Okay, so these pictures have nothing to do with stretching, but they're just cute. And, as you will see...I have no pictures to share of stretching. So, these will have to do!
Onto physical therapy....in addition to strengthening Lily's core, we have been simultaneously working on stretching her hip muscles. After all, if her leg will not point toward the ground, she can't walk! So, truly, that has been the foremost goal.
We'd been working on this ourselves even before seeing the physical therapist. Thankfully, what we'd felt led to do was on the right track!
Here's how we've been getting her a good stretch:
During diaper changes we have been pulling her leg down to its fullest stretch and holding it for about a minute. I do my best to try to distract her by blowing raspberries (or zerberts as I grew up calling them) on her belly, giving her kisses, or singing her a song. Sometimes just the presence of her sisters in the room is enough to distract her long enough to get a good stretch. I wish I could say that I remember to do this every diaper change, but I don't. Seems like it's been okay to forget once and a while without it negatively impacting the results.
Secondly, we stretch her leg downward as she plays. While she sits in her U-seat, on the ball, in our laps, or as she crawls we have been pushing her leg downward (or pulling it backward in the crawling position). Most of the time she doesn't even know we are doing this so she tolerates it quite well. Now, after a couple of months of doing this, she holds her leg at a 90 degree angle from her body while sitting which is a major improvement from when we first got her! We don't have to hold her leg down anymore when she sits because her leg now stays down on its own.
Our PT believes that we need to be stretching for as long and as often as possible. Before we even got home from China, I was wondering if she would need a night brace of some sort that would hold her leg down while she slept (similar to a club foot brace), thus making that sleeping time productive...and eliminating the obstacle of trying to solicit the cooperation of a one-year-old! The orthopedist didn't like the idea of a hard brace. Our PT came up with the idea of wrapping her pelvis and upper thighs in an Ace bandage while she sleeps, so this is what we've been doing. She has occasionally wiggled out of it when I get her up, but rarely. And it does give her a good stretch.
Finally, our PT has a nifty way of measuring progress...which is what I need because it is so hard for me to discern those slight, yet progressive changes children go through (like: when did Lily's hair get so long? when did Emma get so tall? etc, etc.). It is called a Goniometer and it measures the angle of the joint. It works by placing one end along Lily's torso, the other along her leg, and the pivot at her hip joint and then stretching her leg as far as it will go. The pivot has an arrow that shows the extension measured in degrees. Our initial goal is to get to 180 degrees (a straight line for those of you who haven't been in Geometry in a while!), but eventually we would love to see it go beyond that because her leg will have to be able to extend behind her body in order for her to walk.
I had been wondering if we won't see an improvement in her hip's extension after she has the prosthetic because it seemed to me that the weight of the prosthetic combined with wearing it for long stretches during the day would increase her stretch time, thus encouraging even more muscle lengthening in the joint. Her PT and prosthetist both think that this will be the case. As the prosthetist said before Christmas...there just isn't enough weight in that little leg to hold it down and there won't be without the prosthetic.
So, that is the stretching we've been doing in a nutshell.
One thing I feel I should mention is that our PT seems very pleased with her progress which is encouraging to me because there have been many days where I have put my head on my pillow and felt like I should have/could have done way more therapy than we did. There were naps when I forgot to put the Ace bandage on, days where I forgot the Ball, times when busyness crowded out opportunities. But, God has been gracious and has used what we did do to stretch those muscles...I picture Him working in those nights, touching her muscles and causing them to grow as we have so often petitioned Him to do. God is good...all the time.
So...let's go stretch!