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Conclusion Participation for a student with a specific orthopedic disability such as MHE in physical education is not easy but is necessary for the teacher and/or student.While this manuscript provides potential activities in physical education for a student with MHE, they are not going to be successful for every student. The manuscript does provide the teacher a blueprint to consult, and hopefully modify their curriculum accordingly. Working with a student with a dis ability is rewarding, as these students need the support and exercise that physical education can offer to them, all you have to do is try. Try to imagine the child. Should they be thinking, “I am rare, and there is value in all rarity; therefore, I am valuable”. This paper is written to discuss potential appropriate modifica tions for children with Multiple Hereditary Exostosis. The authors are not medical doctors and this manuscript should not be a sub stitute for medical advice from a licensed physician. References Chase, G. (n.d.). Activity Program Management . Retrieved Oc tober 30, 2021, from https://community.plu.edu/~chasega/ main.htm#7 Heuristic. (n.d.). The MHE Research Foundation . Retrieved from https://www.mherf.org/aboutmhe John Hopkins Medicine. (n.d.). Hereditary multiple exostosis (diahyseal aclasia). Johns Hopkins Medicine . Retrieved October 30, 2021, from https://www.hopkinsmedicine.org/ health/conditions-and-diseases/hereditary-multiple-exosto sis-diahyseal-aclasia Kovar, S., Combs, C., Campbell, K., Napper-Owen, G., & Wor rell, V. (2012). Elementary classroom teachers as movement educators (4th Ed.). McGraw-Hill:Boston, MA. Levine, G. (2010). Cardiology secrets (3 rd Ed.). Elsevier Inc: Amsterdam, NL. Mandino, O. (1968). The greatest salesman in the world . Bantam Books. Multiple hereditary exostoses (MHE) . International Center for Limb Lengthening. (2021). Retrieved October 30, 2021, from https://www.limblength.org/conditions/multiple hereditary-exostoses-mhe/. St Mary’s Medical Center. (2018, March 27). Multiple hereditary exostoses . Paley Orthopedic & Spine Institute. Retrieved October 30, 2021, from https://paleyinstitute.org/blog/ conditions/multiple-hereditary-exostoses/#/. Zecchin-Oliveira, A.M, & Poli-Neto, O.B. (2020) Influence of physical exercise in pain threshold in human: A systematic review. Integrated Clinical Medicine, 2-6. https://www.oa text.com/influence-of-physical-exercise-in-pain-threshold in-human-a-systematic-review.php

Parents should be included in communication and approve of the activities. All of these issues should be implemented with further modifications such as distance regulations and equipment modifi cations. Also, the physical education teacher should remember to listen to the suggestions of the student with MHE when creating/ modifying the activities for the class. This should be kept into consideration when modifying activities for children. GaryA. Chase, a Professor of Exercise Science at Pacific Lutheran University for 30 years and creator of the MHE Fitness Program ming System says all exercises should include the following: “ Warm-up . The major purpose of the warm-up is to elevate heart rate and body temperature, and increase blood flow to the muscles. The warm-up period should be gradual (5-15 minutes) consisting of low-intense exercise and stretching. The Stretching exercises should be included as part of the warm-up and cool-down periods after muscle temperature is increased. Cool-down . The conditioning session should end with 5-15 minutes of light exercises and stretching. The cool-down promotes blood return to the heart and prevents blood pooling in the legs. The cool-down may also stabilize heart action and decrease the amount of muscle soreness fol lowing exercise. A beneficial cool-down should consist of light exercise such as walking and calisthenics for at least 5 minutes followed by flexibility exercises. The flexibility exercises should primarily focus on the muscles used during the exercise session.” (Chase, para. 11) In terms of activities that may be appropriate for the student, the following is a chart that show potential activities for the student depending on the student’s potential pain level.As noted previously activities should be cleared with the parents, with doctor input. The chart begins with activities when a child is experiencing a higher level of pain and progresses to activities for individuals who are experiencing a lower level of pain. So how do you implement this for younger students, who are unable to fully explain to you their pain level? The authors of this article recommend the use of a chart for students to note their pain level such as the one shown below. So how do you implement this for younger students, who are unable to fully explain to you their pain level? The authors of this article recommend the use of a chart for students to note their pain level such as the one shown below.

How do you feel today? How do you feel today?

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Conclusion

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Participation for a student with a specific orthopedic disability such as MHE in physical education is not easy but is necessary for the teacher and/or student. While this manuscript provides potential activities in physical education for a student with MHE, they are not going to