Some time ago, I wrote an article about training Foot Drop. After hearing back from the physical therapist that was handling that case and some other feedback, it further cemented the notion that it is total BS to thing that folks with dominant limitations shouldn’t be training as hard as the toughest powerlifter or Marine. Training is Rehab. Where have we heard that before?
This is a recount of a similar exchange with a trainer talking about working with a client that is dealing with Spastic Diplegia.
Indeed Spastic Diplegia can come in a lot of different shapes and sizes. Some of them can be quite damning and dominant. More mild cases are less impactful.
Do not rest in searching and establishing the keyhole that you respond to in terms of neurological training or reorganization. Your condition may be chipped away at, or it may not. But I do believe there are keyholes into all of these conditions; you just have to find the right person with the right magic wand to help you.
Beyond the focused neurological restoration attempts, the rules for training don’t change. Think technical proficiency in terms of the Joint by Joint. Does it meet the qualifications of the Joint by Joint? Does tone affect the quality of the movement to unacceptable levels? The tone will guide the the biomechanics. Your joints and discs won’t care about your tone; they will react accordingly. Don’t put them into positions to fail. Once you find the quality of a pattern, drive the hell out of it. You may or may not have the variability in other patterns. That is when you revert back to 1) to drive 2).
You can very much run in parallel in an improvement conditioning mode and a restorative rehabilitation mode.
I would work this individual just like any other through an FMS, and if you had 2’s in the Deep Squat, I would start with a Goblet Squat progression.
2 in the Hurdle Step would get you to Step Up Progressions.
2 in the ILL would start with Split Squats.
2 in the ASLR would get you to Rack Pulls, DLs, SLDLs, and swings.
2 in SM get you to Presses.
1’s get you into corrective exercises. If these are the right challenges for this person, trust the system and see what you get. At worst, you have an increased catalog to go along with compensated terminal movements like pressing with opposite arm support on the walker or crutch and assisted squats.
Whether you or someone can or can’t help the spastic diplegia, I would develop your conditioning program based on how you move overall.
I would fraction my time for conditioning exploiting what you are good at, and part of the time attempting to restore what you are not good at also honoring the time-cost analysis.
There is nothing specific about how an individual’s movement is affected by spastic diplegia, so there is no specific training or rehab regimen. Just train them within the confines of how you would train anybody else.