On ABR and beyond...

PART 3. The truth About The Walking for Cerebral Palsy -Ground Breaking Biotensegrity Perspective

Biotensegrity: The Legs Are The Weakest Link In Walking. In Cerebral Palsy – Look Upwards To The Torso And Stop Wasting Your Time At "Training" Them.

Well, finally we have reached the crux of "The Truth about the Walking" series.

Video 3: "The Main Paradox of Walking: The Legs Are the Weakest Link" turns your intuitive perception of what walking is "inside out". I encourage you to watch it with full attention. I tried my best to illustrate it well and express the key concepts in as parent-friendly language as possible.

"The Main Paradox of Walking: The Legs Are the Weakest Link" runs for about 37 minutes – hopefully you can watch in one go. If not – you can divide the viewing in 2 parts:

• First 17 minutes illustrate the difference between the intuitive  and simplistic interpretation of walking versus the advanced tensional understanding that stems out of the tensegrity-based approach to the architecture of fascia networks. This comparison is set in the visual context of the tensional "bicycle wheel" vs. hard-spoked cart [artillery]-wheel – so you do not need to cut your way through any formulas. 
• Next 20 min – the framework of tensional "bicycle wheel" vs. hard-spoked cart [artillery]-wheel is translated to the real life examples of the 'buckling legs':
  •  the example of a child with cerebral palsy – showing the way that the legs buckle and withdraw upon the contact with the ground ; and then proceeding to demonstrate how  the 'fake standing' works – the one that the rehabilitation and training are so keen on trying to achieve
  • the example of a young healthy child who is just developing the walking ability; you'd be able to see clearly how the legs are first a liability and it takes the evolution of significant upper body strength to counteract their  primary buckling tendencies.

Frankly, I have high expectations for  getting  strong responses from you after watching – such a response might range from: "Wow!" to "This can't be true" – but the difference between the consistently tensegral understanding of walking and the 'conventional' one is so great – that  if you will have watched the "The Main Paradox of Walking: The Legs Are the Weakest Link" with even minimal attention – you can't possibly stay neutral.

It's a clear call for you to define your position. Because 2 different approaches to the understanding of how the walking works – imply completely the opposite approaches to what has to be done in order to improve and  build the walking.

The word "the opposite" is the key here.

 

Unfortunately, all too often parents of children with Cerebral Palsy tend to try to  "play it safe" and "combine" what they see as 'different therapies' – reasoning that the more is the merrier and that the smart person never puts all the eggs into the same basket . Please -- do not fall for this naive mistake!

Whilst these "safe" philosophies of piling things up might be applicable to the cases where the "therapies" have only cosmetic differences but share essentially the same paradigm – say Doman's crawling mileage, conductive education's  training with blocked pivots within extremities; and Bobath's functionally aligned trainings – let me assure you that with ABR we are talking about THE OPPOSITES.. What happens when you add up the opposites? – They cancel each other, right?

That's why I really encourage you to give these matters a long hard thought, have your due diligence and commit to the chosen 'Cerebral Palsy Therapy' with consistency. Don't fall into the pitfall of trying to add up the opposites – because then you are just wasting your time and money.

Well, that's pretty much it. I encourage you to share this video with your friends – to ask them what they think and how does that influence their view of the way that human body works.

I am obviously open for discussion and clarification of any points – having several other aces up my sleeve.

It's time to change the very fundamentals of the movement science – fascia science discoveries and the tensegral framework are giving us a kick in the butt and absolutely urge and force us to get rid of the primitive and outdated beliefs that has been around for way too long …

 

Truth About Walking_Video 3_Paradigm Shift from ABR Central on Vimeo.

Please follow this link and download this video for your comfortable viewing independent of the online streaming speed.

https://vimeo.com/43357880

The Truth About The Walking_Video 3: Biotensegrity Paradigm Shift

P.S. My huge thanks to the models who made this video possible -- these wonderful kids are helping all of you to become a better 'cerebral palsy pro' parent for your own child...

The truth About The Walking for Parents of Children with Cerebral Palsy PART 2:The Key Dilemmas_

Well, the summer is officially over -- so hopefully you had some nice vacations and developed some cravings for the transformational knowledge.

