Thursday, February 9, 2012
Success in the Fascial Paradigm: Passive-Aggressive Therapy?
I have chosen this photo to lead off this post for a very straightforward reason: it is time for the "therapeutic world" to take off the noise-cancelling headphones and start to acknowledge the undeniable potential of the fascial paradigm in the treatment of Cerebral Palsy and other disorders of movement and posture.
I think it is EXTREMELY important to also acknowledge the generous and unselfish contribution of Nancy and Haroldo Guerrero who have given me permission to use the images of their child to further contribute to the overall good and education of families and professionals alike. It has been my honour and pleasure to have been able to work with them for the last 4 years...and I am humbled by their dedication, work ethic, and superior frame of mind. Therefore on behalf of myself and all of the readers of this post...GRACIAS, NANCY Y HAROLDO!
Although a comprehensive history is always recommended, I will abbreviate this particular history in an effort to remain within a "digestible" amount of information. Matias is a severely affected child who obviously manifests a great deal of musculoskeletal challenges. This manifestation is most easily observed as muscular tension, rigidity, and stiffness. Within the traditional musculoskeletal paradigm, this tension is considered the "problem" therefore it is given primary focus and is the target of selective intervention (stretching, Botox, surgery, tenotomy, etc). As mentioned before in this blog (see previous post "Spastic Muscles: Victim or Perpetrator"), the muscles are SYMPTOMATIC. Therefore, they REFLECT an underlying problem and are therefore considered victims. By definiton, it is unproductive to set them as the primary rehabilitative focus. The true "perpetrator" is the lack of compressional strength (postural strength) which is mediated by the fascial system. There will be a large number of people / professionals scratching their head at this statement..."that doesn't make any sense whatsoever". With all due respect to them, my simple reply would be that it doesnt make sense to them because that's not what they read in their textbooks! My best advice would be to close those books...look at things more analytically...and formulate your own conclusions. This in itself is a difficult task...therefore I propose a simpler approach which comes in the form of a simple fundamental question that you should ask yourself: IS IT POSSIBLE TO IMPROVE THE STRUCTURE OF A SEVERELY AFFECTED CP CHILD WITHOUT ATTACKING THE MUSCLES THEMSELVES? As you should have already guessed...my answer is a resounding YES!
This simple fact leaves no denying that a more passive, less invasive / aggressive should always be considered first. I admit that simple words are rarely enough, so I am very happy to share some very positive results on what can be generally considered a difficult case.
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Success in the Fascial Paradigm