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    I'm looking for the best exercise to strengthen the muscles used in making transfers. I'm a T10 female para, 36 years post, 62 years old. When I hit 60 my strength started to fade. Now my transfers are very sloppy and I end up crashing down on the target of my transfer. Before I transfer I'm filled with insecurity that I won't make it, fall and break some bones. It feels like I just don't have the strength to make a good transfer like I did the first 34 years of being a paraplegic. What would you advise to strengthen the muscles needed to perform a good transfer? Which muscles are used for the transfer?

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      Foot drop AFO for night time?

      I have an AFO that fits into a sneaker, and I have exercises that I do regularly and I walk regularly but am still beginning to experience muscle contracture in the affected foot. It was damaged when a urse gave me an injection and hit the sciatic nerve. Is there an AFO that I can wear at night to help prevent the contracture from getting worse but that is not so bulky that it gets tangled up in the bedcovers?

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        Hi Lola! So sorry I didn't see this post sooner - I am sure you have found a schedule that works for you...
        But in general, starting with 3 times per week is good. You want to be able to give your muscles time to rest and recover so that you don't over fatigue and risk injury. As you start to get stronger, you could add a 4th day. You're mainly training strength which is why you want rest. Endurance training needs to be added as well.
        Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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          Oh no! We don't want any crashes or falls!!
          For transfers, you're using the muscles that push - your pecs (chest) and triceps (back arm), so doing chest press and tricep press exercises will help. However, you also want to make sure you do exercises for the back (rows) and rotator cuff, otherwise the strength imbalances can cause pain.
          Also, practice your technique - the more you lean forward, the less work you have to do to move your bottom. This may be different than how you transferred for so many years.
          Consider getting an outpatient PT appointment with someone who understands SCI. You have a specific goal that shouldn't take more than a couple of sessions.
          Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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            Hmm... the bulkiness is always an issue. I can't say there's a great sleek option. The AFOs for sleeping need to be sufficiently padded so they don't cause skin breakdown (that would obviously lead to more serious problems!) Often PRAFO is the term used for the orthotic used in bed.
            I like that you recognize that the AFO will only prevent further loss of range and not help increase. Standing is the best way to increase range.
            Something else to think about with sleeping is your body positioning. Generally, we sleep with our feet pointed downward because of the mattress or covers, right? If you are able to sleep on your stomach, with your feet hanging down over the end (pillow under shins) then they aren't force down as much.
            Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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              Can FES cause nerve damage

              Not sure if this is a stupid question or not but can repeated FES use cause nerve damage?

              The he reason I ask is that I am motor complete but sensory incomplete and would use the FES leg bike roughly 3x/week. About a year ago i developed a terrible case of what they are finally diagnosing as peripheral neuropathy (ya gotta love doctors that just assume that because you have a SCI that it is automatically central pain).

              anyways just wondering if say overflow from stimming quads, glutes, hamstrings could cause peripheral Neuropathy?

              thanks

              Comment


                That is not a stupid question. But I have not heard of FES causing nerve damage. In fact, it is a treatment recommended for those with diabetic neuropathy because the electrical stimulation is increasing the blood flow and should be keeping the nerves healthy.

                What were the symptoms that you developed? Did anything make the symptoms better or worse?
                Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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                  The symptoms came on pretty fast. One day I pressed my foot down on the foot rest of my wheelchair and noticed some pain, the next day even more, and then the next day I couldn't even touch the foot it was so hot and sensitive. Since then it's just the normal burning pins and needles. I've been through most of the notable nerve pain Meds and then narcotics which only seemed to make things much worse. MRIs showed nothing wrong with my spine other than my initial injury of course.

                  im just trying to come up with anything that could have caused this.

                  thanks

                  Comment


                    That's interesting... I'm sorry that you're dealing with that. Have you kept up with the FES despite the pain?

                    You say that you're sensory incomplete - can you feel your feet if someone touches them? Have you tried TENS? This could be trialled either where you feel the pain, or along the spinal dermatome (I know you don't like to hear that it could be central...) The downside to TENS is that it only works while it is worn. But it may be more effective than medication.

