Paraplegic Muscle Advice

[bradjhicks]

Hi guys/and girls,

I'm a brand new user of this forum. I am an L2 incomplete paraplegic and have been luck enough to have progress over the years since my accident. I currently walk using 2 elbow crutches and wear a pair of small splints to support my ankle, where i have movement. My main questions is - I can stand un-aided and keep my balance but i have to have my knees bent. As soon as i stand up straight my balance goes and i have to grab something before i fall over. My question is, what muscles do i need to work on to be able to stand up straight without loosing balance? And how do i work these muscles. I think i'm right in saying that your toes are a big part of balancing, which obviously i cant use. I'm fairly good at getting about on the floor so there is no real restrictions there for potential exersizes. My partner can also help if i need someone else for a particular exersize. I have a multi gym, rowing machine, exersize bike and treadmil.

Thanks very much for any advice coming my way.

Cheers
Brad

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[alophysio]

hi Brad,

Has anyone detailed exactly what muscle strength you have? We physios tend to use Florence Kendall's Muscle Testing and Function book as a reference for muscle tests.

It is has a big chart of all the muscles of your hips and legs which should be checked carefully since you are an incomplete para.

For obvious reasons, it is nearly impossible to exercise muscles which do not have any nerves to them.

Balance is a really complicated, whole body task. So many things go into it getting your balance right that there are people with complete spines that have trouble!

From your story above, it seems that when you have your knees bent, you are able to balance better but when you straighten your knees, you lose balance right? If so, then your hips have more load to control - the straightening of the legs means that you now have a long lever on which you hips have to control - and this without the knee muscles being able to help you much. It may be that your hip and ankle/foot muscles are all there and just need to get stronger or you are missing muscles that should be working together as a team and so you lose balance.

Now i am from the school which thinks you practice it anyway, even if it is paralysed, because who knows, one day a nerve might grow into the right muscle...so you need to find ways to try learn what you can do, what you can'[t do and what you need to do and go from there

Hope that helps

Cheers!

[bradjhicks]

Yes they have but only in a very basic way. They would put pressure on a part of my leg and ask me to push away. Maybe we dont use the Florence Kendall's Muscle Testing and Function book here in the UK. I should mention that i haven't seen a physio for about 6 years as we seemed to have exhausted all the progress.

Correct, as soon as i stand up legs straight, i tend (start) to fall backwards if that indicates anything? I know i have hamstring muscle control but they are quite weak and i dont seem to be able to strengthen them. I dont think i have any ankle movement. Since the accident the calf area of my leg has lost a lot of mass. Are there any exersizes you could recommend that exercise the ankle/calf a little just to stimulate them in someway. Same for hips. I try and do squats but, because i need to hold onto something due to lack of balance, i'm not sure if my form is good.

Thanks very much for your response. It is much appriciated.

[alophysio]

Hi Brad,

you are in the UK - someone will have heard of Kendall's - they probably did the basic testing which is understandable.

If you haven't been for 6 years, go and see a physio.

There are many exercises that you could try to do but if you don't have the muscle activity, it is hard to suggest them...basically i get concerned about the WAY someone does their exercises...so if you did them the wrong way and strained something, i would be quite upset and i wouldn't want that to happen.

I personally don't think what you are asking for is particularly difficult for a physio who is listening to you.

Having said that, if you have troubles finding one you are happy with, let me know and we can see what we can do.

Cheers!