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SCI Health Issues
Fitness for Wheelchair UsersBy Marcie Davis
For me, exercise became a no brainer when I was staring at 40, overweight, and a sedentary wheelchair user for over 33 years. It was time for action. And action is exactly what I got when I met Delia Carper, a personal trainer and dietitian.
I know what you are thinking: Who can afford a personal trainer? But at this point in my life, I believed I could not afford not to hire one. At my age and with a long term spinal cord injury (SCI), I was a prime candidate for diabetes, heart disease, blood clots, continued loss of range of motion and mobility. It was time to get busy and make a lifestyle change.
Carper explained to me the ways to begin an exercise program. One choice was to go to a health club that was willing to purchase adaptive equipment. Another way was to exercise at home. She stressed that I needed cardiovascular exercise and strength training for a complete exercise program. Working out in a gym sounded daunting to me; so I chose to start doing it at home.
Because I had done no physical activity for so long, Carper said I needed a transition phase to strengthen key muscle groups and increase my range of motion through simple stretching exercises. For example, she suggested using my own body weight for movement and increased circulation before trying to use weights. I wanted to jump in with weights, but she said I should begin with simple body movements, and as I grew stronger we would add some weight.
As you begin any exercise program, pace yourself and be alert to your breathing rate, heart rate, and how you feel in general. Ideally, you want to work your way up to an hour workout session (for example, cardiovascular and weight training activities) three times a week. An excellent way to make sure you are not overexerting is to purchase a heart monitor/sports watch at a local sporting-goods store.
As you begin to exercise, do not get discouraged. If you are only do two minutes of an activity during your work out session, that is fantastic. Everyone has to start somewhere.
Carper emphasized that to build muscle endurance and tone, which will improve your ability to perform repetitive tasks with less muscular fatigue, you should perform exercise with lighter weight and higher repetitions (i.e., 15 reps X 3 sets). To gain muscle strength and power, use heavier weights and fewer repetitions (i.e., 8 reps X 3 sets). As the exercise becomes less challenging, the weight can be increased followed by an increase in repetitions. Schedule a day to rest between workouts, and do not work the same muscle group two days in a row. You may have to use trial and error to establish appropriate weight.
Remember, you should be able to complete three sets of your desired repetitions through a pain free range or motion. People with SCI must maximize the strength and endurance of existing or weak functional muscle groups without causing overwork injuries. By performing a variety of exercises, you can prevent overuse injuries and promote muscular balance.
Keep in mind you do not need fancy gym equipment. Improvise with household items such as soup cans, water bottles, beach ball, volleyballs, or other practical items around your home. You can also make a small investment in exercise bands, medicine balls, or weights that can be purchased at a sporting-good store, Wal-Mart, Target, etc. As I said before, I was uncomfortable going to a gym so I started out in my home with soup cans, small weights, and exercise bands.
Ready, Set, Exercise!
Before beginning an exercise program, have a physical examination to identify exercise restrictions and detect any potential medical complications. Once you have received the green light from a medical professional and you have begun to strengthen and stretch key muscles, you are ready to begin an exercise regimen.
It is imperative that you receive advice from an exercise specialist (i.e. a physical therapist, certified personal trainer, etc.) on how to perform the following exercises correctly and safely. You need to make sure you do not create any new injuries such as carpal tunnel syndrome, pulled muscles, etc.
We have provided a description of these exercises to help guide you as you learn each new exercise.
The following is a suggested exercise program. Choose the ones most appropriate for your abilities.
Warm up by doing arm circles, shoulder shrugs, or some type of light cardiovascular movement for at least 3-5 minutes. Stretching is very important. After warming up, throughout the exercise program and afterward, stop and stretch your major muscle groups with such activities as neck, chest, shoulder, and finger stretches.
Perform every exercise slowly. You should be able to count from one to six from the beginning to the end of each movement. Never hold your breath while exercising and always breathe out on the muscle contraction and inhale on the relaxing of the muscle groups.
Using one-arm movement at a time, whether using weight or not, encourages maximum motor-unit recruitment and full range of motion and helps refine the mind-muscle connection. After completing the predetermined number of reps, switch sides and repeat.