Hands-On Cueing Improved Posture and Gait

My childhood and adolescence was peppered with physiotherapy. I didn’t spend Saturdays as a teen sleeping in – I was at physiotherapy, preparing for my patience to be tested. Specifically, I was at physiotherapy to address my standing posture and functional walking ability (aka gait).

I have cerebral palsy, and I walked with my left foot turned in and up on my tiptoe with my left hip stuck out. To me, this didn’t feel unnatural; it was just what my body did. During my physiotherapy sessions, my therapists and mother would grab my left hip and push it in. I looked in the mirror and saw that I was standing straight, but I felt off-kilter, like I was about to fall.

When I walked, my physiotherapist would place her foot on the inside of my left foot, forcing it to hit the floor straight and flat. Every step I took was shadowed by her, forcing my leg and my foot into a proper position. Again, objectively I understood that my position was being righted. I’d look in the mirror and see that I was standing straight, that my feet appeared normal, but it felt intrusive. My body fought against being guided; I felt more stable with my left hip sticking out and my left foot turned in.

My mother learned the tricks of my therapist, so even at home I couldn’t escape the guided activity. It drove me crazy. The way I was being forced to stand and walk by the therapist made me work harder than just doing it the way I was used to. I fought with my mom almost every day. I’d whine and complain when she gently aligned my hips or my left foot as I stood at the bathroom sink brushing my teeth. Walking what little I did became infuriating because I couldn’t take one step without someone else’s foot between mine. It was getting very annoying!

As time passed and my physiotherapy sessions progressed, I could see in the mirror, that the guidelines regarding my gait and my posture were doing what they were meant to do. I could see myself standing straighter and my gait normalizing a little bit more. It wasn’t just about pushing my hip in, or helping my foot. My physiotherapist’s guidelines for proper posture and gait forced me to transfer weight adequately through my left leg and to stop over-relying on my right.

I discovered that my annoyance was mainly based on the amount of effort I needed to consciously put into fixing my posture and gait pattern. I had to think about it. I had to concentrate. I had to force my trunk, my hips, my leg, my foot, to do something they didn’t want to do. I hated that it was more work for me to stand with “normal” posture and to walk with a “normalized gait.” It made no sense to me, the amount of concentration and exertion it took to accomplish “normal” posture- something that many people accomplish without any thought or effort.

Personally, I think it sucks to have a body that doesn’t do what you know it’s supposed to. It’s annoying when other people have to guide your body – with a helping hand or sometimes foot – to do the right thing. It can feel crowded, intrusive, and nonsensical that it takes more effort to accomplish something normal and proper.

However, given an appropriate amount of time and practice, your body becomes accustomed to certain postures. Eventually, your body learns. You may never do something as simply and naturally as someone who doesn’t have to think about it, but it does get easier, to remember what your body should do. It’s like a running list in my mind of remembering that my foot should do that, or my hip should do this, with less help and verbal or physical cueing from others.

These days, I don’t do physiotherapy as much as I used to, or as much as I should. But my left hip sticks out less. My left foot goes flatter, straighter, easier than it used to. The things others used to need to guide my body to do are now things that, if I concentrate, I can make myself do without someone else’s hands, or foot between mine.

It’s hard to say where I’d be without all that hands-on guidance. The independence I rely on now probably would have taken a hit. The pivot transfers I can’t live without or the weight baring necessary for standing might only be things I dream of. I’m proud of how independently I can function as an adult; but without the hands-on cueing that annoyed me as a child, the life –and level of privacy – I’m able to have now likely wouldn’t be a reality. It’s tiring, and it might seem endlessly annoying when you’re young, but all that guidance is well worth it, in the end.

The opinions expressed in this article may be those of a guest author and not necessarily Propel Physiotherapy.

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