Thanks everyone for replying to a question we had about our son, a couple of weeks ago. It gave us an insight into CP a little more.

Another question! Hope you don't mind!

I have always been instructed by physiotherapists to do stretching exercises on my son's tight muscles, in his legs, and especially around the hips. Also to prevent him from sitting with his legs in a W shape, where his hips would be unnaturally positioned and prone to dislocating later in life.

How absolutely essential are these stretching exercises? I admit that although I try, I don't do them as often as I could...I worry all the time that I am not working hard enough. If you suggest they are crucial to his future, then I will work really hard, but I've never seen any improvement when I did do them conscientiously in the past. How often should I be working with him on his muscles?

Your suggestions will be very much appreciated, because I worry all the time that I am causing him a difficult future.

Helena

Stretching is an absolute essential. I don't think anyone on this board could really disagree. Especially in growing years . Muscles that are not stretched even though it doesn't seem like much is being done can eventually lead to contractures which are the muscles in a shortened state that usually mean you end up with some sort of surgery to correct the problem. Contracted muscles can cause a lot of pain and a lot of further problems elsewhere.

I am 39 and I have L spastic hemiplegia. I am in Physical therapy learning stretches to keep my abdominal muscles from tightening and causing back and hip pain. I started out with just a slight limp and a bad ankle and now I have hip pain, leg pain, etc. etc.............had I known more about stretching at a younger age I may have either prevented some of my problems now.

I tell my PT all the time that I don't think I am accomplishing anything and she says that even though it doesn't feel like the muscles are stretching they really are. Its just with all the hypertonicity they fell at times to me like stiff boards. I have regained a substantial amount of range of motion because of "long-term" stretching. I do my stretching every evening and sometimes twice a day.

Keep up the excellent work and keep up the stretches. Your child will benefit from this over his entire lifetime.

I hope this helped and I wish you luck!

Lastramy

hi mhitch,
Ditto to many of the things Lastramy mentioned in her post. My ortho has stressed time and again how important stretching is for me -- perhaps above other conditioning -- as the potential for contractures is so great.

I am 35 and have mild spastic diplegia CP. My lower extremities are more of the problem for me: hips, hamstrings, calves, and the entire foot/ankle complex. (I am very independent and active but am at the mercy of spasticity daily). Even though the spasticity is ever-present and resistant, stretching is needed to give the muscles that small opportunity to relax and lengthen. It is not a position the muscles know well so it is essential that they get that chance. As Lastramy said, the spasticity puts the muscles into a shortened state which eventually can lead to contractures. Contractures are a permanently shortened muscle that tugs on surrounding ligaments, tendons, and bones. Bones can become deformed by the continuous tension of these connective tissues. The pain associated with shortened muscles is uncomfortable and often the only solution becomes surgery (had 4 myself on my feet in the last 4 yrs).

At your son's age too, having a PT on the team is important because, in addition to the various modalities a PT uses for treatment, he/she is trained to know how much your son is progressing. Yes, it is very costly to have this ongoing treatment and with CP, it can go on forever. But I suppose at critical junctures (e.g., growth spurts) having these extra trained eyes can help guide you and your son about what makes sense.

By all means stretching at home is most critical to keep ROM decent. Having only come to all this as an adult (ie got the dx four yrs ago too), I cannot say what a wise combination is needed between home maintenance and visiting a PT regularly for children. I can only assume that stretching is that much more important.

Hope this helps!

Cheers
Prisc1125

Yes yes yes yes yes yes yes yes yes yes yes it is absolutely essential!