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Hips, Hamstring and Mobility

Sharon Galitzer (Physical Therapist) by Sharon Galitzer (Physical Therapist) Additional Needs

Sharon Galitzer (Physical Therapist)

Sharon Galitzer (Physical Therapist)

I'm a pediatric physical therapist and also the sibling of an adult with special needs.

What’s spasticity? Spasticity is an abnormal prolonged tightness of the muscle which is often as the result of some type of neurological condition.  As a result, movement can be difficult.  In order to move, opposing muscles on the opposite sides of a joint contract and relax, much like a pulley system.  When that pulley arm is shortened, it’s more difficult to generate force and movement can be difficult.

So, what to do?  Spasticity is chronic, and can impact play, function and self-care. This will look different at every age, and for every child. So, understanding some simple facts about spasticity is the most basic step, because knowledge is power.  Consequently, a rich conversation with your child’s specialists will lead to the best intervention.  Here are some facts about spasticity that are important for you to know:

There are many strategies and treatment methods to treat spasticity.

Simple things such as gentle and frequent range of motion, and positioning are encouraged.  Splints provide a prolonged stretch and can maintain or increase range of motion.  Depending on the age and condition of the child, knee immobilizers, night splints, serial casting and standing frames may also be appropriate methods of intervention that provide multiple physiological benefits. Please speak with a therapist or physician to discuss your options.

Spasticity can impact joint integrity.

When spasticity occurs over any joint for a prolonged period of time, the constant line of pull in one direction from spasticity may cause joint instability. If you hear any clicking, notice a leg length or arm length discrepancy, or if your child’s affect or mood changes, if they wince with active movement during bathing, dressing, or weight bearing, check with your pediatrician just to be safe.

Range of motion is important because for optimal positioning and balance a child should be able to achieve flat feet in sitting and standing.

Imagine sitting on the edge of skyscraper, with nothing under foot.  How stable would you feel?  Sitting in a child size chair, a highchair, on a stool, or on a bench…. Support underfoot helps support balance higher up on the chain. If your child’s feet don’t have support, get creative and create a platform for their feet.

It may not look pretty, but it’s still active movement.

We, as parents and as therapists, must celebrate any effort put forth by a child because that means they’re thinking, they’re trying, and active movement shows effort; every effort should be recognized as a success. With that being said, visual, verbal and tactile feedback on their movement may enhance performance.  Refining their movement is specific to each child’s abilities, so set realistic goals, start easy and increase the challenge to meet their abilities, aim for the sky, but always celebrate the small victories of participation.

Spasticity looks different at different stages of development

When a child presents with spasticity, it may take extra effort to move.  So, first and foremost, please consider the energy consumption that a child must exert to accomplish activities of daily living, self-care, and mobility changes.  Adapt the environment to make the child as independent as possible.  There are great new adaptive pieces of adaptive equipment out there to buy or borrow.  It’s just another way to support your child’s development.

I’ve been working with children for many years and spasticity always changes (based on the day, time, mood of the child, and whether the child is well, tired or sick).  More importantly, there are many ways to manage spasticity and remember that it will be a marathon, not a sprint.  Go slow and steady!


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