Know Better, Do Better:
A Conversation with Liesa Ritchie, PT, DPT, PCS
From her beginnings in hand therapy to becoming a global educator and pediatric movement expert, Liesa Ritchie has dedicated her life to improving clinical outcomes for children. Through her work with Know to Change, she empowers pediatric professionals with knowledge and practical tools to make meaningful, lasting change by addressing ALL aspects of toe walking.
From Hand Therapy to Lifelong Pediatric Passion
Liesa Ritchie began her therapy career in 1990, initially working in hand therapy. When that clinic closed, she transitioned into pediatric physical therapy — over three decades later, her passion for pediatric care continues to grow.
She explains her passion stems from making real change to increase her patients’ enjoyment of life.
“When a child’s life is limited by dysfunction or pain, pediatric therapists have a profound opportunity to shape lives from the very beginning. Foundational changes early on can impact their entire lifespan.”
Origin of Liesa’s Organization, Know to Change
What motivated you to start Know To Change, and what do you hope to achieve through this organization with pediatric professionals?
Driven by her love of teaching and the need for her own educational platform, Liesa launched Know to Change. Her goal: to deliver clinically relevant, evidence-informed education with a deeper understanding of movement disorders like toe walking.
According to Liesa, toe walking is not symptom based, it’s a movement disorder rooted in the brain and sensory system.
“Our job as therapists isn’t just to ‘stop’ toe walking. It’s to understand why it’s happening and change the body’s movement strategies from the inside out.”
The name Know to Change reflects this mission: Know to change what you are doing when it is not working. Her work encourages pediatric professionals to question traditional methods and embrace a more comprehensive, individualized, systems-based approach to intervention.
Why Traditional Approaches Fall Short
Many pediatric therapy professionals are taught that idiopathic toe walking is primarily caused by tight heel cords, but Liesa challenges this common assumption.
We often treat the symptom — tight muscles or plantarflexion bias — without addressing the neurological and sensory roots of the movement disorder. Toe walking starts in the brain. Without a full-body, multisystem evaluation, we’re missing the bigger picture.
Liesa emphasizes that toe walking is complex, needs to be understood holistically, and that long-term improvement comes from:
- Identifying and addressing the sensory and motor systems
- Re-training gait patterns through consistent practice and exposure
- Moving beyond outdated, symptom-focused treatment models
- Embracing the mentality that the goal is to not STOP toe walking, but to CHANGE it!
Global Education: Teaching Beyond Borders
Liesa’s work has taken her around the world — from teaching in Palestine to presenting in England, Liesa has traveled to over 13 countries!
Teaching in other geographical locations has helped adapt her teaching methods to invoke successful outcomes despite language barriers, cultural implications, differing health care systems, and limited access to resources – honing her adaptability as an instructor.
An example of this was when she taught in a country and her students wore garments that obscured visual feedback leading Liesa to rely more on active listening while teaching.
Working with interpreters and sometimes teaching learners with limited medical background in different languages changed how she communicates clinical concepts.
“It reminded me to teach in ways that are clear, adaptable, and rooted in function.”
Beyond Gait: Passion for Sensory Integration
While gait development and toe walking are key focuses of her work, Liesa has a deep respect for sensory-based therapy approaches. She shared that if she could go back in time, she may have been a sensory-based OT.
“Our patients need both the external stability of alignment paired with a balanced internal physiological state for long term success.”
Words of Wisdom for the Field
Providing therapists with the knowledge base they need to be successful is what fuels Liesa’s passion for teaching. When asked for a message to share one wish for the pediatric therapy community, Liesa offered a simple but powerful statement:
“Know better. Do better. We don’t have the luxury of doing a poor job in this field.”
Coming in 2026: A Deeper Dive into Sensory
Coming in 2026: A Deeper Dive into SensoryWe’re thrilled to announce that Liesa will be joining us in 2026 to offer additional continuing education opportunities focused on sensory! These courses will explore:
- Sensory system integration
- Functional screening tools
- Intervention strategies
Stay tuned for details — this is an opportunity you won’t want to miss!
You can find Liesa on all social media platforms @knowtochange or on her website.
Check out her 2025 upcoming courses!