Today's post is probably one of the most important ones that you'll ever get from me -- I'd dare to say that it should really bring the transformation of your worldview -- of the way that you think about the most specifically human of all human movements -- the walking.

I invite you to challenge one of our most natural and the most intuitively ingrained beliefs -- "achieving better walking requires practicing ... the walking"... It seems so self-evident that even without the instruction from a physical therapist the parents of children with cerebral palsy happily expose their kids to do the "walking" celebrating the contacts that a child has with the ground with cheers. It seems so safe and rewarding...

I invite you to re-think this by first taking it to a bit of an extreme: imagine that you wanted to "teach" your child to fly by throwing him or her out of the window with the enthusiastic advice: "Flap your hands, darling, and you'll soar!" -- Sounds ridiculous, right?

Well, putting a quadriplegic child with cerebral palsy through "walking" is equally ridiculous and in the long run -- more damaging. Why? -- because there is no obvious harm that one would see right away. On opposite -- it feels "right": "Wow, we are making progress; we should do more of this.."

This video is the invitation for you to be smarter than those naive thoughts and actions. Walking is a crowning achievement of the human locomotion -- the pinnacle that requires dozens and dozens of elements to be in place in order for the contact with the ground made via the moving feet to be beneficial virtuous cycle. Otherwise -- you are enthusiastically distorting your child's body being enticed by loud cheers and "expert" advice of physical therapists.

Please, find those 40 minutes of uninterrupted attention and study this video intently. There are 11 points that are discussed --each lasting just a few minutes and they are relatively richly illustrated. So even with my monotonous voice you can surely manage to keep yourself alert.

At the same time this video is an example of the intelligent due diligence approach to whatever actions and therapies you lead your child into. THINK! Even the most intuitive therapies for cerebral palsy and brain injury are loaded with hidden dilemmas that you need to be aware of if you really want to be helping your child. Otherwise you'd be repeating the fate of thousands of other children affected by quadriplegia who ended up having their bodies profoundly distorted by dumb "functional training" and the walking in particular.

I hope that this video will raise your immunity to "intuitive claims" of people who lure and seduce you into the BS of "functional training" by talking about "teaching the brain" or "re-connecting the neural pathways"... This is the complete BS and your kids deserve better than the naive dumbness..

Be smart and be inquisitive -- don't let the 'intuitive' and 'self-evident' fool you.

Truth About Walking_Video 2_Key Dilemmas_YT HD from ABR Central on Vimeo.

I apologise for the use of the language that is stronger than usual -- but whenever I think of all those kids with quadriplegic cerebral palsy who were led into the horrific distortions and suffering by their well-wishing parents -- it is really difficult to keep the neutral tone.

Please leave your comments -- don't hold it. This is a polarizing video -- it's not one of those 'informational' ones where you can just make a little mental note and proceed further. I invite you to get engaged and argumentative. If you feel that my argument is too weak -- say it, articulate your position -- I'll be absolutely happy to push this issue as far as it takes in order to make sure that it "clicks".

Thanks a lot

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.

Cerebral Palsy – reverse or re-arrange?

Writing for this blog always puts me in a real dilemma – on the one hand, there are lots of things I really want to share with you because I believe that you are missing so much of important knowledge about Cerebral Palsy and on rights and wrongs in dealing with it; but on the other hand –I have to switch on the internal censor and ask a simple question: “With what I am eager to share –am I going to help and improve clarity for the families or is it going to add to the information overload?”

In other words – by pouring down all that information on you – am I doing you a service by giving clarity and making your life easier or am I doing you a disservice by adding to overwhelm and exposing you to more concerns and worries?

