maddie did really well with is to simply put the ball a few inches from the couch (or another person) and roll it towards her. The point is to have Maddie apply weight on it with her hands. This helps her open her hands rather than keep them in her usual clenched fists because she likes to try and grab the ball and push on it.

• Of course we spent a fair amount of time doing tummy time on the ball.  It provided great support for her because she was on eye level with me without me trying to lay down on the floor. I could talk and sing to her more easily. The other great thing about tummy time using the ball is I can adjust the level of difficulty by working with or against gravity. When she got tired the PT just rolled the ball backward so she was almost in a standing position. She also bounced and rocked the ball, forcing Maddie to continuously stabilize her core.

• Another exercise that was exciting to see was supporting Maddie on a hands and knees position on the ball. The PT said that even if she gets tired and rests her head on the ball, it's still important to activate her leg muscles and get her comfortable in that position.

• We also did some floor exercises. One thing that was interesting that I had never noticed before was that Maddie doesn't twist her trunk to get something. If she is sitting up, she'll lean forward or to her side, but she doesn't turn to pick up a toy. If a toy is out of her immediate reach, she gives up. She should be supporting herself on one arm and rotating to use her other arm to pick it up. This is the same motion that will help her roll from back to stomach, which she is currently unable to do.  And if she can't roll from back to stomach and pull up, she's never going to crawl. We did several side stretches and helped her twist. 

As the PT was getting ready to leave, she let me know that she has Tuesdays at 11:30 available. I don't know what changed in her schedule from last week, but I'll take it!  I went to Target and bought an exercise ball a few hours after she left and have already begun working with Maddie. I'm feeling very optimistic about the progress we can make with our sweet Madeline.