Spasticity is not a thing separate from the rest of the body. Spasticity is a response to the experience of the body, brain, nervous system, and even metabolism and digestion. It can cause tissue and bony changes over time, but there is a cause and effect relationship that creates the experience of spasticity. It can be reflexive tightening in response to balance and safety issues, or high tone caused be the neurochemistry in the brain being pre-disposed to exciting of the nerves.
Some organizing part of the person has defaulted to the spastic holding pattern. It can be driven by connective tissue, motor cortex, brain stem. A permanent way to resolve spasticity would have to go to the source. If someone has lived with spasticity there might be tissue changes involved that are created over time. Learning has definitely revolved around the presence of spasticity.
The goal of botox, afo’s, and other compensatory supports is to create an environment for a different more useful, comfortable, and typical learning to occur. SPML creates that window of opportunity to learn without the spasticity. One of the reasons that it is more successful than botox is that the window is longer and the doctors have the skill to be extremely precise in the changes they make.
In ABM practitioners’ experience with botox, the brain didn’t make a change but rather continued to try to produce the spastic holding. When the botox wore off there were new connections plus the old connections and the spasticity was worse. In the case of SPML we are seeing long term or permanent change. Either the spasticity does not come back, or the child learns a different way and does not default to the spastic pattern.
I can’t speak for SDR because I have no experience with it personally or with my clients. I just know that once someone has surgery, whether in their eyes, limbs, spine, it is much more difficult and sometimes impossible for an ABM practitioner to help them learn in that area. The spine is a very foundational part of our structure and learning there is crucial. This is a major reason why we hope that children will not need surgery, and why the minimal impact of SPML is so important.
Surgery is not the end goal – learning to function optimally is. After surgery comes the learning.
NOTE: Here is a link to a parent’s blog post about her son’s SPML surgery. The shares all of the research she did before deciding on this procedure.