The story of how I started working with Cerebral Palsy students.
by Anastasia Gambill
Two years ago I knew nothing about Cerebral Palsy (CP) or how working with CP clients was about to change my life. I was just a Pilates and Yoga instructor doing movement therapy to balance bodies and alleviate chronic pain due to alignment issues and physical patterning. I had no idea I was about to embark on the most rewarding journey of my life. I had no idea my “job” would include immense frustration, uncontrollable tears, and even hysterical laughter. Jobs aren’t supposed to work like that. I also had no idea my work could truly change a person’s life, their interactions with friends and family, and even form a foundation for happiness. Then I met Marie, my first CP client.
As a new client, Marie took a leap of faith to work with me. I didn’t understand much about CP. I read everything I could about this condition, the barriers to movement and challenges this condition elicits, but nothing prepared me to meet 22 year old Marie, my new student.
Marie wasn’t sure about me and had seen other therapists and movement specialists, so she approached me with trepidation. How could someone so new to her and her condition understand what was going on in her body more than she did? During our first sessions I was at a loss. I kept watching and reading her body and movement patterns and trying new things to see what she could and couldn’t do – what she was comfortable with and what didn’t work for her. I studied her facial expressions and saw when she was in pain, happy, confused, and a myriad of other emotions while we moved.
Cerebral Palsy (CP) is a general term used to describe a group of chronic (on-going) disorders that impair movement and coordination due to damage to the developing brain in utero, birth, or in early childhood usually before the age of 3 years. CP is caused by abnormality or disruption in brain development from a variety of factors; from fetal stroke, mother/infant blood type incompatibility, infection, lack of oxygen, to suffering a traumatic head injury early in life.
The way an individual is affected by CP varies widely from a barely noticeable difference in the way one may move or speak, to needing assistance to walk, or being unable to move or communicate verbally.
After a month or two with Marie I began to understand her. I saw the signals she was sending me and I could see in her face, responses, and her movement, where we were headed and what was working and what was not. Marie came to me wearing hard plastic braces covering her lower legs and feet that immobilized the articulating joints of the ankles and foot bones. I didn’t question this at first because they were part of her on-going treatment with surgeons and physical therapists. But I realized that mobilizing these joints in a controlled and supportive environment may help her begin the path towards her own movement. I started by asking her to work barefoot in our sessions, focusing on developing sensation and articulation in her feet. Her muscles were atrophied from being in braces most of her life. I also noticed severe curvature in her spine and a lack of control in her upper body and coordination. I began using a back brace with her during our sessions and talked to her and her mother about getting canes to use to work on anchoring her arms and developing cross-lateral/right-left coordination.
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The results were incredible. Without braces and by working on articulation, Marie started to feel in control of her body and was able to exert effort and see the results of that effort. Her will to move increased and I was impressed by her efforts to understand her body and her drive to recruit muscles and effect the kind of basic movement we take for granted on a daily basis. Once she realized that she COULD grow stronger, she was unstoppable. We met once a week. Routinely she would be exhausted between 30 to 45 minutes into our session, but unwilling to stop working and her growth continues.
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Marie introduced me to her friend Nirvana, who also had CP. Nirvana was less mobile than Marie. She could not “free walk” when we began, meaning she could not walk without the support of canes or a walker. In a miraculous few months we were practicing jogging, where Nirvana would let go of her walker and just hold my hands and move rapidly about the room. One day I said, “Okay. Now we are going to try this on your own. I’ll get you started, but then I’ll let go. I’ll count to three before I do, and then you have to hold yourself up.” We did one lap around the room together, and then I counted to three and let go. Nirvana kept moving toward me, holding her balance step after step, as I continued walking backwards. We made it all the way across the room, and then she fell into me, both of us laughing and crying, as she exclaimed, “I’ve never done that before!”
I recently began working with a new client, Will, at Studio Blue, another of Marie’s friend’s who has CP. Much of his left side is either contracted, or unengaged. Our process is similar. We start each session by taking off the leg braces, working barefoot, supporting the upper body with a back brace, then I watch, take notes, try things, and talk with him and his family about what I see. Will is very responsive to direction. I have already seen him grow two inches taller when he walks, learn to use and extend his left arm and hand, and lengthen the muscles on the inside of his legs to support standing. It requires a lot of effort and focus from him, but he can do it, and that is how I know that he can and will grow as we work together.
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My CP clients never fail to help me grow, surprise and amaze me. They have physical limitations but such a huge amount of spirit and drive they continue to develop new skills they aren’t “supposed to” be able to do. I believe my “watch and learn” approach is better than a cookie cutter approach, and I know each client I work with is an individual with different strengths and weaknesses, and goals, and I have learned to work intuitively. I have come to believe in neuroplasticity, the ability of the central nervous system to build new connections, pathways and patterns, even late in life.
This is truly the most rewarding work I have done I my life. I can not describe how satisfying it is as a teacher to meet such motivated students, or the beauty of watching someone discover something they thought they would never be able to do. I am so thankful for Studio Blue’s support in this area and I welcome new students and new challenges.