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Spinal Cord Injuries and Physical Activityby Lizzy Giroud
For the past 18 years, Brian has been able to live his life without any worries. He has done anything and everything that he as ever wanted to do. He is about to graduate high school and has committed to play basketball at a Division One college. Everything is looking up for him. After playing his last high school basketball game, he drives home to shower before heading out with his friends. On the way home, he gets into a car accident and is severely injured. He is sent to the hospital where he learns that he has severed his spinal cord at his thoracic nerves. His doctor tells him that he is paralyzed from the waist down and will have to be in a wheelchair in order to move around. He feels that is life is over and there is no reason to live anymore. But he could not be any more wrong. Spinal cord injuries are defined as, "… damage to the spinal cord that results in a loss of function such as mobility or feeling" (Makoa, 1996, p1). When this damage occurs, it causes messages or communication between the brain and other parts of the body to cease because it cannot go past the area of the spinal cord that has been damaged (PECentral, 2006). Also the neurons that are in the spinal cord cannot regenerate, which means that the damage that has been done will be permanent. Since the spinal cord is very fragile, damaging the spinal cord can happen rather easily (Stopka & Todorovich, 2005). Some of the most common causes for spinal cord injury include motor vehicle accident, acts of violence, falls, and sport related injuries (PECentral, 2006). But trauma is not the only cause for spinal cord injuries. These other causes can be from diseases such as polio, Fredreich's Ataxia, or spina bifida, just to name a few (Makoa, 1996). Most people associate breaking their back or neck with spinal cord injuries. Back injuries and pinched nerves are far different from spinal cord injuries. A person can break his/her back without suffering any damage to the spinal cord. This is true because the bones around the spinal cord may have be broken, but the spinal cord is still intact. In these certain situations, a person may still experience paralysis, but this will stop once the bones have been secured together (Makoa, 1996). What exactly is the spinal cord and the vertebra that surround it? "The spinal cord is the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body" (Makoa, 1996, p1). The vertebrae are bones that surround the spinal cord in order to protect the spinal cord. There are five types of vertebrae that make up the spinal column, and they are named based on their location. At the very top of the spinal cord are the eight cervical vertebrae, and these are located in the neck. Moving down to the chest region are the twelve thoracic vertebra. Following the thoracic vertebrae are the five lumbar vertebrae that are located in the lower back region. The sacral vertebrae are below the lumbar vertebrae and there are five of these vertebrae as well (Makoa, 1996). The coccygeal region is composed of one vertebra that is at the very bottom of the spinal cord. All together there are 31 vertebrae that surround the spinal cord and the spinal nerves (Stopka & Todorovich, 2005). Now that there is an understanding of the spinal cord and the vertebrae, it will be easier to understand how the damage to certain areas of the spinal cord effect the rest of the body. A person who has suffered a spinal cord injury could have either a complete or incomplete injury. "A 'complete' injury means that all motor and sensory function from the lesion down has ceased. An 'incomplete' lesion implies that some motor and/or sensory function remains intact" (Stopka & Todorovich, 2005, p17). In other words, if someone has suffered a complete spinal cord injury, then he/she will not have movement on both sides of their body from the injury point down. If someone has suffered an incomplete spinal cord injury, he/she might be able to move one limb more than the other; the injury would not be symmetrical (PECentral, 2006). Damaging a certain part of the spinal cord determines how severe the spinal cord injury will be. Injuries to the spinal cord in the cervical region usually result in quadriplegia. If the injury occurs above the vertebrae C4, then the person may need to be put on a ventilator in order to breathe. Injuries in the C5 region allow the person to be able to control his/her shoulders and biceps, but not his/her wrist or hand. When the C6 region is damaged, then the person cannot control his/her hands, but can control the wrist. But when the injury occurs at the C7 and T1, the person can straighten his/her arms. They also may continue to have problems with his/her hands and fingers. When the injury occurs in the thoracic region, the end result is usually paraplegia. In these cases, the person still has control over his/her hands. Injuries to the T1 through T8 region of the spinal cord usually allow for hand control, but since the abdominal muscles have lost control, there is no trunk control. In the region of T9 through T12, the person with the spinal cord injury is able to have trunk and abdominal control. The person also has balance control when sitting. Lastly, in the lumbar and sacral regions, the person would be affected by having decreased control over the hip flexors and legs (PECentral, 2006). Injuries in the upper parts of the spinal cord are more severe than injuries in the lower parts of the spinal