Play detective with me as you follow along in this post and the videos.
Here’s Mia skating forward this past Monday, eight weeks into the hockey season, skating twice each week.
Note that when she skates forward, she can rotate her left leg (unaffected side) outward and push off on the inner edge of the skate blade. But, she is doing something else with her right leg and foot (affected side). She has the foot oriented such that she’s leaning on the outer edge of the blade and the foot is pointing straight ahead. When Mia skates fast at hockey practice across the ice, she literally starts at the goal line and ends up at the blue line and turns around and does the same thing again, progressing at roughly a forty-five degree angle across the ice from where she starts. At first, I thought she was trying to get to where Zoe was along the boards. But, now it makes sense. Her left leg is doing most of the work to propel her forward so she’s not skating in a straight line.
Here’s Mia skating backward from the same session.
Note that she has a hard time spending much time bearing weight on her right leg and doesn’t seem to know how to orient it. Unlike many beginning skaters, her ankle is bent outward.
Each practice, the kids do some routine skating drills including “making snow” where they brace one foot against the boards and use the other foot to repeatedly push outward to make a little pile of snow. They do this first with one foot and then with the other. After that, they do “C cuts” which helps them learn to skate backwards. Mia has complained that it’s hard for her to do these skills with righty. This might be her first direct experience of finding something difficult with her right leg and foot. She has expressed similar frustrations with her right hand when trying to do certain tasks.
Other coaches sometimes help orient Mia’s stick so it won’t trip the other kids, packed tightly, nearly forty of them lined up along the boards between the goal line and the blue line.
In my previous post about Preparing for First Hockey Season, Mia was not so advanced in her skating so she was essentially walking on ice, falling and getting up. There was no obvious difference in how she was using her legs in that video clip from two months ago, repeated here for reference.
When walking and running, Mia has no obvious issue with her gait, despite her early stroke. I’ve been wondering about her footedness. In soccer, she chooses to kick the ball with her left foot, and briefly balances on her right foot. She has grown skillful on a scooter, balancing on her left foot and pushing off with her right foot, even using her right foot to depress the rear brake on the scooter which is an advanced maneuver. Here she is on the scooter in early November.
In recent discussions on a forum for families with children who have hemiplegia or had a stroke, there’s been a discussion about how to support the development of these children’s affected foot or leg. I chimed in mentioning my observations about her scooter usage and her soccer preferences, and suggested that skating would be an excellent activity and indicated that Mia is learning now. Part of my goal in documenting Mia’s learning process in detail here is to share the nonlinearity of learning, even for Mia who by all accounts has so far had the best possible recovery from her early stroke.
Mia’s attitude continues to be incredibly determined. She was moved up from the “chair pushers” after just a few weeks to the Red group. Then, when she outgrew her skates and had a few rough practices as she adjusted to her new skates, I offered that she could go back to chair pushers. She declined. Then, in a moment of frustration, she asked to switch groups. She only stayed with the chair pushers a few minutes before returning to the Red group. She is starting to skate faster and wants to keep up and learn. She seems to not mind being among the slowest in the group, and may not notice as she’s so focused and determined.
As I observe and document Mia’s progress, I wonder what to do to help her. My goals are to support her in having fun and learning new skills that are good for her overall development, regardless of whether she wants to continue with hockey.
I could pursue a direct route and send her for private skating lessons or talk with Mia about what she’s doing and how it affects her skating. For now, at this age, I prefer a playful approach combined with giving her neuromuscular system time to mature and figure out how to skate.
I’ve been consulting with others and thinking myself of off-ice activities, inspired by Feldenkrais to introduce variablity in a playful way that will both wake up and strengthen Mia’s ability to stand upright on her skates, and freely shift her weight and use her legs and feet in a variety of ways that she will hopefully be able to transfer at some point into an improved skating stride. I will attempt to experiment with some new warm-up activities for all three of us, so it’s just something we do as a family to get ready for skating, and see what emerges.
Interesting! What happens if she tries skating with her stick in her right hand? I wonder if that little bit of extra support (does it provide support?) would free up her right foot? Have they taught sculling yet? I wonder how that will go, since it’s a different movement.
