Any physical therapists out there? Advice after cast removal please

[dez1978]

I posted before about my 8 yr old breaking his leg. It’s been 9 weeks and he got his boot off a few days ago. He needs to quickly figure out how to walk normally again. Nothing hurts so it’s not that. We’ve been doing PT but they can only get him in once a week. He has to be walking normally and have gained some strength back in the next couple weeks for 2 reasons. 1 we are going to Disney at the end of the month and that’s a lot of walking. He’s huge for his age so a stroller isn’t happening. But also he’s trying to finish his wrestling season and has until March 2nd to get to where his dr wants him to be to clear him for that. It’s in his head I think, like he just got so used to walking like he has a peg leg, he can’t figure out how not to do that. Anyone have any experience or suggestions? Thanks in advance.

 

[kymom99]

Not a PT. Can he ride a bike? It seems like that motion might help him with walking.

 

[dez1978]

Not a PT. Can he ride a bike? It seems like that motion might help him with walking.

I’ll try that tomorrow!

 

[sam_gordon]

Is the problem balance or leg strength or both? I agree the bike would help with the strength, but do you have access to/can you rig a stationary bike? Something to build strength without worrying about balance.

I'm not a PT, and didn't sleep in a Holiday Inn Express last night, so take the above for as much as you paid for it.

 

[DLgal]

This child is 8? You don't want to rush this process. He's too young to do any substantial muscle building. It's gonna take time.

 

[hops&dreams]

Not a PT. Was in and out of a cast for 3 years (perpetually broken wrist). Every time I got a cast off, even if it was just on for a couple weeks, I needed time to build up field of motion and strength.

Even if his PT can only get him in once a week, he should be going home with exercises to do several times a day. These will include stretches, and range of motion exercises to get his mobility back. His muscles have been stationary for weeks. He needs to stretch them back out and get them used to bearing weight the regular way again.

Heat always helped when stretching, and ice/ibuprofen always felt good after a good PT session. A soak in some epsom salt probably wouldn’t hurt either. But ok all that with the PT.

It’s super important for him to follow through with the PT and the daily exercises. Especially if he’s trying to hit those timelines- let your PT know so they can make sure he’s on track for full recovery.

 

[Pooh2]

I had a cast for 7 weeks and had visible atrophy.
I had to wear a brace for the first few weeks due to weakness.
I would call it done on wrestling for the season, let him heal and work with the PT without rushing it, and rent a small wheelchair as needed at Disney.

 

[Southernmiss]

I had a cast for 7 weeks and had visible atrophy.
I had to wear a brace for the first few weeks due to weakness.
I would call it done on wrestling for the season, let him heal and work with the PT without rushing it, and rent a small wheelchair as needed at Disney.

This.

I'm recovering from a broken kneecap.

Surgery Oct 27. In brace until Dec 21 because I quit wearing it. I've been in PT 3 times a week since Thanksgiving week. I'll finally have my last session on Wednesday.

Still don't have some movements back and still work hard every day to get it all back.

While I don't have pain, there's still constant tightness like a large rubber band is constricting my knee. It's a weird sensation like when the needles come when your leg falls asleep. And it just is very there. All. The. Time.


And yes, some of it may be mental block and not anything you can do until he finds the confidence and remembers how to walk normally.

 

[jrmasm]

The PT should give exercises for his parents to do with him in between visits.

 

[Allison]

Do they have exercises to do between PT visits? The PT knows how far to push and when to not push to avoid a setback. Talk to them. Don't rush it just because you want to be able to do things by a certain time. That might not be feasible.

 

[barkley]

Do they have exercises to do between PT visits? The PT knows how far to push and when to not push to avoid a setback. Talk to them. Don't rush it just because you want to be able to do things by a certain time. That might not be feasible.

i agree with this. you also don't want to rush it b/c in order to do so he may end up adapting his gait which may not be noticeable to you/he may not even be aware of doing so. in adapting his gait he may unintentionally cause some issues that ultimately impact his feet, hips and back. i had relatively minor knee surgery several years ago and didn't realize i had changed my gait until i started having some ankle, hip and back pain. i had to learn how to pay attention to how i was walking and practice the right way (for me) so it would become habitual.

 

[GreatLakes]

Since he is 8 a parent or guardian should be speaking with the PT to get a list of things the child can do at home. It will likely be body weight stuff with some resistance bands thrown in. You can get those cheap on Amazon.

The best source of info will be from the person he is seeing every week, even PTs on the message board will just be able to give general advice and not tailored to a kid they are seeing.

I also wouldn't rush the process just to get in a vacation. If that means you have to postpone because it is best for him just postpone. I'm not going to risk my kid's health for a theme park vacation.

 

[dez1978]

I had a cast for 7 weeks and had visible atrophy.
I had to wear a brace for the first few weeks due to weakness.
I would call it done on wrestling for the season, let him heal and work with the PT without rushing it, and rent a small wheelchair as needed at Disney.

