Ambulation after a Spinal Cord Injury

By Matt Lalande in Spinal Cord Injuries on June 06, 2020

Ambulation after a Spinal Cord Injury

Our Ontario Spinal Cord Injury Lawyers understand that your sense of “normal” and “routine” have just gone out the window. And why shouldn’t they? Nobody has ever prepared you for this situation. You don’t know what to do, how to act, how to help. The social pressure is immense.  In our experience, spinal cord injury victims experience a feeling of “unreality.” Your mind and body are both in shock after the injury. Nothing seems real. If you have never been a patient in a hospital before, being in a hospital is a strange and terrifying experience by itself. Even without a terrible injury. Once you get over the initial reaction that the situation can’t be real, then you start to focus on yourself. You realize your body no longer functions the way it did before the accident. You may have lost control of your bladder or bowels, or both.  No matter how hard you try to move the affected parts of your body, they don’t react properly. They may not move at all. They may move erratically or slowly. It is human nature to assume the consequences of the injury are only temporary. We understand that victims simply want everything to back the way it used to be. You may be asking questions like how can parts of my body hurt so much, but I cannot move them? This is a difficult concept for anyone to understand, with or without a spinal cord injury. It is possible to have lost normal feeling in an area of the body, and yet still feel pain. And the pain experienced with some types of spinal cord injuries is the most intense pain a human being can have.

The frustration a person feels after a spinal cord injury is indescribable and there is no doubt that one of the worst feelings a person can have is to lose control in a situation. We, as human beings, value control. It helps define our self-image, and our feeling of value in society. Every one of us takes the ability to control our own bodies for granted – and when you lose the ability to simply ambulate with simple movements, to your raise a hand six inches. Or to grasp a glass of water. To be unable to sense whether you are standing up or sitting down.

As we have written about for many years, a spinal cord injury is a group of devastating afflictions to the spinal cord which may be traumatic or non-traumatic in nature, and can no doubt limit the personal mobility of the affected persons. The inability to ambulate is no doubt one among its many serious consequences. As a result, re-teaching the spinal cord injury victim to attain some form of ambulation is an exxtremely important part of the rehabilitation process of spinal cord injury victims and is a felt need of the affected individual.

Ambulation is possible for many patients with a spinal cord injury. For a person with spinal cord injury, walking can be achieved with or without braces and assistive equipment, such as a walker, cane, or crutches. Your ability to walk depends on the level of the injury, whether the injury is complete or incomplete, your body size, and if you have any other medical problems.

The main determinants of normal gait are balance and posture,  range of motion, muscle strength, co-ordinated motor control, muscle tone, your sense of equilibrium and balance, your vision, cognition, and aerobic capacity.

When will I know if I can ever walk again? How long does it take for feeling and movement to return after a spinal cord injury?

There is unfortunately no internal time clock that says, or alarm that tells the spinal cord victim that we are ready to walk again – Dr. David Chen

Remember – it’s important to speak to your spinal cord injury specialist or physiatrist about this – and rely on their advice and medical opinion.  Dr. David Chen, one of America’s well known spinal cord injury doctors and director of the Spinal Cord Injury Rehab Program at the Rehabilitation Institute of Chigacao, answers this question in this important video.  He tells us that in terms of the duration of time when an individual may hope to see some return of neurologic function, that will hopefully lead on to greater return, varies a lot from individual to individual.  Generally,  in his experience as a leading spinal cord doctor, he has seen that individuals who begin to see some neurologic return, although it may be small, within the first 8 to 12 weeks after injury, tends to be a good prognostic sign for further return of neurologic function. But  – he has also seen individuals who have begun to experience return at time points farther out from 8 to 12 weeks—at three months, four months, five months—who’ve gone on to see a more significant return.  It is simply too difficult to predict just how much time it may take to see return of function, and to predict just how much, and for how long you might see that return. Therefore, most physical recovery will happen in the first 6 months after a spinal cord injury since the spinal cord experiences a heightened state of plasticity.  That being said, there is no doubt that many spinal cord injury vicitms learn how to walk after those initial 6 months because the spinal cord is always capable of adapting.

The reality is, in Dr. Chen’s opinion, is that there is no internal clock in the body  that says, “You’ve got one year from the time of injury, and once you hit that one year time point, nothing further will return.” Again, he has seen individuals who have  gone beyond 12 months, beyond 18 months, even as far as two and three years after an injury, and continues to see return of neurologic function that can result in a much higher functioning  for those individuals. So there is no internal time clock that says, or alarm that says that you are ready to walk.

Depending on the nature of the spinal cord insult and recovery from the same, an individual may be non-ambulatory, wheel-chair ambulatory, therapeutic ambulatory, or community ambulatory. Functional ambulation may be defined as “the ability to walk, with or without the aid of appropriate assistive devices (such as prostheses, orthoses, canes, or walkers), safely and sufficiently to carry out mobility-related activities of daily living.”

Walking requires certain skills, strengths, and range of motion in the joints. If you are unable to move all or some of the muscles in your legs, braces can be used to provide support to your trunk, hips, knees, ankles, and feet. To begin to walk, you must be able to stand up and then keep your balance while in a standing position. You must then move one or both legs forward for a step. In order to do this, you must have the strength to move your legs forward, or the strength in your trunk to swing your legs forward like a pendulum.

In either case, walking with or without braces and assistive equipment is often very tiring for a person with spinal cord injury. Walking training often begins with standing and then progresses to walking over smooth, level ground. This process typically begins while using parallel bars with assistance from a physical therapist. The appropriate assistive device (such as crutches) will be selected, and walking training with that device will begin. After you master walking over smooth, level ground, you will learn to walk over rough, uneven ground and to use ramps and stairs. Often, people with spinal cord injury, who attempt walking, find that using a wheelchair is a more practical, faster, and more energy efficient way to move around. Wheelchair use often becomes the choice of convenience for achieving the most independence.

Have you or a family member suffered a spinal cord injury?

If you or a family member has suffered a spinal cord injury, contact Lalande Personal Injury Lawyers today. We are specialist in seriourly traumatic injuries caused by severe negligence – and 100% of our constuiltations are free. We are happy to simply talk and discuss your situation, advise you of your rights and entitlements and what the future may hold.  The lifetime care of a spinal cord injury could be in the millions – and it’s important that your and your family’s financial future is protected and that the at-fault parties are brought to justice.