Jill lives on disability at an undisclosed address in our community—she won’t tell her parents where. If I described the caustic school nurse, her jumpy mother, her reclusive father, you could probably see how all their lives have been shaped by Jill, and how her life was once shaped by theirs.
Jill has spina bifida. Beginning in Kindergarten I watched her grow up over the years at school, she was one of the kids from the short bus. Struggling down steps and up the side walk in her leg braces and crutches, a heavy book bag hung over her shoulders stooping her forward throwing her off balance. More often than not there was a blue-eyed ocean of sadness that washed through her thick spectacles, many kids tried to befriend her, but for the most part she kept to herself.
I really didn’t get to know her well until she reached the fifth grade. Hanging around the school like some kind of educational groupie, private schools and home schooling were out of the question for economic reasons, I wanted to make sure my kids were safe and got the best education possible. This was after all a public school and I had heard enough horror stories about them made deciding to spend sometime volunteering in classrooms and attending monthly school board meetings to reassure my self that my sons were safe. I discovered that my fears were unfounded, with the exception of one or two individuals; the people who work at the schools in our district have the best interest of the students in mind. Eventually the principal hired me as a teacher’s aide. By this time Jill’s Special Ed teacher had decided that occupational therapy was in order for her so that she could learn some new life skills-- like how to use a wheel chair as well as her crutches to get around easier and more quickly in her everyday tasks. Up until this point in the brief dozen years of her life the school nurse who made Nurse Ratchet from One Flew Over the Cuckoo's Nest look like a saint had restricted her to the use of her crutches, she didn’t want Jill to become ‘dependant’ upon a wheelchair. It was 'indolent' in her professional opinion; no one challenged her judgment for seven long years.
Sometimes Jill struggled down the hallway while other children rushed around her splayed out crutches as she hauled first one side of her body forward stop, the leg braces would shudder and rattle then her weight shifted to the other crutch and bring the other side of her body forward. Mid morning and mid afternoon recesses were ten minutes; more often that not, by the time she reached the playground the bell would ring just as she arrived and she would work diligently to get turned around, start heading back to reach class in time to start.
It was pretty well-known that I was and am still an exercise enthusiast and the principal Mr. Black recommended me to Jill’s teacher for a position to meet once a month with a professional Occupational Therapist, receive training and a set exercises along with Jill to help her improve her coordination, balance, and posture, the goal was to improve her gross motor skills and strengthen all areas of her body. Most of this included learning how to maneuver a wheelchair up and down steep ramps and working with a therapy ball.
Therapy balls go by various names: gym balls, Swiss balls, exercise balls, and therapy balls. No matter what they’re called, they are great for working on balance and flexibility, plus being a whole lot of fun! The big vinyl therapy ball has been used for 30 years in Switzerland. Filled with air and relatively soft, unlike medicine balls, they cushion the body and come in different sizes, for people of different heights. Inflated with a simple pump, they start at about $20. Physical therapy deals with the problems of pain, strength, joint range of motion, endurance, and gross motor functioning. The Occupational therapist met with Jill’s teachers, the school nurse and me several times to out line an Individual Education Plan a set objectives for Jill to achieve over the course of the year. The Nurse scowled and grumbled whispering her expectations of Jill’s failures to anyone who would listen. We tried our best to understand that she had invested a lot of time and energy into Jill’s elementary school years, but she was growing up, getting ready for Junior High and High School. It was simply time to let go….
I was looking forward to having some fun with Jill. We were to do callisthenics to strengthen her muscles and stretches on the ball, as well as warm-up and cool-down routines. Her workouts required the use of multiple muscle groups, by simply sitting and bouncing on the ball; she worked her hamstrings, quadricepss, and abdominal, and back muscles. Adding arm movements she could get an upper-body workout. Soon her coordination, balance, and posture would improve, it would increase her range of motion, strength, and endurance. Such an exciting prospect! Yet upon arriving to pick Jill up from class every day she had pottied in her pants. Confused about his behavior I asked her regular teacher about it.
