I wrote about E's setbacks a few posts ago. Well, her Feldenkrais practitioner Mr. Keith had a few words for me. Since writing that post, Elena has been more active, and her gait is looking better. Maybe with more exercise (different exercise), she's looser? I don't know. When we see setbacks, I'm sure fatigue has a lot to do with it, as does general growing pains (physical, social, academical, etc.) and I'm sure I could use more patience to deal with my kids. (Don't we all?)
Keith put this very eloquently--he acts similarly to how he writes. Maybe you all can identify with my frustrations, and glean some pearls of wisdom from his letter too.
It does not surprise me if her gait has lost some grace. And I think there may be several factors at play.
1) She may be sitting in a chair more for longer periods of time, which is a flexed hip and knee situation. That has a tendency to limit even more the ability to straighten up. It happens to everybody, but matters more when there is a slowness of the nervous system's ability to tell the muscles to relax and lengthen. In working with Elena it was always remarkable how the tone (in her feet especially) would be very general and high. After a few minutes of gentle movement and some attention to them, they became more lively and differentiated in their responsiveness.
It is not just a matter of lengthening the tissues, as in stretching, but of keeping the nervous system actively "listening" to what is going on there. The longer the shoes are on without a break, and the longer she sits not needing to feel and regulate the actions of her legs, the more they lose some finesse. Again, that happens with all of us, but the effects are exaggerated and take more concerted attention to recover from in a situation like Elena's.
2) She may be growing in her bones, and the muscles and connective tissue tend to lag behind the bone growth and adapt to it, so there can be periods of exaggeration of the shortness. Once again, the remedy for this is activity that (gently, in my opinion) moves her through the ranges, repeatedly, and with attention to what is happening, not forcing. Infants spend a lot of time paying attention to themselves… its their full time job. Kids moving out into the world start shifting that learning attention outward. For a kid in Elena's position, she needs this continuous exploration of herself more than other kids her age, because the basic physical learning that normally happens earlier is an on-going project for her. She definitely can continue to learn better control and finesse in her feet, legs, pelvis and low back to improve her gait, but it just doesn't happen as fast. The basic learning and adapting ability is there, but it is as if both the incoming sensation signals, and the outgoing motor control signals are muted. So it takes more time. Beyond that, it takes helping her to stay in a situation which she can experience things multiple times. Infants do that naturally, because they are exploring within the limits that they have… When they can't yet roll over, they are exploring all the things that lead to being able to roll over. Elena has passed by some of the basics for walking, because she could, and because her intelligence and maturity outpaced her physical learning. The games we play together in the Feldenkrais sessions get her to explore those fundamentals over and over and over again, so her nervous system can make sense out of what is happening through those distorted signals.
It is great to hear she likes the water. With the right kind of guidance, and given the skill and strength she has in her upper body, it could be an experience of grace and lightness hard to match on land in a world of balancing on the legs and falling. Those kinds of experiences build up the soul, not just the body of a young person.
One more thing about what Elena was getting this summer from the Feldenkrais sessions: acceptance. I built the activities around her abilities and her intentions. (It sounds like her teacher understands this too.) It was a place where she was pretty much queen of the roost, even though I was putting her into all sorts of situations that required her to pay attention to what she was doing, and do it over and over and over again. That's a rare combination that creates a potent learning situation.
The "holding on so tight" you mention is an example of her "passing by" the explorations that she needs to learn to be on her feet. Because she can find other ways of getting where she wants to go, and because her interests and ambitions have grown beyond working out the fundamentals like an infant or toddler does, just taking away the support is not going to lead to her getting more graceful on her feet. She needs the guidance (and a situation in which she is enjoying it) to put in the "study time" on that part of the development she missed.
Showing posts with label feldenkrais. Show all posts
Showing posts with label feldenkrais. Show all posts
Monday, October 10, 2011
Sunday, April 3, 2011
A Feldenkrais Update
We did a little bit of Feldenkrais last year. Then there was a big break--partially because we were busy, partially because it's expensive, and partially because I wasn't sure if it was worth it. I thought our practitioner "Mr. Keith" was good, but I wasn't sure if that's where we should spend our time and money.
We decided to revisit Feldenkrais right before and right after E's lengthening surgery last November.
And we're still doing it.
WE'RE COMMITTED.