These internal dilemmas really bugged me  for the things that I have been busy with for the last couple of months. In the preparations to BioTensegrity meeting that took place in Munich few weeks ago – I made a dive into the engineering books on Tensegrity and the original works of Buckminster Fuller (the famous engineer-architect who coined the term “Tensegrity”) and found myself at awe with the depth of his insight… It is really amazing for the person who never really came close to the human body in any tangible sense to have so many remarkable foresights that really  lay a perfect framework for the correct interpretation of the Fascia Man…

The Bio-Tensegrity perspective alone is enough to come up with hours and hours of exciting stuff – of how it all ties in and gives a much deeper understanding of Cerebral Palsy and stages of progress and transformation… but then again? – Do you really have time and sufficient interest for all that? …  

I must admit that this weighing of the pros and contras turned out into the period of the relatively prolonged silence – it’s 2 months since I made the last post in this blog… So after a lot of such internal discussions – I decided to curb my enthusiasm for all things new and to try to focus on the ideas with greatest “de-clogging” value.

So I am going to try to stick to the more earthly matters and self-censor along the lines of what I think matters the most to you and how I can help you in reducing the information overload rather than adding to it...

I can’t promise that the text is going to be simple – but it is definitely going to be de-clogging: if you work your way through this – then you are really going to know what is your starting point in the quest of maximizing your child’s developmental potential.

So here it is –the question that has absolutely the greatest value and that defines the choice of a path: Cerebral Palsy – reverse or re-arrange?  

This question is so essential that it deserves some extra clarification.

“Analytical review. Cerebral Palsy and forceful devices- orthoses, splints, braces”

“Analytical review. Cerebral Palsy and forceful devices- orthoses, splints, braces”

Introduction of the tactical information into our communication.

After some intro of a larger scale concepts – such as the key division of all therapies of Cerebral Palsy into the clusters it is time to get more tactical and tackle the smaller issues.

Paradoxically enough, I reckon that these smaller “day-to-day” things are what you are looking for – a lot more eagerly than for a larger scale concepts.

I say paradoxical because obviously everything “day-to-day” tactical – like the subject of today’s post – “Analytical review. Cerebral Palsy and forceful devices- orthoses, splints, braces” – are entirely defined by what the root concepts  are. So if the concepts – seemingly abstract and removed far from everyday practice – are flawed then the flaw passes down all the way to the tactical everyday decisions, getting worse with every step. And the opposite is true – the new methods can only be considered truly new when they bring different claims at the level of concepts. Otherwise – the new method are just a different remix of the same old song.

The knowledge descent hierarchy is  well-known and goes like this:

• Concepts  (defines the field, the  fundamental criteria for defining directions)– descend into
• Principles (Why thing Work one way or another – introducing the idea of “wrong” and “right”) – descend into
• Processes (how to make it work the “right”) – descend into
• Procedures (exact implementation – what model of a splint to use and how to put it on and how  long to wear).

Fact is – in your experience you are used to the fact that the PTs and OTs always talk to you at the level of ‘Procedures’. Rarely they bother to present a mini explanation dumbed-down from the “Process” level – and when it comes to Principles – their reply is one and only “Brain injury is at fault”.

This is the typical style of interaction of the Pros (Professionals) to the Amateurs – crumbs of information: “Just do as you are told”…

Well, another fact is that most of the local level therapists that you face in your school and treatments encounters where you live–  are the ones that have very vague idea of Principles – they covered a couple of textbooks on those Principles during their  studies – but all that is a long gone history. They are the Process people.

The key feature of the process people is expediting obedience – they are the Sergeants and you are the grunts. Why do you have to do certain things with your kids? – Because he/she, the Sergeant told you so. Why? – Don’t ask – just do what you are told. The Officer (who are supposed to be in touch with the “Principles”) knows and that is enough.

I think that you have noticed that very often when you try to move out of this mold – and start questioning what the therapists – especially the ones who practice in schools – do to your child… they  become really irritated and often quite nasty and vicious.  

Don’t be surprised – medical system is modeled  after the army (in fact the current roles were carved into it during the war times ) – imagine what happens in the army if the ‘grunt’ (rookie soldier of the lowest rank) starts asking questions that go to the Officer level?! Chaos and disorder! – That can’t be tolerated by Sergeants – that’s their job description to handle the grunts and to let the Officers  be free of menial tasks.

You equally shouldn’t be surprised when you find out that a Doctor is often no different  – that’s the Officer who has been so used to copy-paste  quotes from textbooks that he grew into those quotes as dogmas without ever asking deeper “Why” question that belongs to level of Concepts.

