374 chapter 42
COMMON SENSE PRECAUTIONS WHEN DOING EXERCISES
Every child’s needs are different. Please do not simply do, or recommend, the same
exercises for each child. First THINK about the child’s problems and needs, what
exercises might help her most, and what could possibly harm her. Adapt the exercises
to the child’s needs, and to how she responds. Here are some important precautions:
1. Protect the joint. Weak joints can easily be damaged by stretching exercises, unless
care is taken. Hold the limb both above and below the joint that you are exercising.
And support as much of the limb as you can.
Do not push
directly on
Hold the leg firmly
the joint.
just above the knee.
Hold the leg
just below
the knee and
Do not pull
far from
the knee.
support the
whole leg
WARNING: Pulling here can dislocate
with your arm.
the knee (or break the bone).
CP 2. Be gentle—and move the joints SLOWLY—
especially when a child has spasticity, or
when joints are stiff or painful.
WARNING: Moving
spastic joints rapidly
makes them stiffer.
SLOW DOWN!
For example, Teresa has juvenile arthritis and her joints are very painful. She holds
them in bent positions that are leading to contractures. Move the joints very slowly and
gently, as far as you can without causing too much pain. Straighten them little by little,
like this:
A common mistake is to rapidly move the limb back and forth like the handle of a
pump. This does no good and can do harm. Go slow, with gentle, steady pressure.
3. Do no harm. In children who have recently broken their neck, back, or other bones,
or who have serious injuries, exercises should be done with great caution. Be careful
not to move the broken or injured part of the body. This may mean that some joints
cannot be exercised until the bones have joined or wounds healed. (For broken
bones, usually wait 4 to 6 weeks.)
4. Never force the motion. Stretching will
often cause discomfort, but it should
not be very painful. If the child
cannot tell you, or does not feel, be
extra careful. Feel how tight the cords
are to be sure you do not tear them.
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