By Matt Lalande in Spinal Cord Injuries on July 02, 2021
Spinal cord injury victims face many barriers throughout their daily lives, such as accessibility, performing daily tasks, bowel and bladder management, and independent living. On top of these barriers, spinal cord injury victims face ongoing health concerns that place paralyzed individuals at a higher risk – which to some degree, can be mitigated by regular movement.
Once thing that experts all agree on is that activity and exercise is extremely important for spinal cord injury victims. Studies have shown that for people with spinal cord injury, exercise can help prevent many secondary conditions, such as diabetes, cardiovascular disease, pressure sores, urinary tract infections, and respiratory disease. In addition, exercise helps prevent deconditioning (getting out of shape) and obesity, and it provides mental health benefits.
Also – a primary benefit of exercise is simply to feel good! The interconnection of mind and body is quite apparent with enjoyable physical activities; one feels good emotionally and mentally as a result of physical activity. Studies have indicated that spinal cord injured persons who exercise not only increase strength, coordination and endurance but also decrease depression, mental inactivity and social isolation.
Given that most spinal cord injury victims are paralyzed in some capacity, many victims tend to adopt a sedentary lifestyle as they are confined to wheelchairs or other assistive devices and have a limited range of exercises available. However, a sedentary lifestyle can lead to a higher risk of health issues such as cardiovascular disease, weight gain, diabetes, high blood pressure, or high cholesterol.
Spinal cord injury victims and those with a sedentary lifestyle are also at an increased risk for developing pressure ulcers, which are caused by prolonged pressure (such as remaining seated for too long) that reduces blood flow to an area of the body. Pressure ulcers are dangerous as they can lead to sepsis or serious infections, cancers such as squamous cell carcinoma, and cellulitis; however, they can also cause discomfort and pain on a regular basis.
A sedentary lifestyle can also have other consequences for individuals, including poor sleep patterns and weight gain. Obesity is another significant health concern for spinal cord injury populations: a study at the University of Toronto found that approximately 40% to 60% of individuals with spinal cord injury suffer from obesity.
In addition to assisting with the problems mentioned above, proper exercise for spinal cord injury victims can provide a range of additional health benefits, such as:
You can prevent all of these problems and benefit both your body and mind by developing a regular exercise program. According to the National Center for Physical Activity and Disability, the best types of exercise for persons with spinal cord injury are:
Aerobic exercise – which builds and maintains cardiovascular health;
Strength training – which maintains the ability to perform activities of daily living and
Mobility and flexibility training – which improves range of motion and reduces spasticity.
It is important to remember that every spinal cord injury victim’s recovery process is unique to their situation and different for everyone. When performing any physical activities, do so at the guidance of or under the supervision of your health care professionals or rehabilitation team. It’s possible to over-stretch or over-extended your muscles if you are not performing physical activities safely or properly.
When starting any new exercise routine, begin slowly and avoid overdoing it. If you have undergone a long recovery process, your body may not retain its muscle mass right away. At any point if you begin to feel pain, stop and do not try to force the exercise. It takes time to develop muscle memory.
Aerobics are important for spinal cord injury victims because aerobic activities help with your cardiovascular health. Spinal cord injury victims are particularly at risk for poor blood circulation, and aerobics can keep your heart rate up to ensure proper blood flow. This is important for everyone, but particularly for those who naturally become more sedentary due to physical impairment.
Some aerobic exercises that are ideal for spinal cord injury victims include:
Mobility and flexibility exercises are extremely important for persons with spinal cord injury. For example, range of motion exercises should be done daily to help improve blood flow. Because very slow blood flow is a main reason blood clots form in veins, improving blood flow is one way to reduce the risk of deep venous thrombosis.
Regular daily stretching is important for spinal cord injury victims to prevent muscles and joints from becoming stiff or weaker. When a portion of your body is immobile, maintaining the muscles that are regularly used is important. Stretching also helps to improve range of motion in these muscles as well as reducing pain, improving flexibility, improving posture, and maintaining muscle memory.
According to the Journal of Neurorehabilitation & Neural Repair, at least 80% of spinal cord injury patients experience muscle spasticity, which often presents as muscle spasms, tendon jerks, muscle tightening, and hyperactive reflexes. While muscle spasticity does have some benefits, including regulating muscle tone, stretching exercises can assist in regulating spasticity so individuals may have more control in pain management.
Some stretching exercises spinal cord injury victims can perform include:
Training the muscles you are able to control is another important type of exercise for spinal cord injury victims. In many cases, relying on the muscles you can control on a regular basis can lead to overuse of those muscles. Overused muscles can cause repetitive motion injuries, and it is important to strength train in order to balance all muscles.
Individuals with lower body paralysis rely on their upper body strength for daily tasks such as bed transfers, pushing and handling wheelchairs, vertical lifting and repositioning, and grip. Therefore, it’s important to make sure those muscles are toned and strengthened in order to ease those daily functions and reduce pain associated with hyperextension.
Strength exercises are important to reduce bone wastage and osteoporosis. Your PSW should take time daily to help assist you with physical exercise and strength conditioning activities. Doing these activities on a regular basis can increase your strength, reduce injury, allow for better rest, and enhance your ability to provide your care.
Some strength training exercises for spinal cord injury victims include:
It’s best for everyone, whether you have a spinal cord injury or not, to follow the Canadian Physical Activity Guidelines of 150 minutes of moderate to vigorous activity per week for adults aged 18 to 64. Adults aged 65 and over should accumulate 150 minutes of light to moderate physical activity per week, and it is recommended that youth aged 17 and under should engage in 60 minutes of any physical activity per day.
