Pain management and muscle strength

Every day, we have to stretch Namine’s feet. Not only do her ankles need to be pushed back (they do not normally rest at a ninety degree angle), but her toes, which tend to curl forward, need to be pushed back as well. I’m not sure how much discomfort there is in the stretching, and…

Every day, we have to stretch Namine’s feet. Not only do her ankles need to be pushed back (they do not normally rest at a ninety degree angle), but her toes, which tend to curl forward, need to be pushed back as well. I’m not sure how much discomfort there is in the stretching, and how it might differentiate from actual pain. I do know that there is apprehension and mental stress as well, though. All of this contributes to a very unhappy Namine during her foot stretches, as well as adjusting the casts after the stretches are done.

I don’t know why it didn’t occur to me sooner. When I was in martial arts, one of the things they taught was pain management. Through meditation – when you get down to it, basically just controlled breathing and concentration – it’s possible to push through and past pain. It doesn’t work against migraines so much, but it works nicely against purely physical pain (of which migraines are not, anyway).

Over the weekend, Namine had a total meltdown-level freakout over having her feet stretched. Nothing I said or did helped, not even picking her up and rocking with her. Unable to think of anything else, I leaned over and told her we were just going to focus on breathing. “Breathe in through your nose, and out through your mouth,” I said, getting so close that my face was all she could see. “Just breathe, Namine. In… out. In… out.” And she calmed down a lot faster than she ever had before.

Did I think Namine was too little, too young to understand pain management? That she wouldn’t get it? I don’t know. But I should know better by now. Every day, Namine continues to surprise me; she does something to prove her progress and improvement in nearly every aspect. The speed at which she got the hang of breathing to relax herself is nothing short of amazing, I think. Now, before each foot stretch, I tell her what we’re going to do. She usually doesn’t cry; she will get a worried look on her face, and her brow crinkles up. But I tell her that we’re going to get through this together; I tell her that we’re going to do our breathing exercises. In… out. In… out. After about a half dozen times of slow, deliberate breathing, I stretch her right foot (because it is the more painful of the two, I want to get it out of the way first), then her left. Namine still cries during the stretching, but as soon as we’re done, she’ll tell me, “aw-UNN!” And we’ll do a dozen or so more breathing exercises. Even just a minute later, she’s calm again. She was never over it that quickly before.

The reason for her foot stretches, of course, is to prevent the need for casts again. Namine won’t receive her new, official AFOs until sometime after Christmas, perhaps even after the new year. The half-cast makeshift braces weren’t doing their thing, so they at the hospital created these plastic braces, held in place with velcro straps. Even so, Namine’s feet curl quite a bit on their own. We’ve been told that Namine has little to no control over this, that it’s just the tension and natural shape of her feet fighting against their new, unnatural form. (Natural to you and me, but not her. We’re fighting the laws of physics here, after all.)

But in having lots of hands-on (or feet-on, from Namine’s point of view, if you will) experience with taking off the braces, stretching her feet, and putting the braces back on, we can tell you this much: there is no way, no way, that Namine has no – or very little – strength in her feet. When we do the stretches and put the braces on, Namine fights us. I don’t just mean she whines, cries, or screams. I mean she pushes against us with her legs, which, while small and thin, still have a wirey strength all their own. She pushes her feet down and actively curls her toes, especially in her right foot. This is not some arbitrary thing she cannot control. She is doing this, herself.

And while she is being counter-productive – after all, we need her feet straight and her ankles at a ninety degree angle – such strength and will is good. It is excellent, and not unexpected. Namine has proven time and again to be strong, determined, and resilient. She’ll need those things for the road that lays ahead of her. It will be difficult, but I have no doubt in my mind, no doubt whatsoever, that she will prevail.

One response

  1. She doesn’t yet have the benefit of being able to stand and press her feet flat against the floor, so I can see how they would want to go back to the curled position.

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