Written by Robyn Ingham – Independent Paediatric Physiotherapist (Dominics Physio since he was 8 Months old)
Why does Dominic need Hydrotherapy and how often?
Sarah and Gary asked me to jot down a few health reasons why it is so important for Dominic to get regular exercise and why hydrotherapy is the best option for him. I tried to do this but have realised I can’t just “jot down a few reasons” but that I have to explain the full impact that Dominic’s cerebral palsy has on him and what could happen if he doesn’t get the daily (yes DAILY!!) exercise. To help me not to waffle (me, never!) I’m going to do this under 3 sub-headings: 1. Why Daily? 2. Why Exercise? and 3. Why Hydrotherapy?
- Why Daily?
We all exercise our bodies daily… yes we do. Just getting out of bed and walking to put the kettle on stretches out our spine and legs, awakens and regenerates our muscle fibres, re-establishes our balance, ignites our core and re-aligns all our joints. Think how many times you move from sitting to standing each day, how many steps you take going about your daily routine, you bend, you reach, and you change direction. Each of these actions keep our muscles toned, our joints lubricated and mobile and our bodies balanced. Dominic is unable to do any of these actions independently and so changing position, realigning his joints, using his muscles etc. are all planned elements of his daily timetable.
Without these daily movements we would all be at risk of all sorts of health issues and so Dominic has a very real risk of developing joint contractures (joints becoming stuck solid), spinal scoliosis (twist or bend of his spine), muscle shortening and weakness as well as sitting in one position all day impacts hugely on his cardio-vascular (heart and lungs) system and his digestive systems. Any of these complications would lead to pain, discomfort, ill-health, possible surgery and generally a poor quality of life.
- Why Exercise?
Ok so we all know we are supposed to exercise regularly (over and above general living as mentioned above), but why?
The obvious reason is so we don’t become overweight. For Dominic this is also true, a continuous battle of calorie in vs calorie burn is a way of life most of us can identify with but when you battle to burn any calorie this is harder. Being overweight for Dominic will impact hugely on his life, it would impact directly on what he is able to do for himself, it would effects his comfort in his wheelchair, it can give him a lot of joint pain, it can affect his heart and lung function and it can therefore directly affect his quality of life.
Bone health and muscle strength are 2 other reasons to exercise, if we never take weight through our bones and joints they become less dense and we become at serious risk of bone breaks. For Dominic his spine needs to be protected as we all know the impact on our backs if we sit too long, Exercise will help Dom to maintain strength in his body so he is able to hold his spine strong and straight.
Exercise helps keep our digestive system healthy as the movement of food through our bodies happens by muscles working so again sitting for too long gives us a sluggish metabolism.
Cardiovascular fitness – healthy heart and lungs depend on regular workouts as our heart is a muscle too and so if it doesn’t “workout” it can become weak.
Psychological impact – a tough one…but yes exercise does make us feel better and especially for children “running around” is part of their lives and so for Dom to be like his peers he needs to have opportunities to partake in active games.
- Why Hydrotherapy?
The true answer is that it is never only 1 type of exercise. Dominic needs to have a lot of variety in his exercise including using a standing frame to get weight bearing, his bike, his walker and floor exercise BUT all of these modalities are very difficult for him and his parents to commit to daily. Biking and his walker are weather dependent (especially as both these pieces of equipment are too big to use indoors) so they are limited to dry days. Both activities also involve Dom being lifted by 2 adults up onto his bike/walker which as he gets bigger may not be possible.
Hydrotherapy in a proper hydrotherapy pool enables Dominic to have the body movement and freedom that we all take for granted. In the water he can get strength training, weight bearing, cardiovascular workout, calorie-burn, full joint range and most important of all “FUN EXERCISE”. For Dominic to have the opportunity to use a hydrotherapy pool 5-7 times a week would mean he can actively influence how some of the aspects of his cerebral palsy will affect him as he grows into a teenager and young man and even into adulthood.