> Elizabeth,
>         Thanks for such a nice note. I am a little concerned with the new laser
> surgery for orthopedics because the literature sent states there is seldom
> need for additional therapies after this surgery. I think when tendon is cut,
> that it may not heal as the surgeons lead us to believe. And I agree with you
> that the child has a new obstacle to deal with in learning stability where the
> muscles were once tight. I have heard that it may take up to one year after
> surgery for the child to regain skills. Cindy


The surgery that they do today doesn't always involve cutting but rather reattachment
so that the muscles  loose slack. The tendons heel fine as the child is kept in a cast
from 3-5 weeks.

The obstacle is not as profound as you think, I've worked with dozens of kids who
have had this surgery and the key is to do weight bearing while the child is in the
casts with some rudimentary walking and when the casts are removed begin
ambulation and some exercises that involve knee flexion to prevent extension contractures
and some exercises designed to stretch the hamstrings.

We just had a child who began walking without a walker after 3 month minus the
scissoring and a heel to toe gait pattern. The therapy was not really that intense.

Alan Fried
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