It's not like some magic switch...but I feel like our "regular" PT (a mix of CME and traditional PT) and Feldenkrais, post-lengthening, really have come together in this "perfect storm", where E's some sort of super sponge and new things are happening all the time. We do F'krais 2x/week (Mondays and Saturdays). Elena loves her time with Mr. Keith. And while she doesn't come out of each session magically running around as if she didn't have CP--we see changes. So does Keith.
If you're not sure what a F'krais session looks like, Keith prepared these videos. It's great commentary, and every time I see something like this...I'm reminded of a little girl, who could barely stay in a sitting position, and who stood literally on her (right) ankle--instead of the bottom of her foot.
Ball Toss
Standing
As always, thanks Mr. Keith!
We decided to revisit Feldenkrais right before and right after E's lengthening surgery last November.
And we're still doing it.
WE'RE COMMITTED.
It's not like some magic switch...but I feel like our "regular" PT (a mix of CME and traditional PT) and Feldenkrais, post-lengthening, really have come together in this "perfect storm", where E's some sort of super sponge and new things are happening all the time. We do F'krais 2x/week (Mondays and Saturdays). Elena loves her time with Mr. Keith. And while she doesn't come out of each session magically running around as if she didn't have CP--we see changes. So does Keith.
If you're not sure what a F'krais session looks like, Keith prepared these videos. It's great commentary, and every time I see something like this...I'm reminded of a little girl, who could barely stay in a sitting position, and who stood literally on her (right) ankle--instead of the bottom of her foot.
Ball Toss
Standing
As always, thanks Mr. Keith!
Saturday, November 27, 2010
Post-Op: 9 days
Well, E has been making slow and steady progress. I was starting to get discouraged...E's been crawling and getting into chairs, but really up until today, she hasn't done much standing; zero walking, and no cruising. Well, today's different!
Yesterday E tried the treadmill. We spent maybe 5 minutes on it, and most of that was just trying to stand up tall.
Today, we did 20 solid minutes of walking and standing, where I was moving her legs slowly, and aiming for strikethrough with her right foot (this stride is typically very short) and it was well-tolerated. Elena was definitely gripping the handlebars tightly, and complained that "her hands hurt"--but she was also bearing weight in her feet, which was the goal. I stopped when she said she was done.
Later on that day, we went to work; E can't use her crutches yet, and we don't have a walker. Cue The Beach Walker! E even ran a little bit (on the "toes" of her casts). We got a "coffee" and then headed off to Feldenkrais.
E was pretty warmed up (and silly) by the time we got there, but she had a great time with Mr. Keith. We haven't been to F'krais for about a year. I like the way he's focusing his efforts on different parts of her body since her feet are in casts (today was mainly her obliques, I think--their recruitment for walking).
We had some friends over for dinner; all the kids played, and then we got ready for bed. Tonight is E's first night with casts, without Valium; so far, so good.
Yesterday E tried the treadmill. We spent maybe 5 minutes on it, and most of that was just trying to stand up tall.
Today, we did 20 solid minutes of walking and standing, where I was moving her legs slowly, and aiming for strikethrough with her right foot (this stride is typically very short) and it was well-tolerated. Elena was definitely gripping the handlebars tightly, and complained that "her hands hurt"--but she was also bearing weight in her feet, which was the goal. I stopped when she said she was done.
Later on that day, we went to work; E can't use her crutches yet, and we don't have a walker. Cue The Beach Walker! E even ran a little bit (on the "toes" of her casts). We got a "coffee" and then headed off to Feldenkrais.
E was pretty warmed up (and silly) by the time we got there, but she had a great time with Mr. Keith. We haven't been to F'krais for about a year. I like the way he's focusing his efforts on different parts of her body since her feet are in casts (today was mainly her obliques, I think--their recruitment for walking).
We had some friends over for dinner; all the kids played, and then we got ready for bed. Tonight is E's first night with casts, without Valium; so far, so good.
Monday, November 2, 2009
Feldenkrais
On Halloween day (E wore her costume all day), E was scheduled for our first "real" stab at Feldenkrais. By that, I mean several sessions in a short span of time. Our plan was to have two sessions today (about 1 hour each), and then one two days later. It's hard to put into words (or video) the feel of the session, b/c a short clip really doesn't show much or do it justice. But, here goes...
