What is Erb’s palsy?
Erb’s Palsy is damage to a network of nerves in the shoulder, called the brachial plexus, and commonly occurs as a result of a traumatic birth. Usually Erb’s palsy occurs when the birth mother has a small pelvis, the baby is significantly big, or both.
What are the symptoms of Erb’s palsy?
Erb’s palsy causes weakness and paralysis, or partial paralysis of the upper limb. Any part of the limb can be affected from the shoulder all the way to the fingers.
Because babies cannot follow instructions, we have to be super creative with our physiotherapy intervention for these superbabies! We use lots of distractions, games, singing, peek a boo and more to stimulate their affected joints. Baby Ella enjoyed our special sensory box filled with different textures, to explore with her right arm!
How can physiotherapy help?
Physiotherapy in Erb’s palsy aims to increase sensation, activate and strengthen muscles. We use a variety of imaginative techniques to get your baby aware of and moving their arm!
Babies can be difficult to assess, so we use lots of fun activities to find out exactly where your baby’s arm is affected. Some of this is through questions about their activities and movements for their parents, some is observation and the rest is play! We will find out where your baby has sensation, where they have active muscles, where they have weak muscles, and if and where they are compensating with other muscles and movements.
When we have established where and how your baby’s arm is affected, we will work on improving sensation and awareness of the affected limb. Sometimes, babies can neglect or ‘forget’ this arm exists, which leads to not using the arm and further weakness. We build up their awareness of the limb through positioning and tactile facilitation. As the baby’s brain and nervous system is constantly building new connections, we make the most of this through facilitating and stimulating these pathways.
When sensation is established, we work on activating the muscle. We will tailor toys and objects to make therapy realistic, achievable and fun. We carry out all tasks little and often, with breaks and time for cuddles with parents!
After activation is complete, we can work on strengthening and building up those muscles affected through play and functional activities. All of our techniques are demonstrated and taught to parents and care givers, with a programme and goals regularly updated.
Range of movement
Sometimes, if a joint has not been moved for some time, it can become stiff. We will regularly measure the joint’s flexibility and compare it over time, to make sure flexibility it maintained. If any signs of stiffness occur, we tailor intervention to the child’s needs, and measure the outcome. If conservative intervention is not enough, we liaise with professionals such as paediatricians and or orthopaedic surgeons for medical and surgical involvement.
There are lots of orthotic devices available to aid muscle activation and maintain range of movement. We work closely with occupational therapists and orthotists and are able to advise and recommend these if required.
Function and gross motor skills
Sometimes the affected joint can alter your baby’s other gross motor skills, such as crawling and standing with support. We use a holistic approach and include gross motor skills practice in all of our sessions and programmes.
No matter how much time we get the pleasure of spending with your superbaby, we know that parents have the advantage having them night and day! Therefore education is at the forefront of all we do with our Erb’s palsy infants, and we make sure that parents are capable and competent at carrying out all programmes and positions.
If you are looking for a superbaby physio for Erb’s palsy, contact us here!