Applying ABM Neuromovement in Rehabilitative Therapy
A Toddler’s Fracture and Persistent Pain
When my son was 2 and a half years old he broke his fibula. He toddled down the stairs and slipped on a clean diaper, his tiny ankle rolled over and his fibula snapped. The tears rolled in, both his and mine, and we rushed off to the hospital to have a teeny tiny red cast secured over his ankle. We were on holiday in Toronto when this happened, and it set the tone for the rest of the summer. Managing a toddler with a cast and a 6 month old baby was no easy feat, but we made do. Summer came and went, the cast was removed and I thought my boy was going to be back running about with reckless abandon. When I asked the doctor what we should do to help his withered leg rehabilitate he replied, “nothing, unlike adults, kids are resilient and they figure it out on their own”.
While this may be true for some children, it is not true for all, sometimes they need some help. For the next few YEARS my son would wake every night screaming in pain. He would grip his ankle right where it broke begging us to make it stop hurting. We returned for scans and the doctor could not find anything. His only suggestion was that he go in and scrape the bone to make sure there are no nerve endings that were causing the pain. Eventually he muttered something that really caught my attention and continues to guide my work to this day, “the pain might be in his brain”.
He then explained to me that the pain could be a result of mixed up messaging in his brain. His brain might still think he is injured and hasn’t “bounced” back. Or his brain hasn’t caught on that his injury is gone and is still compensating. Wow, here I was with a Nursing degree, and a Human Kinetics degree, and I knew so little about the brain’s role in movement, pain, and rehabilitation. Of course it was in his brain! We declined the docs offer to scrape the bone and I left with renewed hope.
Neuroplasticity can be Both the Cause of and Solution to Pain
What the doctor was referring to was neuroplasticity which is defined by the National Institute of Health as
“Neuroplasticity is the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections after injuries”.
Neuroplasticity can be a positive capacity in terms of learning, growth and development. However, neuroplasticity can also negatively impact an individual’s life as seen in addiction. In reference to injury, many people are able to return to activity with no challenge whatsoever, their nervous system recognizes the injury has healed and they relearn how to move as they did before. But not everyone is so lucky, for a variety of reasons some individuals’ brains may not recognize the healing, or remember how to move well. These individuals will need some support in their recovery.
The Anat Baniel Method Neuromovement® is Rooted in the Science of Neuroplasticity
My son’s injury and our discussions with his orthopaedic surgeon led to my discovery of the Feldenkrais Method and eventually the Anat Baniel Method of Neuromovement®. I attended a few classes on my own and was completely mesmerized by the impact on not only my movement patterns, but my depleted nervous system. Long story short, I registered in the next training and was off to Nevada to begin my own ABM journey.
ABM Neuromovement as Rehabilitative Movement
When I returned home from my first 9 day segment I went straight to work with my son. Over the next few days, I “played” with his feet, exploring the movements of the “uninjured” foot and showed him what it could do and how that movement transferred force into other areas. We explored his foot’s movement on his back, on his belly, in standing, on his side, in a variety of ways. And then I moved on to his “injured” foot. To no surprise, it was restricted. His nervous system was guarding the injured leg from head to toe. I gently coerced his brain to reintegrate this leg back into his movement patterns. Too many variations to explain here, if you have ever experienced an ABM lesson you can relate. If you have not, imagine someone exploring all of the potential movements of your limb and connecting them to your whole body. Check out this blog to learn more about what to expect in an Anat Baniel Method Neuromovement lesson.
I did not stretch or strengthen his leg.
I did not force or manipulate his leg.
I moved him gently through his readily available range of motion
I reminded his nervous system of how his body could move harmoniously
I helped him become aware of and release guarding and compensation.
He never screamed about his leg hurting again.
He stopped complaining about his shoes and socks.
His gait returned to normal.
We never returned to the doctor.
When his younger sisters broke their bones (children are not rubber apparently), I worked with them from the moment they were casted. I worked on their “uninjured” limb, reminding their brain of what the injured limb was capable of. When their casts came off they did bounce back. But I am not so sure if they would have rehabilitated so well without any assistance.
Recommendation for Children with Fractures
- Explore movements of the ‘uninjured limb” while the cast is still on (use markers, paint, or stickers to make it fun)
- Avoid wiring in poor movement patterns (limping, compensating, guarding)
- Go slowly, take lots of rest, and avoid pain
- Find a practitioner to help you or your child re-learn functional movement patterns post injury.
While coaching this Spring I met a young boy who had broken his foot and witnessed his attempt to return to sport. First off, this child attended practices with a walking cast. He was limping and compensating while learning a new sport, not a great idea. Once his cast was removed, I noticed his limp persisted and pointed it out to his parents who did not seem to mind. Eventually the pain increased and he had to stop attending practices. I hate offering unsolicited advice to families, instead I will use their stories (anonymously) to fuel my blog.
This boy needed some assistance, he was not bouncing back. Since he was a high level athlete (in another sport), his elite movement patterns were deeply grooved into his brain. His compensations and guarding were causing issues in areas seemingly unrelated to his injury. While he was stretching and strengthening his body these modalities were limited if he did not re-educate his nervous system. He needed to do some brain work! His brain needed some clear communication that the injury had healed and that it could let all the guarding go. He needed help to relearn functional movements and simple concepts such as weight shifting.
I have not seem him again, but I do hope that he eventually heals well. I work with adults in their 60’s and 70’s who have compensations from injuries from when they were small children. Even in their late stage of life they are capable of learning to release the guarding and reintegrate the healed area into their movements again. It’s never too late, but problems are always easier to solve when addressed early.
If you or your child is recovering from a broken limb or injury, I recommend you seek out an ABM Neuromovement or Feldenkrais practitioner to assist you in reintegrating the injured area back into your functional movement patterns so you can return to moving easily and efficiently.
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