Note from F. Hand Masseur on their last week. F. is giving Chris 30 minute hand massage daily. I feel this is the best money spent as Chris’ hands are in such bad shape and need of improvements:

“Monday – very difficult wasn’t relaxed
Tuesday – slightly better than yesterday
Wednesday – good result now involving foam
Thursday – managed deep massage
Friday – very tired after physio so got good result

On Monday I had to do massage later and I found this not a good as the mornings as he wasn’t relaxed. On Tuesday Northwick Park team was here in the morning so again I did him later. I again found mornings are the best time to massage Chris as he is still a bit sleepy and his medication is at his best. I managed to get a wonderful smile and a laugh every day so far he is beginning o like me. (I hope).”

Also a more extensive report as follows:

“Hi Koo,

I had a discussion with LW, who is a PT. I discussed that I was concerned about Chris’ left arms as it was very tight crushing his chest. We came up with the idea of wrapping his arms in 2 inch foam ad placing foam in between the arm and his chest and bandaging this foam tightly to his arm.

The idea of this was continuous sensory stimulation with continuous pressure applied to the muscle facilitating relaxation, stimuli through the skin therefore forsilitating muscular relaxation. This helped him not to pull his arm in more while massaging right hand. I measured the left arm before and after the treatment; it was found that the arm relaxed 5 cm’s which although doesn’t sound a lot this was a fantastic result. The elbow it’s self internally rotates rather than extend, this means the arm comes down a little but moves over to the right shoulder. It encourages pro-nation of his forearm and the bicep was relaxed as demonstrated by gaining more of his great pro nation of his forearm.

The purpose of wrapping was to ensure continuous sensory stimulation throughout the limb. The constant pressure to the muscles facilitates relaxation as does constant stimuli through the skin. I am encouraged that this method is promoting relaxation of his bicep as demonstrated by gaining greater pronation of his forearm and over time should increase extension at the left elbow.

I also spoke with S. from Northwick Park and discussed his Botox. He was very happy for me to continue to massage him but to incorporate stretches to his left elbow to encourage lengthening of the muscle therefore reducing contracture and allowing joints to approach a more neutral alignment.

I hope this reposrt is of some help to you.

Many thanks.

F.”