A Journey With Cerebral Palsy

Working on the strength and flexibility of the hips has been important. The strength in the hips and glutes helps many activities become more productive. One of the weakest muscles in me has been the glutes. The weakness in them seems to make walking more challenging. That lack of strength could be a major reason my knees tend to cave in toward the middle. If we can strengthen the glute muscles, the effect could be improved walking gait. The added stability would also improve my ability with hobbies like skiing or golfing. Bernard has been working an exercise with me that has been familiar. The side-stepping hip abduction to strengthen the glutes. This exercise has been done with a band around my ankles. Placing the mini band around my ankles to create tension. Trainers from the past have placed my ankles inside these exercise bands. Normally assisting me in getting the bands on and off my ankles. Cerebral palsy can cause the function of placing things on the body more challenging. Some examples in my life would be tying shoes or buttoning the buttons of a shirt. The first-time Bernard handed me one of these bands to place around my feet caught me by surprise. He obviously wasn’t going to help me get the band around my ankles. It would be left for me to execute and I remember questioning whether it would be possible to accomplish.

The movement Bernard requested of me had been done many times. The band being placed around my ankles was used to create tension. When the band was placed around my ankles, the concept would be moving laterally. Facing in one direction, my right leg would be called upon to make the first movement. It would move out to the right, taking a lateral step as far as possible, while maintaining balance. The band would add challenge to this move, working the glute on the right side. Once stretched out to a semi-comfortable distance, my right foot would rest on the floor. The second part of our movement would be having the left leg follow the right. Stepping in the same lateral direction, resulting in my two feet arriving back near each other. The idea however, was for the two feet to remain some distance apart. At the rest point, where my feet came back together, relieving the tension on the band. The idea was to continue with some tension remaining in the band. To achieve this goal, my feet were to remain slightly apart at the rest juncture. Keeping the tension of the band ever present during the exercise. Once we had moved ten steps to the right, with the right leg leading. We would change direction, moving back ten steps to the left, with the left leg leading. There would always be more challenge added to the movement.

As the movement became more comfortable, there were things added. While continuing to work on challenging aspects of the exercise. One of the major challenges has often been the movement of my trail leg. When the step to the side has been made, the challenge of lifting the trail leg happens. Usually performing more of a sliding motion with the foot, but being encouraged to lift and place. The reason lifting becomes challenging has to do with maintaining balance. As the band would encourage the trail leg to move quickly. Remembering to focus on maintaining balance becomes tricky. Adding an even further progression has required more concentration on the final step. Bernard has implemented a squat into our abduction movement. Which means with each side step, there becomes a squat required when my feet are apart. This motion only increases the number of things taking place. It turns on more of the lights bulbs in the brain. Increasing the amount of movements requiring concentration. The squat also places more pressure on the trail leg. Bringing the trail leg back to center feels like the movement of least concern. Following the exertion of stretching the band with my step, then performing the squat, the energy has been used for one cycle. So, the concentration can lapse on lifting and planting that trail leg. This becomes the point where the gift of Bernard comes into play. Reminding me to remain focused on the final movement of the exercise. But, even before we are stepping and squatting, the most important part of this exercise takes place.

Placing the band around my ankles to begin the hip abduction movement has been challenging. Maybe one of the more challenging things required in the gym. This process has many moving parts to get accomplished. It requires both fine and gross motor movement. Also, part of the process has been balancing my body. When Bernard handed me the band, the first thing was finding somewhere to sit. The floor wasn’t going to work in my mind, more leverage would be needed. The most ideal place would be sitting somewhere with a back. Something that could be leaned against to provide stability. However, there have never seemed to be many backed chairs in a gym setting. Which meant having to balance myself while placing my shoes through the band. The step-up platform was one of the first places coming to memory. Sitting on the platform allowed me to lean down, getting one foot through rather easily. Then came the challenge, stretching the band far enough, and getting it around the other shoe. It seemed to require more coordination than I possessed. So, patience with the process of getting the band around my ankles became crucial. The first few attempts were missed, as the band would get stuck on the front of my shoe. It would also get caught moving halfway back on the shoe. My grip tended to loosen on the band as well, prompting the momentary pause. The challenge caused frustration at times. Trying to learn the best way to position my shoes to make the process easier. Once, the battle of getting the band on was complete, getting it off after the exercise round would be another challenge.

Having the band around my ankles required me taking small steps in order to move. After rising from whatever seat being used to place the band around my ankles, shuffling my feet would happen. Getting away from the platform to a section of the floor. This movement with the band also required concentration on balance. Being required to move with restriction around my legs meant finding another way to walk. Attempting to take steps too large, could have resulted in getting tripped up. There didn’t seem a way to recover from an impending fall if balance were lost. Which meant being careful with my small steps. Once the round of movements was completed, small steps were taken returning to my seat. The exercise wasn’t completed at that point, the band still needed to be removed from my ankles. My legs would move closer as I bent down toward my ankles. Holding the right side to remove the right foot first. The right being the more stable part of my body, as cerebral palsy impacts the left side more profoundly. The first attempt usually involves turning the front of my foot toward the center. Hoping to catch the band with my right toe and slingshot my foot out. Which never works, however seems to be attempted each time. Then a deep breath, combined with an alright, fine. My medicine goes down and I begin working the band around the bottom of my shoe. Attempting to keep my feet closely together, relieving tension on the band. It often gets stuck around the sole of my right foot during the process. Requiring even more patience and composure before freeing myself from the band. The patience of working with getting the band on and off has been a good challenge. It seems to directly challenge cerebral palsy, working on both fine and gross motor movement.

There were things done to provide more challenge to the exercise. In the past, when the band was placed around my ankles it remained. Which meant doing a couple different movements with the band. We would complete our three sets, then remove the band from my ankles. Placing the band on one time and taking it off a single time. The other component of working with the band previously was having help with the band. When working with Bernard things have been different. Usually combining two or more exercises together with three or four sets of each. The hip abduction movement has been just one of the exercises in a mini circuit. This means placing the band around the ankles three separate times. While also removing the band from my ankles three separate times. This adds more pressure to our work out session. It also allows for ample work on the challenging movement. Each time the band has been handed over, I know there will be some struggle. The battle with the band only becomes more challenging as fatigue begins settling. As the rounds progress, holding my balance on the platform and working the band around my shoe evokes added emotion. The frustration felt only becomes combated by maintaining composure. Without giving up on the task of working with the band. Each time has led to successfully working the band around my ankles, completing the exercise, and removing the band. The resulting execution of the challenge from Bernard only increases confidence in ability.

Another key element in the progression of this exercise has been the type of bands. The bands to be placed around my ankles have changed over time. As the glute muscle increase in strength, Bernard changes the tension of the bands. With the tension increasing, the challenge of the exercise increases. Both with regards to the actual movement and getting the band on and off my ankles. These kinds of exercises help cerebral palsy improvement from multiple areas. We are working on one of the weaker muscle for CP in the glute. Challenge them to strengthen, which in turn would improve the ability to walk. The ability to walk being one of the most concerning aspects of parents who have children with CP. It has been an ability requiring attention for most of my life. Attempting to improve the ability through exercise. The hip abduction movement also challenges the coordination of my entire body. Being called to work together with bands of different tensions. My hands and legs must synchronize to prepare for the exercise. The upper body also becomes called upon to provide stability. While my hands work to slide the band over my shoes. These are the creations of Bernard. Movements added to exercises directly placing cerebral palsy under pressure. He comes up with the added tweaks that would never cross my mind. Bernard reminds me each week, we aren’t trying to get around cerebral palsy, we’re coming right for it.