FDR’s Extra Burden


As to treatment —the mistake was made for the first IO days of giving my feet and lower legs rather heavy massage. This was stopped by Dr. Lovett, of Boston, who was, without doubt, the greatest specialist on infantile paralysis. In January, 1922, 5 months after the attack, he found that the muscles behind the knees had contracted and that there was a tendency to footdrop in the right foot. These were corrected by the use of plaster casts during two weeks. In February, 1Q22, braces were fitted on each leg from the hips to the shoes, and I was able to stand up and learned gradually to walk with crutches. At the same time gentle exercises were begun, first every other day, then daily, exercising each muscle IO times and seeking to avoid any undue strain by giving each muscle the correct movement with gravity. These exercises I did on a board placed on the bed.

The recovery of muscle paralysis began at this time, though for many months it seemed to make little progress. In the summer of 1Q22 I began swimming and found that this exercise seemed better adapted than any other because all weight was removed from the legs and I was able to move the legs in the water far better than I had expected.…

I still wear braces, of course, because the quadriceps are not yet strong enough to bear my weight. One year ago I was able to stand in fresh water without braces when the water was up to my chin. Six months ago I could stand in water up to the top of my shoulders and today can stand in water just level with my arm pits. This is a very simple method for me of determining how fast the quadriceps are coming back. Aside from these muscles the waist muscles on the right side are still weak and the outside muscles on the right leg have strengthened so much more than the inside muscles that they pull my right foot forward. I continue corrective exercises for all the muscles.

To sum up I would give you the following “Don’ts”:

Don’t use heavy massage but use light massage rubbing always towards the heart.

Don’t let the patient over-exercise any muscle or get tired.

Don’t let the patient feel cold, especially the legs, feet or any other part affected. Progress stops entirely when the legs or feet are cold.

Don’t let the patient get too fat.

The following treatment is so far the best, judging from my own experience and that of hundreds of other cases which I have studied:

1. Gentle exercise especially for the muscles which seem to be worst affected.

2. Gentle skin rubbing—not muscle kneading—bearing in mind that good circulation is a prime requisite.

3. Swimming in warm water—lots of it.

4. Sunlight—all the patient can get, especially direct sunlight on the affected parts. It would be ideal to lie in the sun all day with nothing on. This is difficult to accomplish but the nearest approach to it is a bathing suit.

5. Belief on the patient’s part that the muscles are coming back and will eventually regain recovery of the affected parts. There are cases known in Norway where adults have taken the disease and not been able to walk until after a lapse of 10 or even 12 years.

I hope that your patient has not got a very severe case. They all differ, of course, in the degree in which the parts are affected. If braces are necessary there is a man in New York … who makes remarkable light braces of duraluminum. My first braces of steel weighed 7 lbs. apiece —my new ones weigh only 4 lbs. apiece. Remember that braces are only for the convenience of the patient in getting around —a leg in a brace does not have a chance for muscle development. This muscle development must come through exercise when the brace is not on —such as swimming, etc.

At Hyde Park, before discovering Warm Springs, this powerful man, to the shock of his children and friends, practiced dragging himself crablike across the floor, explaining that the one fear he ever knew was that of being caught in a fire. Then, showing off his inordinately strong shoulders and arms, he filled the house with laughter, wrestling his boys on the floor two at a time. His mother ordered an electric tricycle from Europe, but F.D.R. used it only once. He didn’t want his muscles worked ; he wanted to work them himself.

John Gunther describes Roosevelt’s determination to get from floor to floor unaided: “Day after day he would haul his dead weight up the stairs by the power of his hands and arms, step by step, slowly, doggedly; the sweat would pour off his face, and he would tremble with exhaustion. Moreover he insisted on doing this with members of the family or friends watching him, and he would talk all the time as he inched himself up little by little, talk, talk, and make people talk back. It was a kind of enormous spiritual catharsis —as if he had to do it, to prove his independence, and had to have the feat witnessed, to prove that it was nothing.”