SPMLs & EtOH

Abnormal reflex spread typically follows patterned forms. We know where to first look. Why do SPML on the right leg when it is the left hip with the abnormal x-ray finding that got us here? Bullet here was fired from over there. Also denervated muscle units that undergo fibrosis run the whole muscle/tendon length. But they are nasty to get at, in a minimal way, until they surface passing through the myofascial region, where the fibers spread out in a flat plane. Go there. It isn’t surgery to the myofascia or of the myofascia , but a convenient location to find and divide those bands that are making trouble as passing through. These dead bands constrain muscle elongation. Dividing these scar-like bands allows active useful muscle range to be what it should be. Muscle might seem weak if the contracture has been taking the peak load. But, with returned use, the muscle gets to do its own work and regains power.

While we are talking about dead muscle units that degenerate in fibrosis, let’s discuss the ‘nerve block’ agents and why we use ethanol. A closer look at that perfect wave: *Trying to make-do for small blue kids with cardiac related CP, *total frustration with experiments testing range of motion restriction not looking anything like CP, *some other serious complicating disorders with high risks etc. *a make-do operation does better than normal open incision surgery.

All that and then a Hollywood kid whose good operation made him slowly worse. A normally slow muscle got healed to a fast tendon. You have to rethink all of it and rethink past conclusions with new eyes.