A Hands-On Approach

December 9, 2017

Tom Ravetto, PT
Renee G. Rowley, PT, PCS, C/NDT

This practical hands-on course is geared toward pediatric physical and occupational therapists working with toddlers and children who are diagnosed with idiopathic toe-walking. Other providers who work with children who toe walk may also benefit.

Level:  Beginning to Advanced

Contact Hours: 5.75

IN OT – Professional Licensing Agency:
IN APTA: Pending
Out of State (not IN) Licensing Agencies: Check with your state to see if you can apply for out of state CE approval (we do not cover cost)
IL EI Approval: Pending
IN EI Approval : There is no formal process. You must be be able to justify how workshop is related to EI (all or a certain percent)
ST Contact Hours: Good for IN (or other states that require ST related contact hours) only if you can relate the  workshop to ST

Hampton Inn & Suites
8836 Calumet Ave
Munster, IN 46321

Seminar Description
Course participants will be guided into achieving a deeper understanding of the actual causes of this diagnosis. Therapists will come away from the course able to analyze postural impairments that both lead to toe-walking and at the same time prevent its complete resolution.

The course format is primarily an interactive lab experience where participants will come away with an enhanced ability to understand the relationship of one postural impairment to another and how the presence of several of these as a set can result in idiopathic toe-walking. The primary outcome of this course is for therapists to enhance their assessment skills and come away with treatment plans that produce results.

Seminar Objectives
Participants will:

  1. Identify 4-5 physical impairments that lead to toe-walking.
  2. List 2-3 reasons why each of these impairments could have developed in the baby/young child who is later diagnosed with idiopathic toe walking.
  3. Identify treatment strategies that address the child’s physical impairments, including:
    a)     Manual therapy techniques, including myofascial release, deep soft tissue releases, joint mobilization, etc.
    b)     Strengthening, neuromuscular re-education and alignment approaches to shoulder and pelvic girdle, spine, and lower extremities
    c)     Neuromuscular re-education and correction of the postural set
    d)     High level balance activities
    e)     Therapeutic taping
    f)      Sensory input – proprioceptive and kinesthetic – weights and compressive garments
    g)     Use of orthotics, lifts and shoe modifications
    h)     Night splints and casting 
  4. Understand the role of the sensory system in the continuation of the toe- walking pattern even in children who have received extensive physical therapy.
  5. Understand the crucial roles played by OT in addressing the deeper subcortical sensory functional impairments – sensory modulation issues, vestibular function, hyper- and hypo-responsiveness, etc.
  6. Know parameters and guidelines as to when to refer to other disciplines.


8:00 – 8:30 am Registration
8:30 – 10:00 Lecture: Literature Review, Philosophy of Holistic Evaluation and Treatment Approach, Overview of Impairments
10:00 – 10:15 Break
10:15 – 12:00 Lab: Evaluation and Treatment of the Shoulder Girdle, Spine and Ribs
12:00 – 12:45 Lunch (bring your own)
12:45 –  1:45 Lab: Evaluation and Treatment of the Pelvic Girdle
1:45 – 2:30 Lab: Evaluation and Treatment of the Foot/Ankle Complex
2:30 – 2:45 Break
2:45 – 3:15 Discussion: Casting Night Splinting, Orthotics
3:15-3:45 Discussion: Roles of PT and OT, Effects of Growth, Long Term Expectation and Results


About the Speakers:

Tom Ravetto, PT received his B.S. in Physical Therapy from the University of Illinois-Chicago Medical Center in 1996. His first interest was in adult rehabilitation, and he pursued this while working at Olympia Fields Osteopathic Hospital. Tom then expanded his career to include pediatrics as he worked with Olympia Fields to establish their first outpatient pediatric clinic. To further his knowledge, he became an NDT-trained PT in Pediatrics in 1998 under Kacy Hertz, PT, C/NDT. He continues to use his valuable knowledge of NDT in his approach to every patient, no matter the age or condition.

In 1999, Tom began practicing at Kids in Motion and in the south suburban school districts, where he continues to enjoy treating children directly in both settings today.  In addition, he sees individuals of a wide age-range in the home health setting, making Tom fully appreciative of the impact of great treatment throughout the entire life span, in all settings.

Tom is well-versed in manual therapy techniques, myofascial release and therapeutic taping to address alignment and mobility needs. He has pursued advanced coursework steadily in each of these areas, and has integrated their use into his everyday practice to afford his patients joint stabilization and postural stability to gain freedom of movement.

Tom maintains a holistic approach and thinks outside the box in order to tease out and unpeel layers of dysfunction. He is best known for his versatility in his treatment, both by using the principles of NDT to help treat orthopedic and sports injuries and by using his knowledge of manual therapy to enhance his treatment of children with central nervous system involvement. Tom is a much-loved therapist with over twenty years of experience. Course participants will enjoy his teaching style in presenting the comprehensive treatment approach for truly successful outcomes in idiopathic toe-walking management.

Renee G. Rowley, PT, PCS, C/NDT received her B.S. in Physical Therapy from the University of Illinois-Chicago Medical Center with pride in 1979. She began her career in Adult Rehab and became NDT-trained in Adult Hemiplegia in the early 1980’s under Isabelle Bohman, MS, PT. The Neuro-Developmental Therapy (NDT) approach proved invaluable in the busy hospital rehab unit setting for the treatment of adults with hemiplegia, traumatic brain injury, multiple sclerosis, Parkinson’s disease and Guillan-Barre.

At the same time, Renee worked in an evening outpatient orthopedic setting during which she observed another PT relieve his patients of pain, restore function and discharge them in less than half the time than the other staff therapists. This excellent PT mentored Renee over the next year as she observed and learned from his expertise, leading her to the study of orthopedics, especially the spine. She participated in numerous joint mobilization courses taught by Ola Grimsby, PT, and has since never forgotten the importance of integrating the solid knowledge of orthopedics into the handling of every individual with neurological involvement.

Renee later headed into pediatrics after being asked to assist on a pediatric case in the home setting. Again, she was mentored by an excellent pediatric therapist for over a year, then became NDT-trained both in Pediatrics and later in Baby Treatment under Lois Bly, PT, MA, C/NDT.  After first moving into both administration and practice to develop and establish a brand new pediatric program for St. James Hospital, in 1988 Renee then made her final career shift to co-found Kids in Motion, a small outpatient pediatric center in Crestwood, IL, where she happily continues to treat children today.

Through both hosting and taking courses over the years, she has continued her expansive training in: NDT under the numerous gifted instructors in the NDTA; Myofascial Release (MFR) by Regi Boehme, OTR/L, and John Barnes, PT; orthotics principles by Nancy Hylton, PT; orthopedics and manual therapy under many extraordinary instructors. She is now pursuing coursework in Strain-Counterstrain techniques, and continues to gain insights into sensory dysfunction from Kids in Motion’s esteemed Senior OT, Julia R. Bator, OTR/L.

Renee applies her knowledge of NDT and manual therapy into every treatment, with particular interest in the treatment of babies with torticollis, children who display toe-walking, individuals of all ages with cerebral palsy, and children with spinal or foot alignment issues. She is very excited to partner with her respected colleague, Tom Ravetto, in presenting an integrated approach to the successful evaluation and treatment of idiopathic toe walking.


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