cord. Quadriplegia is when the person who has suffered from the spinal cord injury has lost control of all four limbs; both arms and legs. Paraplegia is when the person has no function from the waist down. A person with quadriplegia will have to use a motorized wheelchair in order to be mobile, while a person with paraplegia can use a hand wheelchair. Not all people with spinal cord injuries need to use a wheelchair. Some can use leg braces, walkers and/or crutches (Stopka & Todorovich, 2005). Most people think of spinal cord injuries as the person being immobile, but as one can see, it all depends of the severity of the injury. People with spinal cord injuries still need to exercise just as much as people who do not have spinal cord injuries. Being in a wheelchair that does not limit the amount of exercises and sports that the person can participate in. Exercising has numerous amounts of benefits for people who have suffered spinal cord injuries such as, "… improved muscle strength, endurance, and coordination; improved cardiovascular physical fitness; prevention of heart disease; better regulation of blood pressure; reduced pain; and weight control" (University of Washington, 1999, p1). After learning about all of the benefits of exercise, the next step is to pick out a sport or exercise plan that the person will enjoy and one that can fit into their lifestyle. Picking an enjoyable workout is true for everyone in the world, not just people with spinal cord injuries. If they do not have time for the activity, or they do not like the exercise, then they will just quit (University of Washington, 1999). Once the exercise plan is decided on, the next step is to start exercising. Exercising does not have to be expense. In lots of places around the country, there are YMCAs and community centers that offer low rates for the use of their workout rooms. Also it is a good idea to research the area to see if there are any local clubs or sports team that are geared for people with disabilities. Wheelchair sports are played all over the country and a great way to stay in shape. Practically all sports can be adapted for people with spinal cord injuries. New inventions are always coming out with better ways to assist people with disabilities in sports, so be on the look out! Now that Brian has learned that he is paralyzed from the waist down, and will most likely be in a wheelchair for the rest of his life, he starts to think that his life is over. He does not see any need to further his athletic career now that he will not be able to play at the Division 1 University. But what he is not able to see is all of the opportunities that he still has in front of him. Brian will soon learn that him being paralyzed and in a wheelchair should not hold him back from achieving his dreams. Once Brian gets passed the denial and the grief of his accident, he will begin to realize that he can still play sports. Wheelchair basketball is a great way for him to continue with the sport that he loves. He already knows the skills; he just needs to learn how to play in the chair. It does not matter what the sport is, it can somehow be modified for people who are wheelchairs. If Brian were still in high school, he could try and enter a sports program that is geared towards students with disabilities. One example of this is the American Association of AdaptedSports Programs. This one is based in Georgia and it helps to, "…build interscholastic sports leagues for students with physical disabilities … in grades one though 12, comparable to programs commonly available only to students without disabilities" (AAASP, 1996, p1). The program is designed to give students with disabilities another option when it comes to sports. They may not feel comfortable playing on their school’s athletic teams, so this is just another way to keep them involved in activities while still teaching them the same skills that they would learn playing on any other team. Some of the sports that this program offers are indoor wheelchair soccer, wheelchair basketball, power wheelchair, and track and field. These programs allow the students with disabilities to still reach their maximum athletic potential (AAASP, 1996). No one should be denied the right to participate in athletics based on their physical or mental abilities. Brian is just one example of many children and adults who are faced with the initial challenges of spinal cord injuries. Once they realize that they can still be active and fit even though they are disabled, then the sky is the limit. Having a spinal cord injury should not hold them back from doing or achieving any of their goals and dreams. They might need some help along the way to reach their goals, but everyone needs some help at some point in their lives. References Makoa. (May 1996). National Spinal Cord Injury Association Resource Center. Factsheet #1: Common Questions about Spinal Cord Injury. Retrieved April 1, 2006. http://www.makoa.org/nscia/fact01.html. PECentral. Spinal Cord Injury (SCI). Fact Sheet. Retrieved April 2, 2006. http://www.pecentral.org/adapted/factsheets/spinalcord.htm. Stopka, C. & Todorovich, J. (2005). Applied Special Physical Education and Exercise Therapy. 4th Edition. Pearson Custom Publishing: Boston, MA. p. 17-20. University of Washington-Rehabilitation Medicine.
(November 2, 1999). Northwest Regional Spinal Cord Injury System. Leisure
and Fitness Activities. Retrieved April 8, 2006. http://depts.washington.edu/rehab/sci/leisure_activites.html.
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