On ABR and beyond...

Hip Subluxation in Quadriplegic Cerebral Palsy_Part 7_How the femur head gets in

This post continues our explorations into the matters of hip subluxation in Cerebral Palsy.

I labeled it as Part 7 – but it might have as well been "The Part 1" since it addresses the issues that puzzle you the most.

"How will the leg bone get in if the "pelvic roof" is flat? " … In more appropriate terms it sounds: "How does the femur head find stability under the flattened acetabulum of the pelvis in cases of severe quadriplegic Cerebral Palsy?" – these are the questions that I receive probably most often.

In this video I give the entire context and reference the development of the pelvis in a healthy child through the transitional phases that it goes through.

The key message is straightforward – "it's not about the roof – it's about the wedging of the pelvic width by the triangle of sacrum". In this video you are going to find really clear illustrations on how it all works.

 

In case there are problems with imbedded video -- please follow the direct link:

Hip Subluxation in Quadriplegic Cerebral Palsy_Part 7_How the femur head gets in

 http://vimeo.com/38842795

As always, I invite you to ask questions , leave comments and click likes to share with your friends. Don't hesitate – speak out! Was it helpful? Have I managed to ease your worries? What image did you have in your "mind's eye" before and has it changed after watching this video?

I am very grateful to a mother of this boy who sent me her elaborate questions and encouraged the making of this video as well as agreeing to share it with the other parents-- probably she's  going to appreciate your feedback as well.

Thanks a lot.

 

9 Valuable Lessons for Cerebral Palsy out of a Single Incident of a Broken Leg

This post might seem as a departure from matters of Cerebral Palsy – but it is definitely – not.

On opposite, I hope that you can see this as the opportunity to understand the fundamentals of rehabilitation domain much better once you have the exposure to the other side of the spectrum – how the surgery and physical therapy handle ‘regular’ fractured bones.

It is really important for you to keep in mind that – all the concepts, diagnostic criteria, best practices and tools of both orthopedic surgery and physical rehabilitation were forged and tested in the field of dealing with fractures, bone and joint displacements, muscle tears etc.

For instance I mentioned a number of times before – that deeply ingrained belief of physical therapy in the benefits of stretching and in the ability of a therapist to restore the proper mobility via stretching – stems from the practices of dealing with muscle contractures that follow the immobilization.

That’s where stretching works the best and every experienced physical therapist has an entire collection of ‘victories’ over contractures behind his or her belt. They witnessed with their own eyes how a severely restricted leg mobility consistently gets improved via stretching until full recovery within weeks.

That’s the experience and the expectation they transfer into the Cerebral Palsy field including quadriplegic Cerebral Palsy. What happens then? – First, they see some 10-15-20% of range increase – they celebrate it and reinforce their believe in being on the right course. Second, when the range increase comes to a halt – they start blaming it on the spasticity and brain injury.

Therefore, when a friend of my son had his lower leg bones fractured in the go-cart accident – I waited for few weeks until he got out of pains and decided to seize this opportunity to illustrate the essential differences between the orthopedic handling, physical therapy, rehabilitation and  recovery of a healthy person after a typical injury to a musculoskeletal system – in contrast to the most important specifics of the challenges experienced by Cerebral Palsy kids especially in quadriplegic condition.

I hope that you are going to find this being a valuable perspective that will improve your understanding of the priorities for your own child and have a clearer focus of where you need to put the most of your efforts.

P.S. As always – please let me know what you think and whether this perspective is helpful. Don’t forget the ‘Like’ button as well.

Video 4. Hip Subluxation -Why So Much Attention?--The Truths and the Myths

It's time for the video # 4..

As I mentioned in the overview I tried to cover some of the most wide-spread worries and concerns addressing them with as much of a bird's eye view as possible.

Unfortunately, too often there is so much hysteria being pumped up about the hip subluxation issue by orthopedic profession -- that at some point one might get absolutely swirled by all the pressure and scare-mongering.

I hope the video 4. "Hip Subluxation- Why So Much attention? -- The truths and the myths" is going to help you to get out of being scared mode and panicked cries for help -- and towards being able to approach this complex issue rationally and consciously.

 

I assure you that you have all the necessary intellectual capacity and background to be able to figure out the truths from the myths -- all you need is a bit of help.

I hope these videos will bring you closer to this state of having a clear and rational understanding of what's going on with your child and become confident of your own capacity to deal with challenges should they come your way.

In the previous post I already mentioned that it was difficult to keep this video short -- I couldn't keep myself on the rails all the time and took several tangential educational detours as well.

Hope you do not mind.

So frankly -- I do not know which video is better -- so I put both on. Your feedback is most appreciated and is going to help me to do better videos for you in the future.

Well, that's pretty much it...

P.S. Please do not forget to press Facebook 'Like' button --so more people can benefit from getting a little bit of rational outlook influx towards this emotionally charged issue of hip subluxation.

Cheers...

P.P.S. Do not forget that the best way is to actually to click on the 'ABR on Vimeo' link above -- and then you can actually download this and other videos from Vimeo website. Then you do not need to deal with streaming delays and play interruptions 'that some of you mentioned before

Benefits of over-learning

Amazingly – there is always a teenager within us – the one with a swagger and a bravado: “Only dumb need to be told the same thing in a class twice…”

How did I notice that? – Observing my own son. He is 13 now and finally his studies at school begin to go beyond elementary. He is a bright kid and until this year his school work was a breeze – he was mostly getting A’s without much sweat (Ok, I admit – art and music are not his favorites – but I guess that’s hereditary J). But lately the level of curriculum complexity went up to the extent that sometimes he actually needs an effort to get a deeper grasp  – implying a necessity to read the same chapter in a textbook more than once.

That’s where our positions began to differ quite dramatically – I was happy to see him entering the realm of proper learning whilst he was somewhat upset…

My first reaction was predictable – I just thought that he was in opposition to a ‘burden’ of harder intellectual work, and obviously ‘extra hard work’ is not exactly the easiest thing to sell to your teenage offspring…

However, once I started to dig deeper trying to improve his learning skills, I stumbled upon some insights that I find quite intriguing.

I think that by looking back at those formative school years – there are valuable lessons to be learned for most of us grown-ups as well.

What began as a parental duty, eventually unfolded into a quest about the way we acquire learning skills and use them throughout different facets of our lives.

Let me get back to the opening line of this post – loosely quoting from my son: “Only dumb kids need to have the class material repeated to them (twice or more) – smart ones get it quick …”

His words really struck me.

I suddenly got an insight on why so many of you expect us to teach new things all the time, and why any attempts to go over the material that was introduced earlier meet such a strong resistance.