Here are my impressions.
1. Keith is very patient. He talks very softly, and gets Elena to do things--this feat, alone, is amazing. He can command her attention by talking quietly, or not talking at all.
2. In order for E to be receptive to this gentle persuasion, it takes time. A lot of time. Meaning, the first half of the session it was basically playing with E, and getting E used to the idea of "mirroring" without telling her what to do or even that that was the goal. But by being quiet, and letting E lead part of the time, and "taking turns", it got E to be curious, and gave her some autonomy.
3. This autonomy is crucial. Keith is trying to get Elena to realize, on her own, how to move her body in a new way. For example: I spend a lot of my time barking at E to put her heels down; Keith tries to convey that having her heels up is just another way of moving--that nothing is "forbidden"--but that there are other ways of standing, sitting, moving. I think she is receptive to his message (not necessarily to mine).
Does it work? Well, that's hard to say. I'm not sure. I AM sure that we haven't wasted our time doing this, and we'll pursue it when we can. As far as real eye-opening experiences, here are the big things I noticed during our two sessions:
1. E was TIRED. She was really working hard. They did lots of transitions--all kinds of sitting, throwing balls, switching leads, standing up, balancing on balls, kicking, kneeling, etc.
2. For the first time, E had to think what she was doing with parts of her body she never thought about. For instance, she thought about what her arm NOT throwing the ball was doing (normally they move more or less the same way--both arms throw, only if one holds the ball) and got her to change it. That is DEFINITELY new.
3. When she was tired, she let him move her around. Let him touch her back, bottoms of her feet, let him move her legs around in all different motions. I don't think she would have let me do this, but she was tired, trusted Keith, and loose--her spasticity wasn't too problematic for most of the motions, probably b/c of her state of mind (or fatigue).
And, here's the kicker: we played soccer today (one day post-Feldenkrais) and I tried to get her to do a new soccer drill, where instead of just kicking the ball (or running into it, I should say) I had her put one foot on the ball, take it off, put the other foot on the ball, take it off, stand tall, and then kick (with handholds). She's never done that before. Keith spent a long time having her feet moved around, rolled on balls, foam rollers, etc. I didn't film that one: I'll film again and post
HERE.
4. On our third session, E was quicker to adapt to Keith's "lessons". This time she let him situate her face-up on a table and let him stimulate her feet and move her legs around (more of a classic starting point for older patients). He also made E a mat, with the clandestine goal of having her move different limbs independently (like a "Twister" game). He never showed her what to do, or what the goal was, but by the end of the session she was curious, and willing to identify where her arms and legs were trying to go.
E on the table
E likes Mr. Keith so much she sets up Mr. Zebra so she can treat him
E's "Twister" Mat
Overall, I am very pleased. Not just b/c I see the potential of this method, but because it is so very different from the other things we are doing. I am learning a lot, too. Keith doesn't bargain, or tease, or reward, or insist on movement styles, like I and other therapists do. Don't get me wrong--those things are valuable, and have DEFINITELY paid off. Keith has a very patient approach to movement, and he really makes E think about what she is doing. I'm not sure how much progress we will make, but I'm curious to find out, and E enjoys the time.
Here are my impressions.
1. Keith is very patient. He talks very softly, and gets Elena to do things--this feat, alone, is amazing. He can command her attention by talking quietly, or not talking at all.
2. In order for E to be receptive to this gentle persuasion, it takes time. A lot of time. Meaning, the first half of the session it was basically playing with E, and getting E used to the idea of "mirroring" without telling her what to do or even that that was the goal. But by being quiet, and letting E lead part of the time, and "taking turns", it got E to be curious, and gave her some autonomy.
3. This autonomy is crucial. Keith is trying to get Elena to realize, on her own, how to move her body in a new way. For example: I spend a lot of my time barking at E to put her heels down; Keith tries to convey that having her heels up is just another way of moving--that nothing is "forbidden"--but that there are other ways of standing, sitting, moving. I think she is receptive to his message (not necessarily to mine).
Does it work? Well, that's hard to say. I'm not sure. I AM sure that we haven't wasted our time doing this, and we'll pursue it when we can. As far as real eye-opening experiences, here are the big things I noticed during our two sessions:
1. E was TIRED. She was really working hard. They did lots of transitions--all kinds of sitting, throwing balls, switching leads, standing up, balancing on balls, kicking, kneeling, etc.
