Random Thoughts (July 13 2010)

1) I wonder if soft tissue work (in the atheltic sphere speak) is used in the world of physiotherapy for treatment of spasms/contractures. This might be especially powerful in the management of cerebral palsy, as there is a potential of > 10 years of spastic paresis.

For a general theory of the "scientific" basis (sports medicine is more observational and theory than experimentation), have a read of Mike Robertson's self-myofascial release manual.

Case in point:

I have regularly used self myofascial release on Abah to help with his spasms and maintain his elbow/wrist flexibility. Abah tends to get nasty spasm episodes with even slight passive elbow/wrist/finger extension or distress. To help with this, I "gently" massage in a cross-fiber direction his bicep insertion (for elbow) or finger tendons proximal to the carpal tunnel (for the wrist/hand); this allows for the elbow to extend without even exerting any force to extend them! And as I massage further, the extension is increased. I even use this method to do the regular physiotherapy while he is not experiencing spasms; the hypertonia is reduced greatly.

To understand this better, try this experiment:

Lie down and test your shoulder anterior flexion flexibility (by reaching your arms back in a forward direction ala windmill fashion); when your lumbar spine hyperextends or your arm "hangs in the air", you have reached your limit. Then, use a tennis ball and roll it along your lattisimus dorsi insertion (sides of arm, near the armpit) and retest. You'll find that you can reach farther back without the lumbar hyperextension.

I find (from my own severely limited observation) that most mobility modalities used in physiotherapy of patients employ only passive movement and static stretching. Ironically both induce spasms in people with hypertonia/spasticity.

2) If you want to think about starting but always asking about quitting as well, get the hell out.