Saturday, December 20, 2008

Weak Muscles and Compensatory Movements

Have you ever witnessed an adult with arthritic hips or knees that walk with a gimp, favors to one side or maybe walks in an unusual way? Do you understand why this occurs? It is because they are using accessory muscles in place of muscles that are normally used for that movement. Granted these people are compensating because of pain but the concept also applies to weak muscles. And this is a problem that children with Down syndrome face. While it is true that our kids will eventually learn to sit up, walk, run, etc., it is important that they learn to use the correct muscles for that particular exercise. You see, our bodies were made to operate efficiently whether it be to walk, run, ride a bicycle or whatever we do. For a child that has weakness of a particular muscle, he/she learns to perform the exercise using different muscles and therefore bypass having to use the weak ones.

While it is a temptation to allow the learned movements as wrong as they may be for the sake of meeting the milestone, we must resist doing this. While it is important to give praise for learning a new skill, it is also important to teach the correct pattern of the particular skill.

A few compensatory movements to watch for with children with Down syndrome are standing or walking with their feet and hips pointed toward the outside. This is called rotating the hips externally. Another compensatory movement is sitting with the lower back bowed outward. Having stiff knees is another way that these children compensate for weakness.

All of us as parents desire for our kids to meet milestones and are very happy when they are accomplished. But at the same time, we need to be aware of the correct way to move and the correct muscles that are used to produce that movement. This is where a trained Physical Therapist can help. They can assist the child in learning to use the correct muscle/s. After all, I think that we would all rather have our children learn to perform the movement in the correct way even if it takes longer vs. learning the movement incorrectly sooner. Learning to use the correct muscles for the exercise will benefit the child throughout life.

So I would encourage you to ask questions of your Therapist so that you can look for these movements during non-therapy times. One of the most difficult things to overcome is a child who has already built a habit of compensating.


Cheryl said...

Could you tell me if it would be ok to use an Ergo baby carrier for my baby.I used it with my last child and he loved it,I carried him around in it on my back while I did house work and when we went on outings.I'm just not sure if the positioning would be ok for a baby with DS because of the legs being apart,would this be ok for their hips? Here is a link

I was planning on taking my carrier with me to show the therapist at Ruby's appoinment next month.

JaybirdNWA said...

Ruby's Mom, I should probably refer that question to Ruby's PT since he knows your child and I cannot see the carrier itself. I realize that it is unrealistic to keep our kids out of these positions all the time; however, I try to limit John's use of toys, positions that promote bad patterns.