2. For the first time, E had to think what she was doing with parts of her body she never thought about. For instance, she thought about what her arm NOT throwing the ball was doing (normally they move more or less the same way--both arms throw, only if one holds the ball) and got her to change it. That is DEFINITELY new.
3. When she was tired, she let him move her around. Let him touch her back, bottoms of her feet, let him move her legs around in all different motions. I don't think she would have let me do this, but she was tired, trusted Keith, and loose--her spasticity wasn't too problematic for most of the motions, probably b/c of her state of mind (or fatigue).
And, here's the kicker: we played soccer today (one day post-Feldenkrais) and I tried to get her to do a new soccer drill, where instead of just kicking the ball (or running into it, I should say) I had her put one foot on the ball, take it off, put the other foot on the ball, take it off, stand tall, and then kick (with handholds). She's never done that before. Keith spent a long time having her feet moved around, rolled on balls, foam rollers, etc. I didn't film that one: I'll film again and post
HERE.
4. On our third session, E was quicker to adapt to Keith's "lessons". This time she let him situate her face-up on a table and let him stimulate her feet and move her legs around (more of a classic starting point for older patients). He also made E a mat, with the clandestine goal of having her move different limbs independently (like a "Twister" game). He never showed her what to do, or what the goal was, but by the end of the session she was curious, and willing to identify where her arms and legs were trying to go.
E on the table
E likes Mr. Keith so much she sets up Mr. Zebra so she can treat him
E's "Twister" Mat
Overall, I am very pleased. Not just b/c I see the potential of this method, but because it is so very different from the other things we are doing. I am learning a lot, too. Keith doesn't bargain, or tease, or reward, or insist on movement styles, like I and other therapists do. Don't get me wrong--those things are valuable, and have DEFINITELY paid off. Keith has a very patient approach to movement, and he really makes E think about what she is doing. I'm not sure how much progress we will make, but I'm curious to find out, and E enjoys the time.
Monday, August 17, 2009
Review: Feldenkrais
I had heard of Feldenkrais as a therapeutic activity through one of the newsgroups I belong to; I have to admit, I had low expectations. I figured, if I walked in some place and they started burning incense and ringing bells, I was outta there. I wasn't sure if it was some new-agey hocus-pocus snake-oil miracle cure some crazy was trying to put on me. Still...I figured, well--it's worth a try. It couldn't hurt, right?
I looked up to see if there were any practitioners in my area; there are four. That surprised me. I called a few and left messages, and two called me back. One called me back twice--this is ALWAYS great for me, b/c it means 1) they are interested in my business and 2) frequently I forget to do things, and I like people remembering for me. I made an appointment with the gentleman caller. I also gave Keith this blog as a reference, which he checked out. AND he saw us on TV the night before our visit--bonus!
After entering his workspace I was immediately relieved. I saw lots of familiar tools--foam rollers, all kinds of balls, mats, etc. He was always focused on Elena and how she was moving, and took time to see how E reacted to having him around her space. He gained her trust before trying to move her, touch her feet/back/legs, and Elena had a great time--so great, in fact, that she exclaimed later in the session--"Mr. Keith you are SO COOL".
Keith explained to me what Feldenkrais was about--I'll try to get this right--it's about improving body awareness by helping the client realize how to move in a different way. As opposed to our traditional PT, where we work on strengthening and using weak muscles through repetition, bargaining, and pressure, Feldenkrais is a gentle approach where the client is in charge, and the practitioner (if allowed) will try to show the client a different way to utilize their muscles as they move about freely. Keith ran the session so that when he spoke, he commanded E's attention so that she knew every time he talked it was beneficial to listen. For instance, Keith showed how he controlled a whiffle ball with the bottom of his foot, and asked Elena if she'd like to try. She did, and did it fine on her left foot. The other foot she couldn't do--so he told/showed her that she could use her right foot if she stopped leaning on it (and her right arm) for balance. It's a small nudge of change--but she was very receptive to the message. No magic light bulbs went off, but throughout the session (which was long--about 90 minutes) she did move in a slightly different way, and enjoyed Keith's company and challenges. As an added bonus, he videotaped the entire session--and then sent it to me, completely annotated, for my review. WOW. My husband was impressed with the time, detail, and patience devoted to this session. I will ask if I can cut a clip and post it here.