I don’t know, he said. All the other kids know, I mean there is a definite odor but Jill doesn’t seem to care. No, he hadn’t called her parents and asked them about it. They were going through a divorce and he didn’t want to make things any worse. The most logical thing was to take Jill to the nurse’s office get her cleaned up so we could get to our exercises.
The nurse was adamant; Jill was manipulating her way out of therapy (she was lazy after all) stripped her and laid her small naked body upon the cold yellow tile turning on the water. Jill cleaned her frail body and sobbed. She must have weighed all of 80 pounds her atrophied legs splayed and curled awkwardly as she lay on her side. The large sac of spinal fluid on her back forced her to lie bent and bowed crookedly on her side. This was confusing; I understand enough about how the body works to know that Jill has no control over bodily functions below a certain point in her spine. I went to the teacher’s bathroom and threw up.
One thing about being an educational groupie is that a person learns the system and can use that knowledge to an advantage. The major dread public school districts have is that of a lawsuit. It was time for action. The IEP is a legal contract that the school must meet or they can be held liable. It wasn’t required but I prepared lesson plans and kept notes. Each day I picked up Jill took her to the nurse to get “cleaned up” then it was back to class; OT time was up. After three weeks the lesson plans were turned into Mr. Black. No OT meant the IEP was not going to be met and that could be grounds for proceedings. The parents were contacted and it was discovered that they were timing Jill’s suppository so that she would have bowel movements at school. Mr. Black drew up a contract with the parents getting them to agree to administer the suppository at a time of day so her bathroom habits could be taken care of at home.
Finally Jill could get the help she needed! From my first lesson plan for her:
When you sit on the ball, as you would a chair, make sure your thighs are parallel to the ground. Don't wear pins or anything that might puncture the ball. Make sure you have enough room so that if you lose your balance you won't fall onto a piece of furniture. Since we are working on balance, we will start off with a "spotter"— I will stand beside you and make sure you don't fall off the ball.
Training on its round, rolling surface challenged her body, used in countless positions her strength increased; Jill gained endurance, flexibility, and coordination in ways not possible before. She wanted to learn how to hop-- so hop we did back and forth across the gym. There was yoga to be tried and Jill’s flexibility and stamina increased. She wanted to know how to bounce a ball; we dribbled our way back and forth across the wooden floor,
I on a small square scooter and Jill in her wheel chair for a quick pick up game of basketball. One of her favorite jokes to play was hiding behind the door and start up an impromptu game of
dodge ball with yours truly as the target.
The schoolyear melted into spring; dreams blossomed along with Jill and thus began talk about High School, boy craziness then suddenly worrying about dating! A whole new world opened before her and for the first time people noticed her smiling -- chattering; there were hopes in her eyes. Lessons began on how to hold a fork and knife, when to put your napkin on your lap, the PE teacher Mr. Jefferson with his shiny red convertible Mustang was recruited so Jill could learn how to get in and out of cars with a dress on. Her teacher Mr. Gough volunteered and
Jill learned how to wait for a gentleman to open a door. Make up in elementary school was strictly forbidden, so there were “secret beauty days” on Friday afternoons with manicures and all colors of lipsticks mixed in little pots, furthermore; Principal Black who escorted her to the bus every day would say,
Oh my Miss Jill aren’t you looking splendiferous today! while she clambered up the steps.
