Recently I was having a conversation with a parent about stretching. Her son has Spastic Quadriplegic CP and is really tight pretty much everywhere, but more specifically his hamstrings (back of his thigh muscles) and adductors (inside thigh muscles) of his legs. So mom wanted to know why his legs seem looser after PT but then the next day feel tight again. Taking the high tone/spasticity part out of it, I used my hair tie as an example.
The black hair tie is one fresh out of the pack so its tighter at rest. When its stretched it can get way bigger but once the stretching force (my hand) releases it, it goes back to normal. Now over time, the hair tie gradually gets more stretched out but it takes way longer to stretch out those muscles over time if its only happening for brief little intervals. Now, that doesn’t mean that you should stop working on stretching the muscles because it will eventually get looser over time. This definitely takes time and CONSISTENCY. It takes having a stretch for a longer period of time…so what that means is instead of just holding a brief stretch for 15-30 seconds at a time and then being done with it, you can work on maintaining a position that stretches the muscle. For this client, for example, holding a cross sitting position with a sand bag over his legs for 15-20 minutes is way more effective than just having him lay down and stretch his adductors quickly. Even better part about this – we can work on reaching in sitting while he holds it so we make the best use of the time! Over time this muscle will get longer and be more like the stretched out hair tie.
That’s just one quick example, but there are lots of different ways to do this. Another thing that’s important to note is following up stretching with mobility exercises. So I know it might be hard to do but strengthening the muscle right after stretching (in its new lengthened range), helps it to stay that way!
Another example for that is a baby with torticollis… We find lots of ways and opportunities for the babies to turn their head in the challenging direction IN ADDITION to stretching and range of motion activities.
Something else important to note it that especially for these children/young adults that are sitting in their wheelchairs most of the day, this HAS to be part of a routine to continually do. Doing it for one week will not make a significant impact. Its the small little gains over longer periods of time that will make the big differences! Think about it….pretend you’re sitting at work all day and feeling stiff. You get up and walk around to “stretch” for a minute and then sit back down for another few hours. Do you think that the little stretch you did do made too much of a difference long term? Not so much. It did help you to feel better in that moment but you’ll probably be feeling that way again in another hour after sitting at your desk.
Make sense?
If this sounds familiar to you – and is something you really want to work on for your child, this is a perfect opportunity to inquire for our new group classes. These are open to ALL abilities and they were designed to work on things just like this! Questioning if your child is a good fit? Click below to schedule a call and we’ll help answer any questions you have.
She discovered her passion for the neurologic pediatric and adult population during her clinical affiliation at a special services school in Cape May, New Jersey. She is an active member of the APTA and continues to take post-graduate course work related to treatment methods for neurological diagnoses.
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