Author: JJA
An 8-year old boy with spastic diplegic cerebral palsy was seen at the doctor?s office, complaining of ?not walking well? for the past 6 months. His mother had noticed he was not able to walk as far before taking a rest break and was having more trouble running in the backyard. He had last been seen a year ago and had missed an earlier follow-up visit.
Physical examination showed he had grown 4 inches in the previous year and had significantly tighter hamstrings than had been noted the year before. When he walked, his knees bent and he crouched over much more than he had before.
The doctor asked about his stretching program (?we?ve gotten away from that recently?) and his nighttime splint wear (?we stopped using that when it rubbed on his skin and gave him a sore?). When asked what position the boy preferred to sleep in, the mother replied, ?He likes to curl up in a ball?.
The doctor emphasized the importance of stretching the boy?s muscles on a regular basis and referred the family to physical therapy to review their range of motion exercises. He gave them a prescription for a new set of night time knee extension splints to wear while he was sleeping and informed them that if the hamstring contractures worsened, they might have to see an orthopedic surgeon to get muscle and tendon lengthening surgery.
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