Diana – The stick is kind of irrelevant at this point and she has a strong preference to hold it in her left hand. I think it would stress her to hold it in her right hand. Though, at the last practice when one of the coaches showed the “hockey ready” position which includes both hands on the stick, she was able to do that, for the first time, I think. No sculling yet.
Was Mia affected on her lower body? What therapies do you feel worked best? Thanks.
Christina – Mia’s lower body has been largely unaffected though she does have different habitual patterns of movement in her torso which affect her whole body. She has never had an AFO, took her first steps at twelve months of age, and has been quite agile in gross motor activities all along. Mia has had several intensive series of Feldenkrais lessons intermittently (a few days of lessons every few to several months) since she was an infant. In addition to that, she was in Early Intervention from 1 month to 3 years mostly for OT. Since turning 3, she has had OT through the public preschool once each week to work on fine motor dexterity with her right hand and on bimanual use of her hands.
Thank you so much Mara for your reply. Gisele is 2 years old. I just cut down on some of her therapies, b-c we were overwhelmed. She has 6 hours of constraint therapy which we see huge improvements. She has EI speech therapy. I canceled OT and PT, so that I can do the constraint therapy. I also canceled hippo therapy, and put ABM therapy on hold. ABM came out of Feldenkrais. I wasn’t sure if that was helping her. After reading your response I have changed my mind. Do you remember seeing results immediately after Mia’s therapy with Feldenkrais?
In Anat Baniel’s book she writes examples of a child’s progression in just 1 session.
Thank you again. Love seeing the videos of Mia.
Christina
Christina – I myself have trained as a Feldenkrais practitioner though I am not practicing currently, except in self-care and parenting Mia and Zoe. Feldenkrais and ABM can be effective in a small number of sessions, even one, if the practitioner is very skillful and conditions are ripe. Mia has also done modified CIMT from age 12 months to 2.5 years. I did it in a way that felt congruent with Feldenkrais which was a bit unorthodox but worked for us. Here’s a link to my post on CIMT: http://marazoemia.net/2013/05/15/constraint-induced-movement-therapy/
How lucky are you that you have such a perfect little girl that can iceskate after having been through so much in her little life. Did you ever think? Looking from the outside in is quite the eye opener. I cannot tell you how much of me I see in you and your video. I am a detective just like you and so wish I wasn’t. Do you think Mia knows why you are paying so much attention to her and what she is NOT doing? Your video made me realize some about me and maybe I could do the same for you because I am so greatful. I feel bad for us. We have had this worry consistantly, without a break, since the day they were born. I think we are more affected than they are. I know my son, strokes and seiuzures at birth, left side hemi, knows that I am watching him to see what is wrong instead of what is right. I think I make him uncomfortable and insecure when of course that is not my intention. He is different with his dad who was in denial from the beginning (lucky guy). Whereever we go and whatever we do I am always looking for signs of left sided weakness and any other injury from the strokes so I can be prepared for the next gloom and doom chapter that lie ahead. I am thinking I wish I never knew about the storkes at birth because I would be able to enjoy him for the wonderful little boy that he is without the worry and constant critique. Thank you for sharing your video. It has made me relize so much. I hope you can try to enjoy both your girls without the worry like I am going to try to do. Do you think she would do better if you told her she was all better! I think it is all in Mia’s hands now. I feel like my Michael would make excuses or quit if I told him more about how his left side is weaker than his right, that his gate is off a little because of what happened to him. I do the best I can as I know you do but he sees so much more than I think. He is such a nice little boy and so well behaved (in school) at home, different story, but he so insecure and shy and I can’t help but think it is because of me. He can run fast, play baseball and ride a bike, everything that you would hope for any 7 year old boy. I am going to try to enjoy him more rather than worry about him. Maybe we could both lighten our load a little in 2014 by forgetting for a minute what they went through and realize how much they have overcome. We just need to do the same. Thank you so much for sharing. Your little girls are both perfect. Happy New Year Mom. Sincerely, Michelle mom to Michael (7).
Michelle – Thanks for offering your perspective. I delight in and celebrate Mia’s accomplishments with her daily as I do with Zoe. And, for both of them, I continue to look for ways to support them in doing what they want to do. It’s a fine balancing act, for sure. Parenting is undeniably the hardest job I’ve ever done. Peace to you in the new year.