I had been planning to write something on the subject of spasticity, but it felt too soon, too arrogant when I have still been looking for answers. But this week has been quite overwhelming, and I have learnt a few salient facts.In the last 6 months I have treated (myself and) clients with tool assisted massage. It’s not just for spasticity, of course: it releases fascia, allowing for a wider range of movement and helping to clear movement dysfunction. I have used it with satisfying success with a wide range of clients and a broad spectrum of dysfunction. In a body without spasticity, the results are often outstanding and generally predictable. Throw spasticity into the equation and results are more uneven and can produce complications, but ultimately there can still be progress and recovery.
I have spasticity in both feet: in one it stems from a stroke I suffered in 2007, in the other foot it set in after contracting the mumps virus last year. The spasticity presents very differently in each. I have only intermittent feeling in my right side, and when it returns it is usually in an overwhelming wave of pain. I have full feeling in my left side, and so fully responsive pain receptors to do their job in lockdown, sending off alarm signals to my brain that something is seriously wrong. Both feet claw and cause locking at front foot and mid foot, in a rigid arch. This can also cause lockdown in flexion at the knee, and intense pain at the heel and calf muscles.
Advice from the experts
In the past I have found in some clients (and myself) that it has been very tough to iron out joint disturbance – clearing one dysfunction seemed on occasions to cause another – over and over. However, it does apply to all my clients that the trainer/coach needs to break down the fascia and restructure the muscles to improve movement patterns. Without this intervention, the muscles can develop unnatural patterns of contractions, and the fascia will actually reinforce any misalignment and – above all – muscular imbalance.
I chatted with Lucy Allitt (IAMTools) about this difficulty in clearing a dysfunction in stroke clients. Lucy has a background in Massage Therapy, FunctionalTherapy, Sacro-cranial Therapy and FAKTR. Lucy advised holding pressure over specific points, as she had used this technique successfully to bring about positive change.
In my own case, initially any tool assisted massage would ease the spasticity and allow the foot to open up. That made for a brilliant summer, when the clawing was very temporary and progress began to feel inevitable almost. My gratitude to Andy Driscoll at FASTER Health & Fitness who taught me how to use the technique, and who had seen me through a few blips already. Thanks too are due to Malcolm Innes of IAMTools. Not sure where I’d be without my tool! Throughout the summer I worked on my own dwindling spasticity, regained a decent gait and running style, knocked 16 minutes off my usual run time, and participated in two 10k runs for the hell of it. It was one heck of a summer.
However, this autumn the situation is a little different. The initial release at the foot has recently been sometimes followed by another lockdown somewhere else along the kinetic chain. Another weak spot vulnerable to attack. In my case, the other foot. I now find myself with one foot after the other locking up, causing me new and frustrating mobility issues, and a not insignificant amount of pain. Understandably, I have been looking for new solutions. For one of my clients too, a guy with cerebral palsy, the palpable relief we both enjoyed over the summer has been curtailed, and now if I work on his feet, he suffers a severe lockdown in his weaker arm.
I was fortunate enough to be a very willing guinea pig for the FTE guys at FASTER earlier this month. This group of guys really know their stuff when it comes to movement dysfunction. At a time when my gait was falling to pieces, after yet another viral attack on my muscle system, turning up at their Baker Street studio was a bit like winning the lottery (well, I did say a bit!) and I walked out of there with a pretty functional gait. Thanks to John Hardy, Andy Driscoll, Kevin Hubble and the guys. Awesome stuff.
Pressure and Movement
My usual daily routine all summer was to wake up early and start scraping my feet, to give myself the best chance of enjoying an easy gait and some sensation in the weak foot that day. Because I was working independently and on both feet, I tended to work sitting down. On other clients without too many balance issues, after a brief static period, I prefer to scrape while they move. It produces better results and encourages the client to acknowledge the movement as part of the solution. However, with my chair bound clients, scraping while they move is a little trickier, so I had inched towards treatment that demanded less of them. This proves to have been a poor decision. Movement seems to be key to establishing the new range, and yet not causing a chain reaction of new spastic response. So my regime is constantly changing as I experiment and learn. I learn constantly too from my colleagues Paul Stemp ( a Kinetic Chain Assessment specialist) and James Skinner, another FASTER diploma student. They have both been tirelessly supportive – after all, it must be a bit tedious sometimes to hear about yet more spasticity or yet another half-formed theory on fascia!
I have also been experimenting with applying pressure on the spastic foot. Certain trigger points can help release the spasticity, but again only when movement is included in the treatment. The two feet respond to different pressure points, and there is still a lot of trial and error to go through before I have mapped out how best to respond to my spastic lockdowns, but I am feeling hopeful again.
The medics tell me that my stroke was as a result of a virus that attacked my heart muscles. The virus didnt then obediently go away, but is still within me, and generously recurs every so often. This in turn is because of a failure of my immune system. Hence mumps, and a host of minor infections. I am still seeking answers about just how large a part nutrition plays in recovery from an immune system breakdown. I already eat very well, and avoid wheat, dairy, caffeine and alcohol. I take Vit C, fish oils, Selenium, Magnesium, Zinc, Vit D. However it would seem that a generic “optimum” nutrition of vegetables and good quality meat and fish, fruit, nuts and seeds, partnered with a few supplements is only a good start. A compromised immune system needs a more specific and tailored nutritional response. Without that, you can be valiantly taking supplements in this or that mineral or vitamin, and never hitting the spot. So now I can see I need to pursue blood tests and wait for news of what my body is lacking, still hoping to complete the jigsaw.
Spasticity was not covered in my Personal Training or Exercise Referral courses. The response I met in the early days of searching for solutions was pretty negative. Osteopaths and Physios seemed wary of tackling it. This began to make me feel that this was something I simply had to live with. However, I now have a few techniques to use, and am seeing clients who want that same relief I have experienced countless times when I manage to release a locked limb, and re-gain control of it. My CP client and I have had a setback, but neither of us want to give up. Fascia is amazing, barely understood and worth studying in detail. The FASTER diploma courses give an insight into the subject, (and the latest FASTER course specifically on fascia sounds brilliant) and I hope we will continue to discover more about the fascia web beneath our skin.