So Mary's PT just left and I really don't know how to feel. She has always been really great, but lately she has been really focusing on Mary's hyper-extended knees. Mary will not bend her knees to pick things up. She will keep her knees straight and bend at the hip. She can pick up the smallest object off of the floor... it is really quite amazing. She will bend her knees to sit on a stool or on me and bends them to climb and walk. She also does not squat to stand up or squat to sit directly on the ground. She uses her hands to help her stand and sit. She puts her hands on the ground and pushes up and then bends one knee and then the other; she sits the same way. Anyways, I feel like Mary's PT is really focusing on this and she is talking about putting her in braces that go from her ankles to her knees. I am really not sure how I feel about this. I had another PT say that she would not worry about hyper-extended knees on a DS child unless it continues when she is older and that as she does other strengthening activities her knees will get stronger. Mary is walking and running and climbing on things. Her hyper-extended knees don't keep her from being mobile. She is only 20 mos old and I feel like her knees are getting stronger everyday. Does anyone have any experiences with this? I really want to work on other things like climbing stairs, jumping, etc. What do ya'll think? Should hyper-extended knees ba a priority? How do I talk to the PT without underminding her exerience and her expertise?

aj - thanks! I think that this is probably not a big deal, but Mary's PT makes me feel like it is just horrible. I'm glad to know that she is not alone. I think that a lot of early walkers have similar problems and that as they get stronger they will bend their knees more. Let me know what your PT says about it. Thanks, again. - Jamie

aj - Just to let you know Mary has only recently started bending one knee and then the other when getting up and sitting. For the first 3 mos of walking she stood up and sat with completely stiff knees, like Janna. -Jamie

It seems like every PT has their own opinion! We've experienced that too. The early access pt (through our area education assoc) is always so pleased with Brock's progress and while she works on the mechanics she's not concerned about every little mechanic being correct. The hospital PTs however would have Brock in braces too - not covered by insurance right now, so makes the decision easier for me. We are waiting to get on a Medicaid waiver, and then I'll have to make that tough decision.

I hate the tough decisions!, and hope that you'll be able to make a decision you are comfortable with for Mary.

Squat and recover is a task that pt's love to see our kids do. BUT I have seen lots of kids typical and not do it the way you describe....i wouldn't worry too much unless you see it start to hinder her....-COurtney

Since Lexi had this same issue I thought I would toss in my 2 cents worth. Lexi hyperextends her knees pretty bad and her PT also suggested putting her in SMO's. From her feet to her knees. We followed up with her ortho and he also thought it would be a good idea. She got them and they really aren't as bad as you might think and today she is much better. She also got her first pair when she was about 1.5 and in Jan we are going for her third pair except now they are much shorter since she has made so much progress. I would suggest a visit to a ortho and if he says yes than go for it. Really it can't hurt but it can make it better. I also wanted to let you know that Lexi was not a early walker. She did not walk until she was 33 months.

We had individual PT until the last two months- so I hadn't seen the other ds kids her age and how they were doing gross motor. Sadie has always been behind (really behind) gross motor, due to her floppiness. I think this may have been a blessing. She wasn't able or willing to walk; therefore, her PT worked alot on squatting and bending her knees. Now that she is in a group program, I see all these kiddos who are so stiff legged that they have a hard time with more advanced tasks. I think your PT is right to be worried- Sadie's knees and ankles were rolling every time she put any weight on them. Now, she is pretty strong! When she was evaluated in August- she was at 11 months gross motor. Now, she is walking, turning, kicking a ball (without my help), jumping on a trampoline (legs bent), walking up and down stairs, can squat and pick up anything then resume play, is starting to run, etc. I thank that PT for teaching her the basics- one step at a time- line upon line- because now she doesn't have to go back and relearn them!

I'm not sure about braces.. Sadie's PT always thought she should do more streghtening exercises. She spent a lot of time in the pool- bending and kicking. And now she walks in sand and up and down our steep driveway- all exercises to streghten. I think you need to talk to you PT and tell her your concerns and desires- Knowledge is power! She may not be communicating her thoughts, but she probably has an educated reason why she is concerned. Good luck!!!

John wears the braces that go all the way up the back of his legs. He sees a great PT at the hospital who said she doesn't normally like to put kids in braces but it can be just what some kids need. John's hyper-extended knees were keeping him from walking. When he first got the braces and stood in them his little legs shook because the braces forced him to use muscles he hadn't been using, specifically his thigh muscles. His braces were stiff at the ankle and his foot was slightly tilted upward preventing him from hyper-extending his knees. Last month the cut the braces at the ankle and put a hinge in allowing him more movement. He's been a little unsteady but is getting better. Eventually we'll cut the braces down but for now he needs the support.

It's hard to know what to do in your situation when Mary is already walking and climbing and such. Why don't you ask Mary's PT what she's worried about happening if you don't do the braces.

I can hyper-extend my knees. I was once told I had great swimmer's legs because of it. Maybe Mary will be a champion swimmer one day with her amazing legs! And if you do decide to go with braces, the place John got his offers them with fun designs on them. His have zoo animals.