If his dr didn’t think he could do it, I wouldn’t allow it. I’m sure the dr is and will be plenty cautious and won’t ok it if he’s not ready, and that’s perfectly ok if he can’t do it. But it’s something he wants to do and is pushing for it.

He is doing strengthening exercises and stuff in between appointments. But he can’t get back in until Friday this week which is a lot of time wasted if there is something I can do at home to help him with his gait.

we’ve been up front with him that he may not be able to wrestle again this year. But he wants to try and the dr is being supportive of the effort, so I’m going to try to help him with that. I know he’s only 8, but this is a big deal to him. It would feel pretty crappy to give up on him if he’s not ready to give up on himself yet.

 

[luv2cheer92]

Since he is 8 a parent of guardian should be speaking with the PT to get a list of things the child can do at home. It will likely be body weight stuff with some resistance bands thrown in. You can get those cheap on Amazon.

The best source of info will be from the person he is seeing every week, even PTs on the message board will just be able to give general advice and not tailored to a kid they are seeing.

I also wouldn't rush the process just to get in a vacation. If that means you have to postpone because it is best for him just postpone. I'm not going to risk my kid's health for a theme park vacation.

This. I am a DPT. There has been a lot of good advice in this thread. But it is impossible for anybody, even me, to give the proper advice without physically seeing him.

 

[unrequited23]

When I was recovering from a fractured ankle, I had to really focus on keeping both feet pointed forward and stepping heel to toe. Maybe you could make up a goofy rhyme or song for him to remember what part of his gait he needs to focus on...something like "bend the knees so legs don't freeze" or whatever would help him. My PT always started with time on a stationary bike to warm up the muscles. If there is a very long time between appointments you might want to see if he can add an extra set of reps to his exercises after 4 or 5 days. Also, I would suggest checking his shoes for wear and possibly replacing them. I underpronate so I always wear our shoes unevenly.

 

[DLgal]

If his dr didn’t think he could do it, I wouldn’t allow it. I’m sure the dr is and will be plenty cautious and won’t ok it if he’s not ready, and that’s perfectly ok if he can’t do it. But it’s something he wants to do and is pushing for it.

He is doing strengthening exercises and stuff in between appointments. But he can’t get back in until Friday this week which is a lot of time wasted if there is something I can do at home to help him with his gait.

we’ve been up front with him that he may not be able to wrestle again this year. But he wants to try and the dr is being supportive of the effort, so I’m going to try to help him with that. I know he’s only 8, but this is a big deal to him. It would feel pretty crappy to give up on him if he’s not ready to give up on himself yet.

I get what you are saying, but this situation is not "giving up." It is being smart and knowing your limits. This is also an important life lesson that kids need to learn eventually. Disappointment is part of life and he is still so young and has plenty of years to continue working towards his wrestling goals. This isn't a "last hurrah" type situation. A broken leg bone is a big deal and the recovery is time consuming, but it's not a sport ending injury as long as you take the proper amount of time to rehab. Jump back in too quick and he risks hurting himself again, possibly worse.

I speak as a child gymnast who was sidelined forever by a tibia fracture that I pushed through, and which still causes me pain to this day, over 35 years later.

 

[Christine]

I was in a cast for 8 weeks back in 2021. It was tough coming out of it but I was 58 at the time. I was in PT and they basically had me doing seated pushes on the "shuttle" machine. Basically it's like seated squats. Also, balancing on the weak leg (single leg balance for 30 seconds, stop, do it again, and again). I did step ups on a step. Laying down, they'd put an ankle weight on my ankle and I'd then do a straight-leg raise in order to strengthen the quads. The exercises from the PT and and do them at home every day. For an 8 year old, this should come back very quickly.

 

[sam_gordon]

He is doing strengthening exercises and stuff in between appointments. But he can’t get back in until Friday this week which is a lot of time wasted if there is something I can do at home to help him with his gait.

Wait, so the PT has given him exercises and things to do in between appointments and you want to do MORE? There is no time wasted if he's doing the exercises at the frequency the PT gave him. Focus on doing that and at the next appointment ask if there's something more to be done.

 

[robinb]

I’m not a PT, but I worried about your Disney trip in a couple of weeks. I would play it by ear, but have a backup plan of a double stroller or a wheelchair for him. You don’t want to set him back and sore from too much avoidable walking.

 

[dez1978]

Wait, so the PT has given him exercises and things to do in between appointments and you want to do MORE? There is no time wasted if he's doing the exercises at the frequency the PT gave him. Focus on doing that and at the next appointment ask if there's something more to be done.

he hasn’t been able to see the pt since before he got his boot off. So we don’t have any new exercises beyond what he was doing previously. I was just looking for some ideas until we could see the pt again this Friday. What he’s doing now are strengthening exercises for his leg but don’t address the gait issue bc having the boot off means he’s using it in a way he couldn’t before. Doing leg lifts and stretching etc. So yes, we’re looking for the next step