Rehab Cell

Physical Medicine and Rehabilitation

Stretches for Duchenne Muscular Dystrophy

Stretches for Duchenne Muscular Dystrophy

This selection of stretches is offered
as a guide only. They should not replace the program and advice given by the child’s primary therapist. Contractures develop because not all muscles around a joint will weaken at the same time. As a result of this, boys will develop
compensatory postures and ways of walking. The Tendo Achilles is often the first to
tighten. Gastrocnemius and soleus muscles insert into the Tendo Achilles. Stretches should be introduced early and incorporated into the daily routine. Active self stretching may be possible. The usual sport stretch against the wall is easy for most boys. The Gastrocnemius muscles can be stretched first. It is important the toes point forwards and are turned in a little as well. The heel is kept firmly on the floor. With the front leg bent,
the boy leans towards the wall until a stretch is felt in the back of the calf. A stretch for soleus can be done in this
position, but this time both knees are bent. The boy leans into the wall, bending the
back leg until a stretch is felt in the lower part of the calf muscle. His heels must remain on the floor. Passive self stretches can be done on a
rocker board against a wall. Positioning is extremely important. The feet should be slightly pigeon-toed to ensure the Tendo Achilles is being stretched. A self stretch for the hamstring group
can be incorporated into the daily floor activities when playing or reading. Note the knee should be straight and
slightly out to the side. Another popular hamstring stretch is done by lying on the floor in the doorway or against the post. The boy moves as close to the wall as
possible with his knees still slightly bent. He then straightens his knee against the
wall and holds this position keeping his hips on the floor. When performing manual stretches, the
important points to remember are: To position the child so he is well
supported and comfortable. Stabilize the joints which are not being
moved. The intensity of the stretch should be
submaximal and should never cause pain. Hold the stretch for as long as possible,
as a prolonged stretch permits the muscle spindle to habituate to the new length
and allows the lengthening reaction to occur. Over stretching is to be avoided,
as the muscle responds by contracting further. If the boy actively resists, a
lengthening contraction occurs which may cause further damage to the muscle
fibers. Manual Achilles tendon stretches should
be taught to the family very soon after diagnosis. The child lies on his back in a comfortable position. The operator cups his heel firmly in one
hand and rests the sole of the foot on her forearm. She stabilizes above the knee with the
other hand and exerts a downward pressure on it to keep it straight. She then pulls firmly on the heel while pushing the sole up until the stretch is felt in the calf. A small towel may be placed under the knee to prevent overextension. If resistance of the stretch is encountered, first bend the knee,
then stretch the heel cord, and while maintaining the stretch position,
straighten the knee. To stretch the hamstrings, the boy is again positioned comfortably on his back. The operator places the ankle of the leg
to be stretched on her shoulder and stabilizes the other leg by pressing
down on the knee. She also ensures that the moving leg is
kept straight. She then rocks forward using this
movement to perform the stretch. Stretches for the hip flexors in the early stage are best performed with the child lying prone. The operator cups the bent knee in her hand, allowing the ankle to rest on her arm. She places her other hand firmly on the
boys buttocks. She then pulls the leg up and inwards
towards the other leg, while exerting downwards pressure on the bottom. This maneuver will also stretch the
iliotibial band, which sometimes tightens in the early stage, especially when a wide base stance is adopted. When there is obvious tightening,
and stretching is difficult, it is often easier to perform the stretch with the child in side lying. In this method,
the operator stabilizes the pelvis with her knee and free hand. The top leg is taken back into extension. And with the knee extended, downward pressure is then exerted on the leg. In later stages, stretching the hip flexors may not be possible in prone, and an
alternative position in side lying may be more comfortable. Notice how the operator stabilizes the
lumbar spine with her knee. This localizes the stretch to the hip. Alternatively, the stretch can be
performed in the Thomas position. She makes sure that the opposite leg is
well flexed onto the abdomen to fixate the lumbar spine. When boys are no longer walking, it is
advisable to add a stretch for tibialis posterior which tightens when walking
ceases. Particular attention is paid to the upper limb when boys are no longer walking. Contractors are likely to occur in the
elbow flexors, forearm pronators, wrist flexors, and the long finger flexors.

19 thoughts on “Stretches for Duchenne Muscular Dystrophy

  1. Is there a medical reason why the boy is completely undressed apart from a pair of brief pants?  And why is he flat on the table?

  2. Hey do you have any assisted stretches for a quadriplegic?
    Also if you could take the time to check out my great friends story I would greatly appreciate it. He is a quadriplegic who suffers from duchenne muscular dystrophy and  recently he lost a part of his independence and needs a vehicle to be transported in. We are raising money to purchase a vehicle for him, all proceeds goes to his family any contribution would help if you cant contribute I understand, thank you for your time.

  3. je suis un père qui vien d'apprendre que mon fils qui vient d'avoir 5ans est atteint de dystrophie musculaires ,ça fais 3jrs suis abbatu ce qui arrive à mon petit ,cette vidéo me donne de l'espoir ,merci

  4. Мычышная дицтрофияга кандай дары беруге болады казакша былсеныздер аитасыздарма

  5. আমার ভাই এর এই রোগ টা আছে আগে হাটতে পারতো এখন হাটতে পারে না ২ থেকে ৩ বছর

  6. Hello
    My name is Emi. I'm 21 years old. I live in Albania. I suffer from duchenne muscular dystrophy. Recently, I have a lot of difficulty walking. Please help me with any information.

  7. There is a new drug they just started testing in the US this year, but it is already approved in Germany. We enrolled our little son (7 yo) only 3 months ago (in may) and are seeing some progress in walking. Moreover, it is free because it is a part of an FDA study. I'm just sending messages to folks in the community spreading the news. Find me on facebook Jessica Titoff

  8. No medicine can cure muscular dystrophy, but a visit to Planet Ayurveda changed all that. I saw a video of Dr. Vikram Chauhan curing a person on YouTube and wrote my friends details on their web site and got the reply very soon. He asked me to buy some packs like Balaswagandhadi Thailam and a few more and follow a diet chart seriously. She did just that and felt the symptoms fading within a fortnight and was fully well after about 2, 3 months. the doctor had asked her to follow this diet chart and this disease will never recur. It has been 8 years, so far so good!

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