Am I sold? Not completely. I think it is valuable, definitely. My problem is two-fold: 1) It is expensive. I don't think it's expensive for the work done--I am happy with Keith's work (from my one visit), and especially impressed with his video commentary. It is expensive as another addition to our already pricey therapy/doctor/equipment list. 2) It is time consuming. E's school year starts at the end of this month, and our schedule is already pretty busy. I thought I might be able to commit a small amount of time to Feldenkrais, but I wasn't sure if that would garner any results.
Keith's suggestion is that we try a few visits in rapid succession, if time and money permits. He thinks that would be more beneficial than regular meetings spaced weeks apart. I agree with him. I am happy with our first visit, and I think I should give it a go. Our plan is to see what Elena's school schedule is--when she has a school holiday, we are going to schedule three visits during that week of E's school--one on the day off, one or two where we take her to school late or leave early, and/or ton the weekend (if Keith can swing it).
Overall--very positive experience. If time and money were no object, we'd definitely do this. At this moment, I'm unsure if it is worth changing/substituting Feldenkrais for something else in her current therapy schedule. We'll see.
INSERT PICTURE(S) HERE
I looked up to see if there were any practitioners in my area; there are four. That surprised me. I called a few and left messages, and two called me back. One called me back twice--this is ALWAYS great for me, b/c it means 1) they are interested in my business and 2) frequently I forget to do things, and I like people remembering for me. I made an appointment with the gentleman caller. I also gave Keith this blog as a reference, which he checked out. AND he saw us on TV the night before our visit--bonus!
After entering his workspace I was immediately relieved. I saw lots of familiar tools--foam rollers, all kinds of balls, mats, etc. He was always focused on Elena and how she was moving, and took time to see how E reacted to having him around her space. He gained her trust before trying to move her, touch her feet/back/legs, and Elena had a great time--so great, in fact, that she exclaimed later in the session--"Mr. Keith you are SO COOL".
Keith explained to me what Feldenkrais was about--I'll try to get this right--it's about improving body awareness by helping the client realize how to move in a different way. As opposed to our traditional PT, where we work on strengthening and using weak muscles through repetition, bargaining, and pressure, Feldenkrais is a gentle approach where the client is in charge, and the practitioner (if allowed) will try to show the client a different way to utilize their muscles as they move about freely. Keith ran the session so that when he spoke, he commanded E's attention so that she knew every time he talked it was beneficial to listen. For instance, Keith showed how he controlled a whiffle ball with the bottom of his foot, and asked Elena if she'd like to try. She did, and did it fine on her left foot. The other foot she couldn't do--so he told/showed her that she could use her right foot if she stopped leaning on it (and her right arm) for balance. It's a small nudge of change--but she was very receptive to the message. No magic light bulbs went off, but throughout the session (which was long--about 90 minutes) she did move in a slightly different way, and enjoyed Keith's company and challenges. As an added bonus, he videotaped the entire session--and then sent it to me, completely annotated, for my review. WOW. My husband was impressed with the time, detail, and patience devoted to this session. I will ask if I can cut a clip and post it here.
Am I sold? Not completely. I think it is valuable, definitely. My problem is two-fold: 1) It is expensive. I don't think it's expensive for the work done--I am happy with Keith's work (from my one visit), and especially impressed with his video commentary. It is expensive as another addition to our already pricey therapy/doctor/equipment list. 2) It is time consuming. E's school year starts at the end of this month, and our schedule is already pretty busy. I thought I might be able to commit a small amount of time to Feldenkrais, but I wasn't sure if that would garner any results.
Keith's suggestion is that we try a few visits in rapid succession, if time and money permits. He thinks that would be more beneficial than regular meetings spaced weeks apart. I agree with him. I am happy with our first visit, and I think I should give it a go. Our plan is to see what Elena's school schedule is--when she has a school holiday, we are going to schedule three visits during that week of E's school--one on the day off, one or two where we take her to school late or leave early, and/or ton the weekend (if Keith can swing it).
Overall--very positive experience. If time and money were no object, we'd definitely do this. At this moment, I'm unsure if it is worth changing/substituting Feldenkrais for something else in her current therapy schedule. We'll see.
INSERT PICTURE(S) HERE
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