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Ask the Doctor: Fitness and Spinal Cord Injury

By Sam Ho, MD, Spinal Cord Injury Program Medical Director

What benefits can exercise provide for persons with spinal cord injuries?

Consistent exercise improves cardiovascular and respiratory systems, as well as muscle function and efficiency. This can decrease the risk of heart disease, respiratory disorders, and coronary artery disease. Engaging in regular exercise, and maintaining good overall health can decrease medical complications that are commonly associated with spinal cord injuries, such as deep vein thromboses, skin problems, and urinary tract infections.

Are there any risks to exercising when you have a spinal cord injury?

Exercise is a great way to improve your body’s overall function, but some conditions can be worsened by exercise. One of these conditions is deep vein thrombosis, which is a blood clot in the legs. This can create a very serious, life-threatening situation so if you have deep vein thrombosis and want to begin an exercise program, you should consult with your doctor beforehand.

Another condition that needs to be closely monitored is autonomic dysreflexia. Autonomic dysreflexia occurs in people with a spinal cord injury at or above the thoracic level 6 (T6). It's a sudden rise in blood pressure due to an abnormal response to a problem somewhere in your body. Usually it's caused by a bladder or bowel problem. This is an emergency situation that needs immediate attention, and can be life-threatening. It's important to know what the symptoms are, and to pay close attention to your condition while you exercise.

Some milder impediments to exercise are dizziness, body temperature fluctuations, pressure sores, and muscle spasticity. These can make exercise more of a challenge, but being aware of these problems, and planning accordingly can prevent them from becoming a hindrance. The most important thing to remember is to consult a professional (such as your doctor or a trained exercise professional) before beginning to exercise. When exercise is conducted correctly and in a safe manner, it greatly benefits your general health and wellness.

How do I find a fitness center that can accommodate my needs?

Many options are available when it comes to fitness centers. Local YMCAs, community centers, gyms, and health clubs are some of the places you can enjoy a good workout. There are several things to consider about a fitness center before making your choice:

  • Accessible parking spaces
  • Automatic entrance doors
  • Access to drinking fountains, snack machines and phones
  • The bathroom stalls, locker rooms, showers, and benches should be easy for you to use

Fitness equipment should be spaced in a way that makes it accessible. Most of the equipment doesn't need to be modified for wheelchair users although adaptive equipment is more convenient.

If you're serious about finding a fitness center, the best way to find out if a center meets your needs is to call and ask. Do a little research on the fitness centers in your area until you find one that allows you easy access to what you need, and makes you feel comfortable and confident in your exercise program. If facilities are unaware of what you need, take the time to educate them - you might have a few more options as a result.

What should I do before beginning an exercise program?

The first thing you should do is consult your doctor. Ask about the risks exercise can pose with regard to your specific medical condition and the potential impact of any prescribed medications. Ask your doctor for a referral to a trained exercise professional who can tailor a program to meet your individual needs.

What can I do in addition to exercise to remain healthy?

Proper nutrition is important to keeping your body healthy. Drink about two quarts of water a day to prevent urinary tract infections and regulate body temperature, digestion, and bowel management. This is especially important while exercising. Even if you aren't sweating excessively, it's very important to maintain a high level of hydration.

Other factors that improve and maintain health are managing stress, getting enough sleep, cutting down or eliminating the use of caffeine, alcohol and tobacco, being socially active, and participating regularly in physical activities.

What should be the goal of my exercise program?

Your goals will partially depend on your level of function. One main goal to have is strengthening muscles that are weak or under-utilized. Start with little or no resistance and build as the exercise becomes easier.

Why should I worry about weight management?

Weight management for those with spinal cord injuries is important because of the many health benefits it can provide. Managing weight can:

Lower your risk for premature death, and the development of some forms of cancer, heart disease, high blood pressure, diabetes, respiratory illness, pressure sores, urinary tract infections, and urinary stones

  • Decrease feelings of anxiety, depression, and stress
  • Improve muscle strength, endurance, self-image, and ability to get a good night’s sleep
  • Help manage your muscle spasms, chronic pain and bowel program

The first step to losing weight is reducing your daily calorie intake. However, maintain proper nutrition while dieting. Healthy nutrition can give your body energy, help you fight infections, maintain a proper weight, and keep all of your body’s systems working correctly. This means a balance of all five food groups. It's best to stay away from saturated fats, trans-fats, and excessive sugar or sodium.

The majority of the food you eat should be complex carbohydrates (such as whole grain breads, beans, nuts, etc.), vegetables, and fruit. Also make sure that you are getting adequate amounts of protein, fiber, and calcium. The key is to keep from overindulging in any one food group. Your doctor can also give suggestions, and guidance as to the best weight loss program for you.

What type of exercise is best when beginning to exercise again?

When designing an exercise program find something you enjoy. A good exercise program must be one that includes all areas of fitness, such as cardiovascular fitness, strength training, endurance, and flexibility.

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