Anthony has been tip-toe walking for as long as I can remember. Whether it's running, jumping, climbing or walking, and whether it's at school, home or in the garden, Anthony does it on his toes. We buy the toughest school boots available. He bends them all and goes through the ball of them by the end of each term. Anthony is very sensory seeking and it's long been thought that he enjoys the feeling of pressure this puts on his feet. In the summer we took him to a trial trampolining class and noticed he wasn't able to point his toes up when they were stretching - in fact it didn't look like he could do it at all.
We got in touch with Anthony's occupational therapist and he was referred to a physiotherapist. Anthony has a diagnosis of ASD, with dyspraxia and sensory processing difficulties. He is currently being assessed for Attention Deficit Hyperactivity Disorder (ADHD) and at physio appointment we found he also has 'hypermobility' in his knees. I believe only about 10-15% of people with autism have ASD as their only condition. Most have a 'co-morbid' condition, one that co-occurs with ASD. About half have sensory processing disorder (SPD), like Anthony, and about a third have obsessive-compulsive disorder (OCD).
We have heard of hypermobility before. Anthony's younger brother, David, can bend himself into the most uncomfortable looking positions but there is no current reason to be concerned about his hypermobility impacting on his development. People with hypermobility are particularly supple and able to move their limbs into positions others find impossible. There are different types of hypermobility and some people can find painful.
Anthony's hypermobility in his knees are part of the reason he goes onto his tip toes. This is a comfortable position for him as it allows him to stiffen or gently lock his knees to compensate for the extra movement he has there. Quite clever really. However, as a result, the muscles around his heel and calf aren't being stretched and as he has grown they have either not kept up or possibly even tightened. This explains why he can't pull his toes up very far.
We have exercises to do to increase Anthony's flexibility and strengthen his legs. If it doesn't work we may have to help him with some special shoes. So, we'll add another task to the daily routine. And wonder if Anthony's handsome body is camouflaging any more hyper-whatever co-morbid conditions.
External Links
Hypermobility Syndrome Association HMSA
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