There’s a memory that is ever present in my mind. When Katherine was 17 months old and still not walking, we started physical therapy to give her the extra boost she needed to take those first steps. I thought she lacked the confidence to walk. I told myself that and actually believed it for a while, I think.
This question is as clear as the day I asked her therapist, “How many months do you think it’ll be until Katherine can walk?”
The question was as naive as my belief that she lacked the confidence she needed to walk independently. Confidence doesn’t have anything to do with the “normal” and “natural” process of walking. I rationalized many different scenarios in my head at the time, but there is a very strong drive for humans to want to walk.
Flash forward to today and confidence plays a big role in Katherine’s willingness to try to walk. If you’ve never had the opportunity to try to teach a person to walk before, let me assure you that it is a surreal and challenging experience. You never take walking for granted ever again, either.
Katherine is old enough to know that she cannot walk like others. She will tell you that she doesn’t “walk very well” and “falls a bunch.” We now know why she doesn’t walk very well, which is very helpful to understand, but it’s far too complex for a four-year old to understand.
As we’ve explained in previous posts, we know that the cerebellum helps regulate and direct the signals coming into and out of your brain. For example, the cerebellum does not initiate the signal from your brain telling your legs to move. However, that signal passes through the cerebellum before it is sent to the legs, and the cerebellum helps direct it and tell it how much pressure, strength and speed to use. The leg then sends the signal back the brain to tell it what has happened. That signal also passes through the cerebellum before being sent to the part of the brain in control of the leg. With a damaged/abnormal cerebellum, those signals can get mixed up, amplified, muted, or misdirected. This results in clumsiness, difficulty controlling the force or pressure of one’s muscles, difficulty writing, poor articulation of speech, poor motor planning, and a lack of coordination when walking, clapping, playing patty-cake, etc.
Because these signals travel through the cerebellum thousands of times per second from all parts of our bodies, significant problems can occur. As an example, the simple (to most of us) act of standing, alone, requires thousands of these signals to pass through the cerebellum each second; nerves of the ankles, feet, knees, thighs, torso, arms, neck, and head signal the brain about what they are doing, the inner ear tells it up from down, the eyes tell it what is going on around us, etc. These signals pass through the cerebellum, are regulated, and passed on to the higher brain for interpretation. That higher brain then decides what to do, and signals back how the body needs to adjust given all the signals coming in from all of these body parts. Maintaining balance while standing is a coordinated and complex function—one that modern computers could not hope to replicate – that we take for granted and do not even think about. That is not the case for Katherine. Katherine’s entire “balance center” of her cerebellum is the most affected, making balance a daunting task, requiring a great deal of concentration. Add to that trying to coordinate all of these body parts to walk, and the task is beyond her current abilities.
However, she is making progress.
The brain is remarkably adaptable. People suffering from significant brain injuries can re-learn to walk, talk, and function. Repetition and rehabilitation allow the brain to make new pathways and connections to do what it once did elsewhere.
As Katherine grows stronger in her core and legs, she is able to balance much better. And as she feels more confident in her balance, she’s increasingly willing to try to balance, which makes her stronger, both mentally and physically.
Trust plays an important role, too, because Katherine knows that if I let go she can fall and hurt herself.
Balance, strength, trust, confidence, repetition. Repeat. Repeat. Repeat. Repeat until her brain starts to do all that for her. I am confident that one day it will.
That question I asked her therapist over three years ago seems so silly now. How many months until she walks? Now I tell myself that “slow and steady wins the race” and that she will walk when everything clicks for her.
Balance, strength, trust, confidence, repetition. Repeat.
Katherine often asks, “What if I fall, mama?”
The answer always echoing inside my head is the quote, “Oh, but darling…what if you fly?”