Even with a spinal cord injury (SCI), it is important to take care of your spine to ensure good posture and prevent respiratory issues
After a spinal cord injury, it might be tempting to write the spine off as pointless, but it still plays an important role in good posture. For people with a SCI, good posture is essential to preventing respiratory challenges as slouching can compress the lungs. In addition, good posture can assist with digestion (as the stomach is not constricted), improves blood flow and keeps the nervous system healthy.
Poor posture is often a result of a weak trunk, inactivity or a decrease in physical fitness or bad sitting habits. For example, a wheelchair user might hook the same arm on the chair back for support or lean to one side.
Equipment could also be a big contributor to poor posture. If the equipment is old or ill-fitting, it can exacerbate the poor habits such as leaning.
Fortunately, there is a lot that can be done to support and improve your posture and care for your spine. If you are concerned with hurting your spine with any of the exercises, please consult a medical professional before attempting the exercises.
Caring for your spine
The first step to improving your spine health is to care for it. This starts with ensuring that your spine has sufficient time to rest, and adequate support. Ensuring you have the right equipment and are positioned correctly while sleeping play an important role.
Restful night
You want your spine to relax and recover from the strain placed on it during the day while you sleep. A firm or medium-firm mattress is recommended to best support your spine. Soft mattrasses often result in the spine sagging into an unnatural position. Ideally, the spine should be in its natural alignment.
When sleeping on your back, place a pillow beneath your knees to remove the stress placed on your lower back. When sleeping on your side, place a pillow between your knees. This ensures that the hips are balanced. A neck pillow can also assist with supporting the cervical spine.
Massage the muscles
A professional massage offers many therapeutic benefits including increasing blood flow to an area, loosening muscles and boosting the feeling of relaxation. Consider booking yourself a regular, professional massage to ease the pressure on your back.
Update equipment
Equipment, such as wheelchairs and cushions, play an important role in maintaining good posture. Ill-fitting equipment can exacerbate bad behaviour such as slouching or leaning. As equipment is used it becomes worn and damaged. As a result, it might not function as well as before. Consider a cushion that might be more worn on one side that results in the user leaning to one side.
There could also be newer technology that is better suited to your injury or level of mobility. It is not uncommon for your mobility to decline with age. You might need to swap from a manual to a power chair to better support the spine and reduce the strain on your shoulders.
When purchasing equipment, be sure to consult an expert. A seating specialist, for example, can assist you with finding a chair or cushion that helps you distribute your weight evenly.
Addressing posture
In addition to supporting the spine and providing it with enough rest, it is important to address your posture. One of the best ways to improve posture is through exercise to strength the trunk or core (stomach) muscles, and back.
Exercising in a pool by, for example swimming laps, is a great way to strengthen your upper body without placing additional pressure or strain on the back. The water offers a more gentle form of resistance.
There are a few exercises, specifically for people with a spinal cord injury, that can strengthen the core and back to assist with posture.
Trunk tilts
The “trunk” refers to your full upper body (including chest, stomach and full back). Trunk tilts require you to lean with your full upper body in every direction (sides, forwards and backwards). Try to lean without using your arms for assistance or balance. Also make sure that you aren’t simply using your neck, but leaning with your body.
Depending on your strength and mobility, move as much of your upper body as possible without falling over. If possible, try staying in the leaning position for a few moments before returning. Do this exercise slowly to really challenge your core and back.
Trunk extensions
Sit at the edge of your chair. Keeping your back straight and core engaged, slowly lean back until you touch the backrest of the wheelchair with your back. Hold there for five seconds before slowly returning to an upright position.
Reaches
This exercise will require you to reach for items on different heights and directions. To simplify the exercise, place stickers on the wall at different heights. Number the stickers so that you can touch them in order. Avoid putting the stickers in order so that the exercise is more challenging.
Tap the targets with your right hand, then left, followed by both hands simultaneously.
A friend or family member can also assist you with this exercise by holding out their hand on different heights for you to high five. Try to only use your core and back to balance when reaching for your target.
Push ups
While in your chair, with the brakes locked, lift your body up by placing your hands on the armrests and pushing down. Try to keep your core and back engaged. Keep your shoulders back when pushing up. Slowly lower yourself back into your chair and repeat for as many times as possible.
Top exercise tips
Engaging your core could be a strange concept if you’ve never actively worked your core. To engage or “activate” your core, suck in your stomach. Think of it as pulling your stomach to your spine. You should be able to breath comfortable while feeling your stomach muscles compress. Depending on how strong your stomach muscles are, this might be very or not so obvious.
Similarly, if you want to “activate” your back, focus on contracting your back. Unlike the stomach, which you want to pull towards your back, you want your back to contract into itself. Think of the back muscles pulling towards your spine.
The simplest way to practice contracting your back muscles is by pulling your shoulders back and down. By pulling in your stomach, you will also feel muscles in your lower back contract in response.
All of this, of course, depends on your level of mobility. Keep this in mind when exercising and consult a professional if you are unsure whether you are doing the exercises correctly or are afraid that you will injure your back or core.
