Evan is Seven years old and is the youngest client that I have ever had the pleasure of working with.
Evan underwent SDR surgery (Selective Dorsal Rhizotomy surgery) at the very young age of 3, after being diagnosed with Cerebral Palsy. There are various forms of Cerebral Palsy, but generally, it effects the development of movement and posture and causes activity limitation. This is caused by some of the nerve endings in the lower spine not communicating as effectively with the brain as they should.
The condition that Evan has is Spastic Cerebral Palsy, which means that all the muscles and joints in his lower limbs are always tight. This results in discomfort and it also has knock on effects such as poor sleeping patterns which in turn effect his concentration.
The Spasticity in his lower limbs would cause Evan to walk in a scissor like fashion (where the knees come in and cross over) also Evan would walk on his toes, which would look similar to a ballerina when they pivot on their toes. Both of these conditions are brought on by the muscles being so tight that they are unable to relax.
In many children like Evan, the condition can sometimes be helped by the use of Occupational or Physiotherapy, where strengthening and stretching exercises are carried out. This is not always effective with all cases and in the long term the impact of such therapies is limited. Often Spasticity can result in painful Orthopaedic interventions, Botox injections or the insertion of a Baclofen pump. The benefits of the latter two lessen after time and come with their own risks.
Another option is SDR Surgery (Selective Dorsal Rhizotomy). This surgery is recommended at an early age because as time goes on, tight muscles and spasms can cause arthritis and tendinitis in the early ages of around 20. By operating at an early age, the damage caused by Spasticity can, in many cases be avoided, along with Orthopaedic surgeries that result from this damage.
SDR Surgery involves identifying which nerves are not communicating as they should with the brain and are causing the Spasticity. When this has been established, the nerves that are causing the problem can be cut.
Evan had undergone this surgery at the age of 3 and was very weak afterwards. His lower limbs were the opposite of how they were before. His legs instead of being very taught and tight were now like spaghetti.
Evan now had to work really hard for 4 weeks with extensive therapy involving stretching and strengthening exercises and learning how to be able to stand. He was able to stand unaided for the first time in his life after the 4 weeks, and this took a tremendous amount of courage, strength and determination.
There is a lot of work that Evan has to do on a daily basis and this includes having somebody who goes through daily exercises and stretching when Evan is at school, as well as after school classes that include swimming. Children are encouraged to walk as much as possible and to take part in non physical activities to help promote strength and mobility in a fun way e.g. swimming, cycling, rock climbing, horse riding.
What we are trying to correct at the moment is the toe walking with Evan’s right leg and the overall strengthening of his glutes and hamstrings. We are seeing improvements in his posture, gait and flexibly all the time. This is down to the hard work that Evan puts in and I have to be honest, it is an absolute pleasure working with him (even when is he trying to wind me up, as he does have a wicked side to him).
Well done Evan keep up the good work mate!!!
Personal Trainer Cardiff