- Incomplete versus complete SCI - What am I?
- How the body moves
- Principles of physical rehabilitation
- Functional movements with complete SCI
- C4 complete
- C5 complete
- C6 complete
- C7 complete and below (including paraplegia of all levels)
- Ageing and spinal cord injury
How the body moves
Most of us move without thinking about how we are doing it. The process is almost instantaneous and yet it relies on a complex set of feed-forward and feed-back mechanisms built into our brain, spinal cord, nerves and muscles.
Movement relies on several components:
- Desire / need / intention to move
- Brain function to plan and initiate the movement (the brain is the movement control centre)
- Functioning spinal cord and nerves to transmit signals to and from the brain
- Muscles that can contract with enough force to result in movement (the muscles, along with joints, skin and other soft tissues are the moving parts)
- Skin and other receptors that sense the pressure, speed, force and trajectory of the movement
Brain function to fine tune movement based on sensory feedback
Impact of SCI on ability to move
When your spinal cord was injured, the signals necessary to generate movement could not travel up and down because of the damage to the pathway they travel along. (The connection between the movement control centre and the moving parts was lost).
Recovery of movement after SCI
Spinal Shock occurs in the initial stages after SCI (first 4-6 weeks). During this time, paralysed muscles are floppy (or flaccid) and stay still during attempts to contract them to move. After this time, the paralysed muscles seem to come to life as they start twitching on their own. Sometimes when you touch your paralysed legs or someone else moves them, the muscles contract and cause your leg to move. This muscle activity is call spasm. It is a reflex response of the muscles and is not within your voluntary control (that is, you can’t make your muscle perform the movement simply by thinking about doing the movement). This is a normal part of your body’s recovery after SCI but doesn’t necessarily mean you are on your way to recovery of the control of movement.
Of course recovery of the control of movement is also very common after SCI. Recovery of this voluntary control of movement is everyone’s hope immediately after the injury and of course it is very exciting when it happens. It is important to monitor for changes in your motor and sensory function during this early time and to talk to the health professionals involved in your care about changes you observe. They can help you monitor this recovery and develop an appropriate physical rehabilitation program to maximise recovery of function.
While your physical rehabilitation is essential for maximising neurological recovery, it is not able to repair your damaged spinal cord and will not be helpful if the signals for movement can not travel up and down your spinal cord. When no signals are able to travel the length of the spinal cord, the injury is described as complete. If you have a complete injury, you will need to learn new, compensatory ways to move.
Recovery of movement below the level of your SCI indicates you have an incomplete injury. These other articles about incomplete SCI can provide further information about what to expect.