Dancing was her biggest dream. The school stage was set to low lights and plenty of dancing music for her to choose from. She loved rockin’ and rollin’ on therapy balls, scooters and wheel chairs. Sometimes Mr. Hood the janitor stopped by grinning, or Mrs. Brown from the cafeteria peeked in giving Jill a big thumbs up! Best of all was Ms Martinez , Jill’s second grade teacher joined in during her planning hour. Woo hoo! She could hold her own when it came to any Michael Jackson tune. Jill wondered if she would ever be able to slow dance, so I taught her how my dad taught me. Because most guys wouldn’t know where or how to hold her there was plenty of role-playing, she learned to gently take the man’s hand and guide to the spot where she wanted him to hold her on her back. Then she would explain that she would have to balance on his feet and to please hold her tight because although she wouldn’t break she didn’t want to fall. Sometimes there was role-playing Jill pouting and pitching a fit because make no mistake to her credit this was hard work and very frustrating; it was good to get to laugh at herself.
Therapy balls are now being used in hospitals, birth centers allows the mother to have the freedom to shift her weight for the comfort and mothers-to-be say it is the most comfortable thing for them to sit on in the last few weeks of pregnancy.
Some history about therapy balls
The Swiss Ball originated in 1963 when an Italian manufacturer, Mr. Aquilino Cosani, started producing toys made of vinyl instead of rubber. Mr. Cosani developed a special technique for manufacturing these large colorful balls, later known as Gymnastik™ or Gymnic™ balls, and began selling them throughout Europe.
Shortly thereafter, an English Physiotherapist named Mary Quinton discovered these Gymnastik™ balls while in Bern, Switzerland and began integrating them into her intervention treatment programs for newborns and infants. Subsequently, Ms. Quinton introduced these Gymnastik™ balls to her mentor’s—the Bobath’s—and they began using them in England in their rehabilitation programs.
But, it wasn’t until Dr. Susan Klein-Vogelbach, the founding director of the PT school in Basel, Switzerland, was introduced to these balls that their use with the adult population had its origin. She was the first individual to utilize these balls with the adult population, particularly with those individuals having orthopedic &/or other medical problems.
Despite their Italian origin, it was the American Physical Therapists who eventually coined the term “Swiss Balls” because these therapists witnessed their use while visiting several of the PT clinics in Switzerland. But, it was the Bobaths who were largely responsible for introducing the use of the “Swiss Ball” to the United States. In 1989, a physical therapist named Joanne Posner-Mayer began instructing US therapists on the neurological, orthopedic and fitness applications of the Swiss Ball. Today, athletic trainers, strength coaches, personal trainers and physical therapists use the Swiss Ball in their fitness and rehab programs, which they have designed for their athletes, patients and the general fitness population.
Benefits
The beauty of the ball is in the balance. My gym instructor and I have been using one over the past year as a part of my recovery and rehabilitation. Using one while sitting in front of the computer is great. While the body is quietly busy balancing; the ball is isolating and toning abs, back, buttocks and thigh muscles. Posture is corrected. If you would like to try this make sure to start out with short time limits and increase gradually.
Therapy balls are available at Costco or any athletic supply stores. Choosing the right size of ball is important and it’s best to be fitted to each person's body proportions. For people who are especially long-legged or very heavy, the next larger size may be appropriate. Below is a guide. Try it on for size before you buy. In a sitting position; hips and knees should be bent to 90 degrees when your seated on ball. Otherwise it could harm your back and knees. These are joints and body parts that will have to last you a lifetime so take good care of them.
Recommended ball sizes:
- 45 cm for heights ranges of 55” to 60”
- 55 cm for height range of 61” to 66”
- 65 cm for height range of 67” to 71”
- 75 cm for height range of 72” to 75”
- 85 cm for height range of 75”+
I could not have been prouder when I read an announcement last fall in the school newsletter that Jill Nesseth was starting a dance club at the high school and all were welcomed to join. Who could have ever imagined?
Sources:
A Total Body Swiss Ball Workout: Part 1 :
http://www.peakperformancenyc.com/swisswork1.html
Exercise ball physical therapy for back pain, by Spine-Health:
www.spine-health.com/topics/conserv/ rehab/ball/ball01.html
Labor Support Tools from
Cutting Edge Press:
www.childbirth.org/CEP/CEPtools.html