Ask any doctor – does he see any flaws with the way the Cobb angle represents scoliosis  and whether the concept of “scoliosis” accurately represents the 3D deformity of the child’s spine? Ask a doctor – does he see any problems with  the way that so-called “hip subluxation” represents the 3D deformity of the pelvis? – He’ll be puzzled and outraged at the same time.

Puzzled – because he never thinks that way – his reasoning ends with the labels “scoliosis” & “hip subluxation” – he never ever questioned the way these labels came to being.

But even more likely he wouldn’t even get to the point of being puzzled – because he is going to be outranged – how could a person with no official qualifications, a grunt – you – dare to question the engraved “Principles”…

What I am trying to do when communicating with you  – is to talk to you at the level of ‘Concepts’ – the really big questions that precede the definition of the “wrong” and “right” by setting the reference system.  

So effectively I am elevating our conversation to the  level of a “General”. Well – often you might feel somewhat lost – because for your entire “service” of being the parent of a child with special needs – you’ve been dealing with Sergeants in a status of a lowly grunt.

Why do I feel that is really important to talk directly to you at the ‘Concepts’ level? – 2 main reasons:

a) I see you as a primary guardian of your child and a primary therapist – so for me you are colleague of an equal statute – a key person. I assume the role of your mentor – but I am definitely not a Sergeant or an Officer.

b) The existent system is logical. It is flawed at the level of the Concepts – if you try to change it at the level of Procedure or Processes or even Principles – things are consistent from one level to another. Wrong principles define the horrid and inefficient Procedures.

But the change has to start all the way from the very origin – the Concepts

But at the same time I understand that often times you might find difficult to see how new Concepts (what I share with you)  relate to the outdated Procedures (realities of your everyday interactions with Sergeants)  and what do you actually need to do in the situations when you are under pressure.

So, I think that the best course of action for me is to do the mix – I will continue share the new Concepts related to Cerebral Palsy with you – but I will also start doing more of the “Response to Outdated Procedure” level explanations.

Probably it is going to take a certain time for me to find the right format – but I am looking forwards for your replies:

a) Am I reading the social dynamics of your everyday situation correctly;

b) How accessible are my Tactical level explanations – what you’d want to get explained – Clearer? Simpler? Broader?

 

Therapies for cerebral palsy- the clusters approach. ABR Workshop at Pac Rim Video Part 1.

Well, dear friends,  the summer is almost over – and it is time to get back to the ABR matters.

I didn’t bug you during the last few weeks with ABR-related food for thought – as parents you deserve some vacation as much as your kids… without me bugging you with large chunks of information to process.

Historically ABR calendar follows the division into the academic/ shool years rather than the calendar ones – so I guess I need to congratulate you with the beginning of the new school year.

More studies are coming your way!... I hope that makes you excited rather than grumpy… :-)

Mind-Blowing Freaking Miracle... Pelvis Transformation in Quadriplegic Cerebral Palsy

Usually I am quite reserved in progress descriptions that kids achieve with ABR – trying to avoid the hype and over-expectations. Typically I am more keen on outlining the specifics of the challenges that lie ahead rather than celebrating the achievements already made. And often enough parents find this style not the most motivating … but that’s the way I see the world:  whatever has been achieved as of today is already part of the past – so, let’s try to focus on the next step forwards…

By telling you this I just want to draw a bit of extra attention to what I am about to share with you today… because this time it is different… and even I cannot contain emotions … because it is indeed – a mind-blowing freaking  unbelievable miracle!

Well, I hope that I have your attention now :-)

… and probably you think that I am going to demonstrate a quadriplegic  child who miraculously went from horizontal incapacitation to running around and jumping on a single leg? – Sorry, not this time…

This type of stuff – “a developmental airlift “, or a “developmental helicopter ride”, that allows to skip phases of development – is cut of heavenly cloth. I am much more earth-bound.

Nonetheless the transformation that I am about to share with you counts on a scale of miracle as long as we stay earth-bound and realistic.

