For those people living with a spinal cord injury who cannot access a specialist recovery centre like Making Strides, exercise is still essential for achieving and maintaining optimal health and function.
Each person’s injury is unique. Your function and ability to exercise after SCI depend on the level and completeness of your injury. The way the body responds to exercise and its physical capability to complete traditional exercises can be affected and there are some special exercise precautions for people with SCI to be aware of.
Blood Pressure (BP)
Many people with SCI experience low blood pressure (BP) when they change body position (going from lying to sitting or sitting to standing) and also during exercise because return blood flow to the heart from the legs isn’t as effective as pre-injury. The more flaccid a person’s lower limbs the more likely they are to experience this problem. If your blood pressure drops, you can become lightheaded or a little queasy. You can avoid or manage low BP during exercise by:
Wearing pressure stockings or using wrapping/ bandaging on the legs to increase return blood flow.
Talking to your GP about Medications to assist maintain blood pressure.
Use effective warm ups starting slowly and progressing your exercise session gradually to avoid sudden pressure drops.
Temperature and Heart Rate
Injuries at T- 6 or above, can affect your body’s ability to regulate your heart rate and temperature. Your heart rate and temperature may not increase as they normally would, and you may not sweat when exercising hard affecting your ability to gauge how hard your working. There are other ways to monitor your exertion and the intensity of the exercise;
Talk test; When exercising you need to work hard enough to be breathing heavily but not so hard that you can’t talk to a friend without gasping for air.
Rate of perceived exertion (RPE); This method is appropriate for injuries T6 and below or for those whose body temperature and heart rate increase in response to exercise. It is based on the physical sensations a person experiences during physical activity, including increased heart rate, increased breathing rate, increased sweating, and muscle fatigue.
Always make sure your exercise environment is cool and you dress in loose clothing that allows freedom of movement.
Be careful transferring on and off equipment and look for potential friction areas that could cause pressure or shearing. Be mindful of protecting and monitoring your skin throughout whatever exercise you choose to do. Wearing long leg skins during exercise is a good
Autonomic dysreflexia (AD)
Make sure you know your body's signs and symptoms of AD, as well as it’s response to possible painful or irritable stimulation that could lead to AD.
Good technique should always be your first priority over repetitions or weight used to avoid repetitive motion injuries. Avoid performing only one movement or overworking one muscle in any session. Choose exercises that do not overuse muscles or replicate movements already used frequently during your daily activities, such as the muscles you use to push a manual wheelchair. Instead try to use opposing muscles/ movements.
Be mindful that spasticity may make it difficult to do an activity well or it may throw you out of position while using a machine. If you have a lot of spasticity, have someone with you the first time that you trial new equipment or exercises.
Have a god base understanding of all medications you are on and their potential effects on exercise performance. Some medications dampen your pain threshold and you may not be able to tell if an exercise is painful and possibly causing harm. No exercise should not be painful! There is a difference between pain and mild discomfort due to exertion (the burn).