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I Need Help w/a Difficult Case

There are so many great minds on here, please assist if you can.

I just started working on a 5 year old yesterday who was diagnosed at birth w/macrocephaly, low muscle tone, and no deep tendon reflexes. She was given PT from about 4mos-8mos and then the drs said no use, she would never be able to walk.

Hogwash! She walks just fine, although she is a little pigeon-toed, and she has normal intellect. n my first session I used PNF to assess what kind of strength she has. She was very cooperative. She feels no pain. She has in the past had multiple dislocations in her shoulders and wrists and doesn't feel it. Does anyone have experience w/a case like this, or suggestions for working on her? I would love to be able to improve her circumstances.

Thanks!

Replies to This Discussion

Permalink Reply by Dennis Gibbons on August 13, 2009 at 6:15am

Laura,
The lack of sensation of pain that I have dealt with was in Autistic children and I would have to totally rely on the sensation of change within in my touch. My suggestion would be to find the concentrically contracted tissues and allow them to release to neutral. In many cases getting them to respond will need to come from the Golgi tendon apparatus. Hopefully this might help with the lack of tendon reflexes. I have found that many times the Sartorious is in a full isometric concentric contracture which will bring the pelvis forward and medially rotate the Tibia. In consideration of the shoulders I have found a direct correlation between the Piriformis and Subscapularis muscles. If you find the Piriformis concentric the Subscapularis will be eccentric and vice versa. A simultaneous release will often bring resolve. Also try release the A/C ariticulation along with the release of the coracobrachialis muscle. In movement the coracobrachialis will act as a centering muscle and help hold the posture you are looking for. I hope this info helps you and please let us know how it is going, no child should have to suffer like that.

Permalink Reply by Rene Roberto on August 14, 2009 at 9:13pm

I just heard a case today at a CEU course in CranioSacral II of hydroencephaly. There were wonderful improvements with CST applications. Maybe it is also applicable to macrocephaly? I am going to ask the instructor tomorrow.

Rene.

Permalink Reply by Bert Davich on December 5, 2009 at 1:29am

Hi Laura,
I didn't have a clue about macrocephaly until your post and a subsequent search.

One thing did jump to mind regarding the low muscle tone issue. Have you considered "Active Isolated Strengthening Exercises" (not just stretching) that Aaron Mattes pioneered? This is only a suggestion that you might evaluate, not a recommendation.

Permalink Reply by Laura Allen on December 5, 2009 at 5:24am

Thanks for the suggestions. I actually have not had the chance to work on her in a couple of months now.

Due to her lack of muscle tone and lack of reflexes, she does not feel it when it is time for her to urinate or defecate, and her mother has trained her to just go on schedule (as best she can). She gives her fiber every day for her bowels. but the little girl is very prone to getting UTI which frequently wind up systemic and necessitate her going to the hospital. That is what's happened now.

Bert Davich said:

Hi Laura,
I didn't have a clue about macrocephaly until your post and a subsequent search.

One thing did jump to mind regarding the low muscle tone issue. Have you considered "Active Isolated Strengthening Exercises" (not just stretching) that Aaron Mattes pioneered? This is only a suggestion that you might evaluate, not a recommendation.