Medical jargon can be confusing. Never be afraid to ask your medical team what they mean. Here are few explanations of some common phases.
Shortening of muscles and soft tissue surrounding joints can prevent a normal range of movement. This is called a contracture. Prolonged resting positions and muscle stiffness e.g. from increased tone, can lead to a permanent change in muscle, soft tissue length and also affect the nerves. These changes will impact the way a joint can, or cannot, move and can increase the risk of deformity and pain.
When there is more than one orthopaedic procedure in the same operation/admission this is described as Multi-level surgery.
Post-surgery, acute services and your community team will work together. This will promote a smooth recovery and rehabilitation.
Muscle Fatigue is common in neurological conditions. Fatigue is when your muscles become tired and/or sore and you feel a lack of energy.
Fatigue in some neurological conditions can be:
It is important to be aware of when your muscles become tired. Rest is important, as too much activity can take longer to recover from. It is important to pace your activity.
Pacing means:
Depending on your condition you may need a walking aid or a wheelchair to help you move around. This can help to manage your energy for periods throughout the day.
Physiotherapists can help you in many of these areas. They can provide you with specific advice on muscle weakness and fatigue management. They can do this by looking at posture and advising on energy conservation. This helps you to focus on the things that matter most. Physiotherapists want to make sure you grow well. They will help you find ways of keeping your muscles as strong as they can be. Physiotherapists may give you exercises and stretches to stop your muscles from becoming tight. If they are already tight physiotherapists can look for ways to prevent further tightness.
Therapists will always tailor a programme appropriate for your condition.
With neurological conditions, your muscles can be weaker, especially with specific neuromuscular disorders. The muscles involved will vary depending on your diagnosis. Weakness can happen during childhood or later in life. You may find some activities more difficult to manage yourself and need some help with others. In some neuromuscular disorders, it takes less stress to damage a muscle. Repair may take longer. Depending on the condition, the damaged muscle can be more difficult to build up or make stronger.
Muscle strength impacts every aspect of our life. Muscles are needed for movement. Altered movements will affect our posture, energy, the way we walk or move around. Weakness may result in you experiencing some discomfort. If you don't have enough muscle strength, you may need help with external support such as Orthotics.
Muscles help us to speak and breathe, so we may need extra help in these areas depending upon our condition. (click here for more information on Speech & Language Therapy).
An orthosis is an externally applied device. It is also called a ‘brace’, ‘splint’ or ‘orthotic’. The purpose and design of an orthosis may change over time along with the changing needs of your child.
An orthosis can:
Often your physiotherapist and Orthotist will work together, to promote the function and wellbeing of your child through appropriate orthoses.
This is your child’s ability to know where their body is in space. It helps your child stabilise a joint during a task. Decreased proprioceptive awareness can make some tasks more difficult. Physiotherapists can provide activities to help improve function.
Range of movement is a term used to describe how much your child’s joint can move. Changes in your child’s range of movement can make it more difficult for them to move or do some activities. It can also cause pain. Physiotherapists can provide advice and encourage activities to help maintain range of movement.
Respiratory Care is being aware of how to keep the lungs healthy if they are affected by a neurological condition. Respiratory issues can vary a lot between children and each condition.
Breathing involves the respiratory muscles and chest bones. This includes the diaphragm (the big muscle under the lungs) and the muscles between the ribs (the intercostals) as well as the ribs and spine. There are some other muscles but it is these two muscle groups that are the main breathing muscles. With neurological conditions, these can be weak or can become weaker over time and affect the shape of the chest (see Scoliosis below).
Weak muscles can cause 'under breathing'. This is when our muscles cannot open our lungs fully to take in and breathe out enough air effectively. It is not that there is anything wrong with the lungs. The lungs still work well. But the muscles that control the amount of air that goes in and out of our lungs cannot do this as well as they used to.
The breathing muscles help us cough effectively. Weak muscles can result in an ineffective cough. This means secretions may remain stuck in the airways and block smaller airways. Not clearing secretions can result in chest infections.
Your doctor and physiotherapist can help to get everything moving again. (Click here for more information).
Scoliosis is a curvature of the spine and is common in many neurological disorders. Often in neurological conditions, the curvature progresses (increases) over time. This is due to muscle weakness and/or increased tone.
Signs of scoliosis include:
Once the curve gets to a certain stage it can cause discomfort. Postural care programmes can help you to know how to support your body throughout the day and night. This may help to reduce the progression of scoliosis. You can speak to your physiotherapist about this. Click here for more information on Postural Care.
If you have scoliosis you can be more at risk of chest infections. The straighter the spine the easier it is to look after your chest during chest infections.
Spinal fusion is a surgery that can help to straighten your back. Once the curve reaches a certain angle, we know that the curve will continue to get worse. It can make sitting more difficult and you may feel more uncomfortable. Spinal fusion is not appropriate for everyone. The decision for surgery requires specialist assessments and discussions with yourself and your family.
If you do need surgery then your postural needs will change after this. Your community team will discuss and advise on any changes in equipment.
You should discuss when you can go back to your usual activity with your spinal surgeon. Generally, moderate activity should be stopped until you have healed. Your surgeon will be able to give you more information on this. Everyone is different and it will depend on the level of surgery you have had and how quickly you heal.
Tone is a word used by Physiotherapists to describe how a muscle feels and reacts. Children with neurological conditions often have altered tone. This can impact their ability to move or manage certain activities. Your physiotherapist will work with you to understand tone. They can help manage your child’s tone through a range of techniques, such as positioning and handling. They may also recommend equipment and activities to help maximise your child's potential. Often, management with medication is also required. Your physiotherapist can refer your child to an appropriate service for this support.