What I am going to demonstrate is an exceptionally rapid structural transformation of a classic distorted and merged quadriplegic pelvis following the “egg” work…

Let’s proceed to the video to have the entire case well illustrated…

I hope that I have managed to get you excited enough to sit through a 35 minute video…

First I wanted to charge straight through to the comparison of before and after – but afterwards decided that it is going to be of greater educational value for you to have it done in 3 parts:

• Normal pelvis structure and X-ray
• Typical pelvis of a child with quadriplegic Cerebral Palsy that ends up under the knife of an orthopedic surgeon with a massive intervention (bone cutting, metal screws insertion etc.)
• The “mind blowing freaking miracle” – amazing transformation of the pelvic structure in a severe spastic quadriplegic child following the “egg” rolling work delivered by the ABR superstar man – Alexander “The Great “from Greece :-)

And all that leads to a not so subtle hint – your child’s future is in YOUR HANDS – but these hands have to be skillful to extract the full potential that ABR work has for your child… – so you need to study and practice and pay attention to detail without rushing to “I got it –can I go home earlier?”

 

P.S. I am going to add a couple of final episodes to the previous video – “Cerebral Palsy and fascia science in a tea cup” – and I hope are going to appreciate the connection that my tea cup simple example of the relationship between a dense film-like membrane and porous underlying gel has with the specifics of skeletal transformations in Cerebral Palsy pelvis…

 

P.P.S. Comments and likes are most appreciated.

 

Fascia and Cerebral Palsy science in a tea cup

This is a mini-post that illustrates that sometimes valuable insights into the fundamentals of what’s happening to fascia and musculoskeletal structures as a result of challenges associated with cerebral palsy could be gained from most mundane everyday experience – from observations of what’s happening in a tea cup –literally…

Anyone who had a training by me knows that: 1) I am a tea fan; 2) that I have a tendency to leave cups with unfinished tea everywhere opting for the new cup of a fresh tea instead..

Well, I’ve been criticized for this untidy habit more time that I can remember – to no avail I must admit… However, sometimes there are some unforeseen bonuses that come out of it…

For the recent weeks I’ve been thinking a lot of how to visualize for parents the effects of fascia layers adhesion in case where the flow of the interstitial fluid is affected and how we can restore their proper division by means of  Thermoplastic elastomers (TPE) as the Force Transfer Medium [well that’s the official title of “egg rolling” :-)]

So couple of days ago I looked at one of my cups with the tea leftovers from a previous day … and found and excellent illustration ..

I hope you are going to find that metaphor/ spatial homology useful and insightful

 

 Thanks …

As usual Facebook likes and comments are most appreciated

Hip Subluxation in Cerebral Palsy-Video 5-Specifics

I guess it is more than a time to proceed from general reviews of hip subluxation in Cerebral palsy videos to the specifics.

 

Video 5 turned out to be quite long -- so I divided it in 2 parts -- but eventually decided to add a summary as well -- that's Part 3.

In these videos I actually go point by point over the original questions, observations and concerns that were voiced in the original 6 min video by Emma's mom.

So even though the videos are quite long I think they are not too difficult to watch since any single topic is covered within a  few minutes max. I hope that in these videos I've managed to illustrate how the concepts introduced in the earlier videos blend together and provide a relatively straightforward framework for analysis of an individual case.

Of course, in an individual case of your child there could be some variations of the angles or of the dominant directions of legs mobility response -- however, the essence always remains the same: One needs to use a transanatomical framework to understand the full scope of transition.

I think that the main practical takeaway from these videos is the idea of evaluating your child's evolution through the chart that takes into account multiple aspects of the evolution in the pelvic region and within lower extremities-- including the percentage measurement of femur head alignment  in respect to the acetabulum but seeing it only as a single entry in a much larger matrix of changes.

I hope this helps.

I feel that these video series on hip subluxation in cerebral palsy give a comprehensive coverage of the subject -- to the point that "there shouldn't be any questions left"...  However, being realistic I am sure there are further questions and I am  looking forwards for receiving them -- because from my perspective of a broad "umbrella" I might be overlooking some of the very specific concerns that you might have.

As the final word for these series I want to express my gratitude to Team Emma for their willingness to go beyond "privacy" and to embrace a collective good for all the parents in a similar situation by making these video series possible. I think that some expression of your appreciation in the comments to this post will be much appreciated by Emma's parents.

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