[leamcq]

Hi guys,
the scissoring implies overactivity of the anterior adductors, this is commonly because of poor lumbosacral and posterior hips stability.This is often present with overactivity of the superficial back extensors. The toe walking could also be caused by insufficient hip extension and proximal control. If the client is 'hanging on' with these muscles, you cannot succedd with lengthening strategies as this will destabilise further. Rather than consider stretching & Bot. toxin you probably need to look at getting better pelvic alignment & stability, possibly in supine initially, to get firing of the rear adductors/ extensors/ & external rotators which act like the rotator cuff of the hip. Practising a walking motion against manually applied resistance in supine can be good, as you can control the alignment, joint proprioception and put emphasis of resistance or assistance where needed in the cycle. This can then be translated to other postures. The most important factor is what muscles is the client activiating to stand up from rest, as this will dictate how they are pulling themselves together and how they will act againbst gravity. The movement pattern they produce is only a continuance of this.

Lea