Physical therapy during lengthening can be physically demanding on the patient and emotionally demanding on their families. Some of the following can help ensure a smoother process during therapy with a young child:
Give your child as much control as possible. Provide choices that incorporate viable therapy options.
- “Do you want to play a video game or listen to a book?”
- “Do you want a towel under your knee for the belly bend or not?”
- “Do you want a hot pack under your thigh during the stretch?”
Use techniques to help your child take an active role in the process. If helpful, have your child hand you the gauze during pin care, contract then relax the muscle during a stretch, take a very deep breath during a painful stretch, etc. Allow your child to tell you at what point he or she needs to hold before moving on during stretches. Perhaps at seventy degrees the child may need to hold for ten seconds before progressing. Give positive affirmation that your child is doing a good job:
- “I know that it hurts, but I like the way you helped to count.”
- “If you can take seven deep, slow breaths it will be over.”
- “I am impressed with your big breaths.”
- “You did a great job bending today!”
Use a calm, relaxed tone of voice. If your child is uncooperative during therapy, the therapist may ask you to step out for a few minutes. This is perfectly normal and does wonders to help the child get on board with the therapist. It is very helpful to ask your child where the pain is specifically located. A change of hand placement may help to avoid pulling on skin. Use a towel for padding on the affected side to decrease pain or pressure. Let the child know that you have tried to decrease pain but there may continue to be discomfort, but it is important to stretch the muscle anyway.
To decrease pain:
- Use slow progression of the stretch so the muscles can relax. Perform multiple, slow stretches.
- Apply heat and massage prior to stretch.
- Perform gentle distraction of the joint during the stretch (ask your therapist to teach you).
- Promote deep, slow breathing techniques to facilitate relaxation, promote self-control, and provide distraction.
- Provide distraction techniques such as games (hit the balloon five times, blow five bubbles, etc.). Some families find age-appropriate audio books helpful for providing distraction. Some families find ipads and cell phones to be effective distraction.
- Electrical stimulation can help relieve pain and reduce spasms. Ask your therapist if interested.
- Apply cold packs at the end of a tough stretch.
- Provide a clear beginning and end to the stretch, such as counting down to zero.
- Ask your therapist to problem-solve and discuss your child’s concerns. A fresh perspective can be very helpful.
Please try and avoid the following:
- Telling your child not to cry as it increases their stress and anxiety.
- Using a harsh tone during a painful stretch.
- Telling your child that something does not hurt (even if you don’t think that it hurts).
- Instead, try to help your child verbalize their feelings. “Are you afraid it is going to hurt?” “Are you mad because we have to do your exercises?” “I know that it hurts but you are helping your muscles grow!”
- Using words that might make your child feel like they have failed if a certain degree of measurement was not reached.
- Attempting a large stretch without performing proper warm up and tissue preparation.