However, if you are busy and have difficulty fitting regular exercise in your daily routine, as little as 10 minutes per day can still be beneficial. It is always better to perform little exercise than none at all, especially when your health is a concern.
Again, it’s important to follow the guidance of your rehabilitation team and occupational therapists when beginning any physical activity program. Those who work closely with you are able to effectively assess which activities work for you, and what your body requires for care and management. You may have specific concerns and capabilities that require specific movements or other pre-existing conditions that make certain activities difficult or dangerous.
A gym or a fitness centre is a great place to start exercising once you return home. Don’t assume that your gym or fitness center is accessible, but don’t assume that it’s not! The chances are good that the center has had other members with disabilities and that the equipment and facilities are accessible. Before joining a fitness center, take a tour and learn about the facility, programs, and staff. If you find that the facilities or equipment are not accessible, or if you need accommodations, talk with the staff. Most likely, they will be willing to listen and make reasonable changes to accommodate you and other members with disabilities.
Many communities have developed wheelchair sports programs for basketball, soccer, tennis, swimming, bocce ball, quad rugby, racing, track and field, softball, and sitting volleyball. Many of these programs offer introductory clinics, training for competitive teams, and opportunities to play the sport noncompetitively with friends and family. As you look for sports opportunities, don’t limit yourself to a sport that you participated in before your injury. One nationally ranked wheelchair racer was a wrestler before his injury. Another person, who had never played tennis before his spinal cord injury, became a competitive tennis player.
He attended a tennis clinic while he was in the rehabilitation hospital, and he was competing a year later. Sports are also an excellent way to interact with friends and family. Often, the rules are similar to conventional ways of playing the sport. Wheelchair tennis is a great example. The only change in the rules is that the tennis player using a wheelchair gets two bounces of the ball if needed.
Many opportunities are available for learning about, and getting involved in, sports. Just getting out and throwing the ball around with a friend can be fun, but you can also look into getting more involved through wheelchair sports organizations. Going to wheelchair sports events and tournaments— from wheelchair racing to basketball to quad ruby—can give you a feel for what these sports are all about. You’ll be amazed at the high level of competition seen at many of these events. Talk with your recreational or occupational therapist to learn more.
Bowling alleys have made their lanes accessible and provide a ramp to roll the ball on if needed. (People with good upper body control will not need this ramp.) Gardening is also a relaxing activity that can also provide physical exercise. At your local garden shop, you can purchase long-handled tools so you can reach from your chair. Another idea is to raise your garden bed. Your local garden shop staff or a recreation therapist can tell you simple ways to raise the bed.
Golfing is another activity that is still possible. Accessible golf carts can go on the green, adapted golf clubs are available, and gold lessons can provide basic instruction. There are many accessible golf courses within the Hamilton and GTA.
Swimming is a great physical activity offering overall body toning. Many new swimming pools are being built with ramps so you can wheel in a water wheelchair right into the water. Others have lifts. Check with a local therapy program and see if they offer adapted aquatics lessons for your first time in the pool. Using adapted techniques and floats if needed, you can soon be swimming!
Going shopping is also an option for exercise. Have you ever thought about how much energy you expend going from one end of the mall to the other? Many shopping malls now have walking programs and are open early to provide a safe, level, air-conditioned walking environment. It’s a great way to build up your endurance. High schools and local parks also have tracks you can use.
Hydrotherapy – or aquatic water therapy, is another great organized therapeutic modality that has been used to treat persons with neurological disorders for years. One well known article tells us that hydrotherapy helps in reducing spinal cord injury muscle spasticity and cardiometabolic risk profiles, while favorably enhancing underwater gait kinematics and cardiorespiratory capacity.
Don’t forget – mental exercise is just as important as physical exercise. There’s no doubt that you have been through extreme stress and psychological pain – and it’s important to never stop exercising your mind and trying to feel better mentally. We would suggest to always leave time throughout your day to try and read, follow current events, news and take time to learn and follow what you are interested in. Apple’s iPads, for example, have major accessibility options (Go to Settings > Accessibility) to view such settings as : vision accessibility settings, voice over, zoom, a magnifier, you can change the display & text size, the motion, adjust the spoken content, switch control and voice control.
Other mental exercises such as playing cards, doing puzzles, crosswords or playing board games can provide mental exercise – and may be a welcome change of pace and a source of fun.
Our Hamilton spinal cord injury lawyers have worked extensively with spinal cord injury victims since 2003, offering a range of support, resources, and legal assistance to the injured as well as their families. We understand how difficult the transition home will be, as well as the ongoing long-term care considerations you will face. It’s our goal to ensure this transition and recovery process is as seamless as possible with quality advice, knowledge, and resources.
Matt Lalande has been working closely with spinal cord injury victims since 2003, providing them with helpful, sympathetic support that goes well beyond legal representation. We are well experienced in representing catastrophic spinal cord injury claims, as well as providing assistance with your recovery and transition home.
If you or someone in your care is recovering from a severe spinal cord injury, we are happy to meet with you and answer your questions, offer advice, and assist you with the next steps. We can travel to you and meet you where you are comfortable, or arrange to meet with a caregiver, social worker, or support worker on your behalf.
Schedule a call back or free consultation using our online contact form or by calling us locally at 905-333-8888. If you are outside of Hamilton, you can contact us province-wide at 1-844-LALANDE (525-2633). All consultations are free, with no obligation to retain our firm, and no up front fees.