When a Child Wants to Move But Can�t

By John Upledger, DO, OMM
May 29, 2009

When a Child Wants to Move But Can�t

By John Upledger, DO, OMM
May 29, 2009

Editor's note: Dr. Upledger has asked Tad Wanveer to contribute this month's column. Tad has been the guest author for several previous "CranioSacrally Speaking" columns.

Cerebral palsy (CP) is a group of movement and posture challenges that stem from the abnormal development of, or damage to, the motor-control areas of the brain. For more than 20 years, CranioSacral Therapy (CST) has been used to enhance brain function and help those with CP move with greater ease and balance. It can help them reach their highest potential by balancing motion, facilitating brain reorganization and elevating the body's natural self-corrective processes.

The Puzzling Causes of CP

The types of brain injuries that cause CP are not fully understood. The damage seems to primarily stem from congenital problems due to infection, toxicity, genetic disorders, trauma and complications of premature birth.

A common cause is perinatal (five months before through one month after birth) asphyxia, which is when the brain is subjected to hypoxia (deprived of adequate oxygen supply); ischemia (restriction of blood supply); and hypercarbia (abnormally high levels of carbon dioxide in the blood).

Within the brain, consequences of these conditions can include metabolic changes and edema, leading to cell gliosis (the formation of a dense, fibrous network of glial cells in the area of damage), cyst formation and/or fluid congestion.

Brain damage with CP is non-progressive, though motor problems can change. The severity of CP ranges from mild to severe, depending on the amount of brain damage. Some children might experience difficulty with movement and challenges with one or more of these issues: gait, swallowing, chewing, balance, posture, sight, hearing, speech, breathing and sensory processing. Seizure activity also is present in many children with CP.

CP Types and Classifications

There are four types of CP, all named for a type of movement disturbance: spastic, athetoid, ataxic and mixed.

Spastic CP is the most common type, affecting 70 percent to 80 percent of all cases. Characterized by hypertonia (abnormal muscle tightness, rigidity and reduced ability to stretch), it's due to injury to the pyramidal system. This is the network of motor nerves extending from the brain to various spinal cord levels, particularly the cortex and internal capsule. The injury disturbs the brain's ability to modulate motor-neuron activity, and it leads to varying degrees of continuous muscle contraction, also known as elevated deep tendon reflex.

Athetoid CP is characterized by hypotonia (abnormally low muscle tone and strength), or mixed muscle tone (muscles that are sometimes hypotonic and sometimes hypertonic), and abnormal involuntary movements. Athetoid CP often is due to a disturbance of the extrapyramidal system. This network of brain neurons modulates movement and maintains muscle tone and body stability, especially in the basal ganglia.

Ataxic CP is characterized by difficulty with movement coordination. It's often due to damage of the cerebellum, which fine-tunes and controls the timing of movement. Ataxic CP can affect any part of the motor system, including the extremities, torso and speech.

Mixed CP is characterized by a combination of the aforementioned forms. Various parts of the body are affected by CP. They are classified as: hemiplegia (affecting one side of the body); diplegia (affecting the whole body, lower extremities more than upper extremities); or quadriplegia (affecting the whole body, lower and upper extremities equally).

CST Enhances the Child's Natural Body Processes

CranioSacral Therapy can assist the CP client in numerous ways. It can decrease brain congestion, hypertonicity or hypotonicity, and enhance motor-system neurological signaling.

Gentle cranial mobilization techniques can reduce brain congestion by helping membrane layers around the brain move with more efficiency and ease. The membrane motion can travel throughout the brain to enhance tissue and fluid movement, and decrease intracellular congestion, abnormal pressure on the cells and gliosis. It also can increase the availability of nutrients to the cells. All this maximizes the self-corrective potential of brain cells, creating an optimal environment for neuroplasticity - the ability of the brain to reorganize itself by forming new neural connections.

CST helps decrease hypertonicity and hypotonicity through techniques like the delicate tractioning of muscle and fascia, following and assisting body parts into positions of release, directing energy to decrease or increase tone and facilitating tissue movement in synchrony with the craniosacral rhythm. The rhythm is created by the motion of body tissue in response to the filling and emptying of cerebrospinal fluid within the craniosacral system.

All this helps muscles by increasing vascular flow, flushing toxins, increasing muscle fiber length or strength, and decreasing fascial strain. As muscle correction occurs, different sensory signals are sent from the muscles to the spinal cord and on to the brain, where they can encourage it to reorganize existing sensory areas that can stimulate improvement or help form new motor areas and pathways.

CST can enhance motor system neurological signaling through the application of the "direction of energy" technique. This helps neurons and nerve pathways use and integrate neurological information with optimal efficiency by boosting the energy available for cells to work, move and effect change.

Also, the delicate mobilization of the craniosacral system can decrease spinal cord irritation that might have occurred due to overloaded, overactive or underactive muscle reflexes by facilitating the movement of fluid and tissue around and within the spinal cord.

Through all of these processes, CranioSacral Therapy gently facilitates the self-corrective mechanisms through techniques that improve the balanced motion of cells, tissue, fluids and systems. It supports the remarkable plasticity of the nervous system and the extraordinary potential for compensation within the whole body. The result often is newfound movement, balance, expression and freedom for the child with CP.