                    Also, do you stretch regularly? It is common for the hip flexors to get tight from sitting so much, and also from the work you're doing on the bike. The hip flexors attach to the lumbar spine, and could pull on it, causing some pain down the nerves that exit from this area. This is common even in people who walk. Also the hip rotator muscles are under the gluteal muscles can get tight and push on the sciatic nerves. These issues would not be seen on any imaging, but could contribute to nerve pain. Start adding some prolonged stretching to your regular routine, and see if that helps alleviate your symptoms.
                    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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                      Here's what my radiology report said: There are 5 nonrib‐bearing lumbar type vertebral bodies.Levoconvex curvature is centered at the thoracolumbar junction. The
                      vertebral elements are otherwise in anatomic alignment. There is no
                      evidence for instability on flexion and extension views.
                      Mild physiologic anterior wedging is demonstrated of the T12 vertebral
                      body. Vertebral body height is otherwise relatively preserved.
                      Intervertebral height loss is mild in degree, spanning from L3‐L4 through
                      L5‐S1. Scattered mild to moderate facet arthropathy is demonstrated
                      throughout the lumbar spine.

                      My doctor said I have 'mild scoliosis'. Since my curvature is a "levoconvex curvature", which side is the weak side? Left or right. I read about a study showing that a plank exercise of the weak side (a simple yoga pose) can quickly help correct curvatures. Your advice would be appreciated. Thank you.

                      Comment


                        Im 19 years old , t9 level 6 months post accident. Im doing physiotherapy every day 3 hours but we dont have too much information and he has not any experience with SCI.
                        I have back stabiliztion which gives me discomfort working out and trying to work balance.
                        Also most of the exercises to move the legs I am succesful doing only by giving a hard movement with my hips.
                        I am afraid how caution should I be and if there is any limit in movement and working out because I dont want to danage anything.
                        Good progress has been so far , burning sensation and little contractions.
                        They are not easily visible but my physiotherapist is enthusiast about them.

                        Very good thread , learned a lot here

                        Comment


                          Generally, the concave side is the stronger side because the muscles are pulling on the spine without the muscles on the other side activating to provide opposition. So the C would typically open to the stronger side.

                          Exercising everything you can is always beneficial. The difficulty comes when the weaker muscles simply have less innervation from the spinal cord injury... working to strengthen weaker muscles is always recommended, but even with all of the best exercise, you may still have some imbalances. Don't let that discourage you, but also don't think of the results as failure. Definitely be sure to stretch regularly! Especially those stronger muscles because they are more prone to getting tighter from working (when there's weakness, the stronger muscles tend to turn on even when you're not trying!) and then will pull more on the spine. Using the yoga poses to stretch would be great
                          Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

                          Comment


                            Keep up the good work, Martiniani! Sounds like you and your PT are learning together

                            How to know when you're risking injury is tough to answer online and not knowing your body... six months post surgery should be sufficient for the bones to have healed. If you notice any increase in your spasms, that is a sign that your body is not liking the stress it's being put under. I would also be cautious of doing any weight bearing exercises (standing/walking) without the proper support/orthotics just to protect your joints. You may not be able to feel the strain you are putting weak muscles and joints under, and you don't have to have pain in ten years from the stress you put them under now. Standing frames help with this stabilization, as do orthotics, and the new robotics. Most body weight supported treadmill options keep this principle in mind as well.

                            I hope that helps. If there's anything specific that you're trying that you think is questionable, give that example and we can try problem solving.
                            Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

                            Comment


                              Do you offer online personal training ?
                              I read something about a personal course but found no contact information or website.

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                                I offer an online exercise program with videos-on-demand to get extra exercise in. It's a great adjust to any therapy or gym program, and also an option for people who have difficulty getting to other services. The business is my screen name - the webpage is also the same. Check it out; my direct email is kristin@scitotalfitness.com for anyone who has more questions.
                                Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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