Roger L. Butterbaugh, Ph.D.
Licensed Marriage and Family Therapist
Frazier Rehab Institute, Louisville, Kentucky

This body that I've been living in since I was born, doesn't work like it used to. In fact, some parts don't work at all. I can't feel them. I can't move them. And what I've learned is that they can be heavy like a lump of clay and useless getting from bed to the wheelchair. Earlier this year, I ran a race with my cousin. Me worried? Scared to death. What's next? Who knows?

After injury and hospitalization, new spinal cord patients usually know or sense deep within that life is going to be very different than it used to be. And yet, it is difficult to know exactly what to think or how to feel because there are so many uncertainties. "Do the doctors really know or are they wrong? It doesn't really matter what they say because I've always come back from injury-I work hard. Think positive, I've got to think positive. What will my friends and family think of me? I don't want my girlfriend to see me like this. Maybe I should have died? I can't move my toes, my ankles. They must be asleep. I must be asleep. This is a dream, it's unreal."

Exercise is physical activity that is routine and structured to promote improved overall endurance, flexibility, and strength. It is recommended that the average able-bodied individual exercise at least 3-5 times a week for 20-60 minutes yet there are many barriers to regular exercise including lack of: time, personal desire, money, energy, or resources. For an individual who has suffered a spinal cord injury (SCI) exercise, though not done routinely prior to injury, is more crucial to overall health than ever before.

There are many possible complications that can follow spinal cord injury secondary to compromised sensation and motor control. These individuals are at risk for potential skin breakdown. Depending on the level of injury, there is also the risk of pulmonary complications and involuntary autonomic responses affecting the heart rate, respiration rate, and blood pressure. The vascular system of these individuals is compromised, placing them at risk for: blood clots secondary to venous pooling, increased fatigued, decreased temperature regulation, and decreased overall cardiovascular fitness. Thus, these complications demonstrate both the dilemma and crucial significance of exercise and good nutrition for spinal cord injury survivors.

Karen K. Bloom, MD, FACP
Rehab Associates, Louisville, Kentucky

Spasticity may have some benefits. It prevents muscle atrophy or decrease in muscle size. That is why people with upper motor lesions usually maintain their muscle bulk. Spasticity may help to control swelling in feet and may also lock weak muscles into place to make transfers or weight bearing easier.