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Outwardly, Matt’s daily activities might lead people to assume that his efforts, and ours, were targeting one deficit at a time. But that was far from the truth. The battle to reclaim Matt’s physical form ran parallel to the rigorous struggle of re-igniting his neurological circuits. Exercise and ambulation are powerful catalysts for cognitive recovery, boosting blood flow and delivering critical oxygen and nutrients.
These essential elements support biological processes involved in neural repair and reorganization, which are directly linked to advancements in speech, language, attention, memory, and executive function. Inherently, rebuilding the physique also becomes the most effective medicine for the mind.
Did we fully grasp these concepts, or intentionally integrate them into our home programs? Not consciously, but if asked, we could have easily articulated the physiological rationale for our actions. In part, this knowledge and understanding were deeply ingrained in us as physical therapists. Yet, it was also gained through years of experience raising children and the valuable lessons learned through trial and error. In general, I sense most individuals have a gut or innate awareness of developmental stages; they just don’t think of it that way.
Physical Therapy, under Eric’s determined command, continued at a steady pace, with a heavy emphasis on power, speed, and equilibrium. Stairs remained a favorite hangout. With minimal arm support, Matt slowly took two steps up, then descended backwards to touch the floor. Holding a medicine ball between outstretched arms, he was instructed to ascend and descend the first step in a fluid motion. At times, he side-stepped, crisscrossing his ankles, and even did so blindfolded. Then there were all forms of hopping and jumping activities on flat surfaces, over a cane across his path, or down from a ten-inch platform. Matt begrudgingly did tasks that denied him the security of holding on to a rail or Eric’s arm. He would hesitate, reach, or groan, doing his best to skirt Eric’s directives—to which Eric jokingly chided or figuratively slapped Matt’s hands to discourage his persistent gripping. This was comical, as was watching Matt plow forward, towing Eric behind him on a wheeled stool, adding extra drag with his heels at a whim.
I missed Eric’s banter when, in May, he “abandoned” the physical therapy profession to pursue a career advancement opportunity in hospital administration. But we were not alone. Tom effectively stepped in, introducing Matt to a different treatment approach, Functional Movement Science, and to a calm, reassuring, supportive demeanor. This technique employed varied postures and movement patterns, such as wide stances, half-kneeling, and one foot ahead of the other, combined with 10 repetitions of bending forward, side-to-side, and twists, to refine balance and motor control.
In July, a coworker casually suggested I mobilize Matt’s sacroiliac (SI) joint to open up his pelvic region. She suspected this tightness was contributing to his right pelvis dropping and his feet turning inward as he moved. After applying gentle pulsating pressure to the joint, Matt then stood with his feet turned out as far as possible and practiced taking slow, small steps like a duck. Lo and behold, immediately afterward, as he strode forward, things straightened out, and his pelvis didn’t drop. However, this required a concerted effort, and he could do it only for short intervals before old habits kicked in. Bless his heart; he tried so hard to do it correctly. Matt was very patient with me.
In the fall, Tom handed off the baton, this time to Kim, a new-to-me, quiet, spoken individual. She concentrated on Matt’s standing posture and balance, using various exercises such as pushing a heavy medicine ball—similar to dribbling a soccer ball—and strengthening the hip and buttock muscles with resistance bands.
This frequent changing of the guard might not work for every patient, or even for a clinician who desires to see their patient across the finish line. Yet, besides the obvious, exposure to each therapist's unique personalities and areas of expertise kept things fresh and engaged Matt in unexpected ways. This dynamic caused him to adapt, communicate, and interact with new people, thereby stretching his social skills. Collectively, the therapists shared goodwill, optimism, and an intense drive to aid Matt in all aspects of his physical recovery, especially his ability to navigate the world on his own.
© 2026, Sarah Watkins
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