Stretching

GG&C

Stretching

Stretching should only be done with your child if your physiotherapist has already given guidance and asked you to do stretching at home.  

 

If your child has Cerebral Palsy or another neurological condition which affects their ability to move it is important to help them stretch.  Stretching helps to maintain the range of movement around the joints like shoulders, elbows, hips, knees and ankles.  Stretching helps to maintain the length of soft tissue like muscles, tendons and ligaments.  Stretching also helps prevent the development of contractures.  Contractures are where the soft tissues have become shortened and tighter around the joints and reduce the ability for the joint to move through full range of motion.  Joints can become fixed and positioned which makes it harder for your child to move, for them to be positioned in equipment and can also be uncomfortable.

It's important to stretch for a few minutes every day and that can be done before putting on splints, after having a bath, or before going to bed.  There are many ways to do stretches including self stretches using your own body weight, or using equipment like standers, or for young children you will have to help them.

It is important that the child is relaxed before doing the stretch.  A stretch should feel like a strain and be done slowly so the tissue can adapt.  If it's done fast and it's painful, the child will react and the muscles will react and it will be ineffective. 

It is good to hold a stretch for 20 to 30 seconds and for it to be repeated a few times each side.  Your therapist will help give guidance on this.

Ankle Stretching

You want your child to be completely relaxed and not distracted.  You need to bend the knee up and take control of their foot.  You want to stretch down the Achilles tendon down the back, you don't want to be stretching the foot because then you're stretching the structures so it's good to take a good grip of the bone at the back of the ankle and feel that good stretch and use your arm to lever against the foot.  You don't want to turn the foot out the way if anything you want it to come in a little bit.  So a nice slow stretch, feeling the stretch all the way down calf and then taking above the knee you can hold that stretch and bring it all the way down for a nice long stretch, holding for 20 to 30 seconds.  

If the child feels discomfort when you pull the stretch on, you can just take it off a bit or when you come down you can just let the knee relax.  When you're stretching the calf you will feel better stretched the full knee extension.   So again hold the ankle just above the bone at either side and give it a good pull down using your arm to lever on the foot and coming slowly down and hold.