372 chapter 42
GUIDELINES FOR DOING STRETCHING AND
RANGE-OF-MOTION EXERCISES
1. When doing these exercises, consider the position of the whole child, not just the
joint you are moving. For example:
The knee will often straighten
more (and you will be
stretching different
muscles) when the
hip is straight
than when the hip
is bent.
This is because some
muscles go from the
hipbone to below
the knee.
To prove this, try to
touch your toes with
your knees straight.
You will feel the
‘muscles stretch, and
the cords tighten
here.
In a similar way, movement in the ankle is affected by the position of the knee
(see p. 29), and movement of the fingers by the position of the wrist (see p. 375).
2. If the joints are stiff or painful, or cords and muscles are tight, often it helps to apply
heat to the joint and muscles before beginning to move or stretch them. Heat
reduces pain and relaxes tight muscles. Heat can be applied with hot water soaks, a
warm bath, or hot wax. For methods, see p. 132 and 133.
For a stiff,
painful joint
apply heat
for 10 or
15 minutes
before
doing the
exercises.
3. Move the joint SLOWLY through its complete range of motion.
If the range is not complete, try to stretch it slowly and gently just a little more each
time. Do not use force, and stop stretching when it starts to hurt.
Hold the limb in a stretched
position while you count to 25.
Then slowly stretch the joint
a little more and hold it
again for a while.
Continue this way until you have
stretched it as far as you can without
forcing it or causing much pain.
The more often you repeat this, the faster the limb will get straighter.
4. Have the child herself do as much of the exercise as she can. Help her only with
what she cannot do herself. For example:
Instead of
doing the
child’s range-
of-motion
exercise for
her,
have her do
the exercise
using her own
muscles as
much as she
can.
Then have
her help
with the
other hand
(or you
help her if
necessary).
Whenever possible, exercises that help to maintain or increase joint motion should also help to
maintain or increase strength. In other words, range-of-motion, stretching, and strengthening
exercises can often be done together.
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