Day 157 - Jack of all Trades, Master of None

Physio with James was interesting today.

In an effort to keep cleo's interest (James' words) he continually comes up with new exercises and new movements for her to try. Each one is aimed at enabling her to "recruit" specific muscles. However quantity (in terms of the number of different exercises) is not always the answer, quality can be just as important. Now, we have accepted some time ago that cleo will likely never get much use back in her arm and hand, and certainly nothing like the dexterity which we all take for granted. So, in conversation with James today we all agreed that maybe a good way to go forward from here is to look at a small number of very specific movements for cleo to work on, one at a time. This may consist of several short sessions daily simply trying to turn her hand from palm down to palm upwards. The idea being that these specific movements, once better control has been achieved through many repetitions (creating pathways) they might then be combines in twos and threes to create a useful and co-ordinated movement that might be utilised to perform key tasks which presently cleo is not able to do.

In all the movements that cleo tries with her arm and hand, at present the overriding muscle that fires up is the biceps (the large muscle at the front of the upper arm). Getting control is about not just making the muscles fire but being able to relax them as well. There are other muscles that need to work in conjunction with the biceps which presently, although they are working slightly are being rather "overwhelmed" by the strength in that one specific muscle. So, cleo has to learn to relax muscles too. James has suggested that there might be several ways to do this: breath control, concentration, stimulating another muscle group in the body, which only cleo can find out, but at least this will enable the development of control. To start with the relaxation might take a long time, and much concentration, but, do it enough times and it starts to become second nature, as with anything.

James is going to work on some specific exercises based on these key movements and will run over these next week. We think that it might only be 4 or 5 specifics that can be practised at home over and over again. Get those right however, and then start to combine them, and in time you may just get some meaningful, and more to the point, controlled movement.

In one sense this has been borne out by cleos improvements in very specific things which she has done lots of in the last three months; example: getting in and out of the car. When she first came home she could hardly do this at all, now, I help her to the car and once there she can get herself in and shut the door. Even the way she walks now, is far improved although not perfect by any means, but all these improvements have come about through repetition and practise, time and time again.

Look at it like this; do too many different exercises (quantity) giving a varied experience but achieve no real quality in any of them and its a little like being Jack of all trades, and Master of none.

Cleo has to specialise, and gain a quality in those few key muscle movements, once that is done we can move on from there. We have to understand that this is not a short term thing, it will not go away, and it's only through sheer hard work and blood sweat and tears (and we both know that there will be tears) that we might look back in 6 months or a year or 5 years and say "Wow, what an improvement!"

I truly hope we can.