United Brachial Plexus Network, Inc.

How do "they" fix it?

My daughter has very poor (if any) supination. What might be done to correct this?

TIA!!

Hi Bonnie - there was a really good article about supination in the October Outreach Awareness Issue.. did you get this one? and if not email nancy@ubpn.org and she will get you a copy. Supination is more complicated than it seems. And it also seems like is a problem that affects many chidlren.

Maia can get to neutral but no further.

My son gets to neutral, not much beyond that, wouldnt have it anyother way
He just carries stuff on top of his hand instead of in it!!!
its perfect

Hi, my 8 month old uses a dynasplint. So far we have seen a good amount of improvement,and she has only been wearing it for maybe two months. We started using it, because she was so pronated she was developing a "waiters tip".
You can read more about it at www.dynasplint.com

Whitneys mom - waiter's tip is common with our little ones. Usually a simple lightweight wrist/hand splint - modified over time - helps with this. Real improvement comes when the muscles start getting innervation. I'm actually pretty surprised that a dynasplint is being used on such a young child... it's such a heavy brace for one so young - did they make a lightweight one up for her because of her age? BTW - in the normal developmental realm, supination doesn't come in until around 11 months.

I'd love to see a picture of it...can you email me one?

Thanks,
francine

http://www.injurednewborn.com/maia/splints.html
(here's my daughter wearing her dynasplint and ultra flex)

I am sure there are different reasons for lack of supination. Bicep strength is usually one thing impacting ability to supinate. In my child's case, a surgical procedure was done to release the capsule. This allowed for the shoulder to get into a much more normal position which greatly reduced the internal rotation, therefore it naturally increased supination. My child went from about neutral, maybe slightly past it, to almost full supination post surgery. Makes a lot of sense to me. If the child is internally rotated and you get the shoulder in a more proper position you just increased supination. You can practice with yourself by internally rotating your shoulder and try to supinate. It is just impossible to supinate well.

Ideas - surgical release to address internal rotation, supinator strap, bicep strengthening, therapy, therapy and more therapy, do whatever you can to get your child to practice supinating. good luck.

time for terms defs. for new folks:
What is "supination?"
What is "waiters tip?"

and... how would a splint help with this?

Hi
supination is the ability to place the hand in the palm facing upwards position - picture someone carrying a bowl of soup on their palm -supination

waiters tip is the name given to classic position a baby with opbi will hold their arm in - the hand turns inwards towards the body, with the palm of the hand facing backwards with the fingers curled over. apparently this was a common position for a waiter to accept a tip from a customer without drawing attention to it.
hope these help a little