Michelle’s Blog

Given the opportunity as the first student PT to do one of these, I wanted to share some thoughts I’ve had here at Suburban. Suburban is my fourth and final clinical experience, meaning it’s my last stop before graduation. And as much as I enjoy being a student, I will not miss being broke. Not even a little bit. Here are my thoughts.

1. I want to learn as much as I can about this physical therapy stuff. Being that private practice is the setting in which I want to work, I am grateful that Suburban is my last stop and that it has been provided a fine learning experience. This opportunity for learning and growth is a main determinant in where I chose to begin my career.
2. The relationship between student and clinical instructor (CI) must be reciprocal. If the CI thinks the student has nothing to offer, the student will shut that CI out and be unreceptive. As crazy as it may seem, students are not brain dead. They have treatment ideas too that wish to be heard and discussed. Honestly, my CI here at Suburban, Michelle, has been the best CI at seeking my input. And I’m not just putting that to get the good grade. If and when that relationship is established, the experience for both parties will be enriched.
3. A big reason to why Suburban succeeds in providing quality care is that they are a great team made up of therapists, aides, front office, finance personnel, IT, and transportation personnel. To quote Patrick Lencioni, “Not finance. Not strategy. Not technology. It is teamwork that remains the ultimate competitive advantage, both because it is so powerful and so rare.” Suburban seems to have attained this rarity.

Matthew Connor
UMDNJ Class of 2009

Around the time children start to learn to walk, around 9 to 16 months old, they are often unsteady, have a wide base of support, and they may sometimes prefer to walk on their tiptoes. Studies have shown that toe-walking is considered an acceptable part in normal development. Toe walking is common up to 18 months, but may persist until the child is 2-3 years old. The child usually grows out of toe walking and develops a heel-toe gait pattern at the age of 3.

Persistent toe walking, beyond 3 years of age, may be associated with diagnoses such as cerebral palsy, autism, spina bifida, tethered cord syndrome, muscular dystrophy, sensory integration deficits, or other neuromuscular issues. Other cases of toe walking may have no known etiology, and is diagnosed as Idiopathic Toe Walking. In any of the cases, children may benefit from interventions such as physical therapy, footwear modifications (shoe inserts, heel lifts), ankle foot orthotics (AFO), serial casting. Although it is rare, surgical intervention may be an option to lengthen tight heel cords that may be causing the gait abnormality.

Physical therapy intervention usually involves passive and active range of motion exercises that focus on the ankle stretching (usually tight calf heel cords), strengthening, gait training, balance training, and a home exercise program. In addition, a physical therapist is also involved in suggesting if/when other interventions, such as footwear modifications and orthotics, are appropriate.