Today we will look at the best neuroplasticity exercises for spinal cord injury. While recovery outcomes vary, consistent effort and structured rehabilitation can significantly enhance quality of life.

Let’s jump in!

Understanding Neuroplasticity in Spinal Cord Injury

Neuroplasticity is the central nervous system’s ability to reorganize itself by forming new neural connections and strengthening existing pathways. After a spinal cord injury (SCI), the brain and spinal cord adapt by rerouting signals, which can support recovery. This adaptability allows other neural pathways to take over functions previously handled by damaged areas.

Targeted exercises enhance this process, promoting functional improvements over time. The extent that neuroplasticity can promote recovery varies based on injury severity, exercise consistency, and individual physiological factors.

The Role of Exercise in Neuroplasticity

The foundation of neuroplasticity is repetition. Repetitive experiences, including targeted exercises and activities, stimulate the creation and strengthening of neural pathways. This has the potential to reinforce the connections needed to restore movement and sensation after a spinal cord injury. Over time, as the nervous system strengthens its pathways, functions that were previously lost may gradually improve.

Individuals with incomplete spinal cord injuries, who have some spared neural connections at their level of injury, have the highest potential for neuroplastic changes. The more neural connections left intact, the more likely it is that adaptive rewiring through neuroplasticity can occur. 

Conversely, neuroplasticity is limited in individuals who have complete spinal cord injuries, in which the spinal cord has been completely severed. While individuals with complete spinal cord injuries may make some improvements, they often primarily focus on learning compensatory techniques to enhance independence. Researchers have found some treatments, such as stem cell transplantation, to potentially enhance neuroplasticity after a complete SCI but evidence is still being gathered.

Exercise may not only aid in improving mobility and coordination, but it can also prevent secondary complications such as muscle atrophy, joint contractures, and cardiovascular issues among both complete and incomplete spinal cord injury survivors. By incorporating a variety of targeted activities, individuals with SCI can actively support their recovery and improve their overall well-being.

The following exercises are designed to stimulate neuroplasticity and promote functional improvements by progressively challenging the nervous system. Many of these exercises complement each other, working together to support different aspects of recovery and optimize your rehab. While these serve as an excellent starting point, it is recommended to talk with your physical and/or occupational therapist to learn which exercises may be most beneficial for you.

Best Neuroplasticity Exercises for Spinal Cord Injury

1. Passive and Active Range of Motion Exercises

Before engaging in more intensive rehabilitation, it’s important to maintain joint mobility and circulation. Passive and active range of motion exercises provide the foundation for movement recovery by preserving flexibility and promoting sensory input to the nervous system.

Passive Range of Motion (PROM)

Generally, passive ROM is when a therapist, or caregiver moves the patient’s limbs through their natural range. This prevents stiffness, maintains joint integrity, and keeps muscles engaged, preparing the body for more active movement when possible. 

Some individuals may be able to perform passive range of motion exercises on their own using unaffected parts of the body to move the affected extremities. For example, those with intact upper body functions may use their hands and arms to move the feet and ankles through passive exercises.

Active Range of Motion (AROM)

Conversely, as neural connections strengthen, individuals can begin actively moving their limbs with or without assistance. This is known as active range of motion. This builds strength, reinforces neural pathways, and enhances voluntary motor control, making it a crucial step toward functional independence.

2. Weight-Bearing Activities

Once basic mobility is addressed, weight-bearing activities help reintroduce controlled pressure on the extremities, strengthening bones and improving circulation while offering sensory feedback to the nervous system.

Standing Frames/Exoskeletons

Using a standing frame or exoskeletons can allows individuals to bear weight through their legs, maintaining bone density and improving circulation. Over time, this activity also aids in core stability, digestion, and posture control, which are essential for overall health.

Parallel Bars

Parallel bars provide a safe environment to practice standing, shifting weight, and initiating controlled steps. This progressive activity strengthens lower extremities and builds confidence before advancing to gait training.

3. Task-Specific Training

Repetition of everyday movements reinforces neural pathways and builds strength for essential activities. Task-specific training directly improves functional independence by focusing on real-world applications.

Sit-to-Stand Exercises

Practicing sit-to-stand movements enhances leg strength and coordination, making transfers and mobility smoother. This exercise strengthens postural muscles and prepares individuals for more advanced gait training.

Reaching and Grasping Tasks

Fine motor skills are equally important for independence. Exercises focused on grasping and manipulating objects improve hand function, making daily tasks like eating and dressing easier.

Walking Training

By using body-weight support systems or assistive devices, individuals can retrain their gait (pattern of walking) and improve walking mechanics. This type of training builds endurance and encourages neuroplasticity by reinforcing proper movement patterns.

4. Gait Training

For individuals with some level of mobility, gait training is an essential component of neuroplasticity-based rehabilitation. Walking exercises integrate balance, strength, and coordination.

Treadmill Training

Treadmill training with weight support allows for repetitive, guided stepping. This approach helps the nervous system relearn walking mechanics and reinforces rhythmic movement patterns.

Overground Walking

As strength and balance improve, individuals transition to overground walking with assistive devices. This step prepares them for independent movement in daily life.

5. Mirror Therapy

Mirror therapy is particularly useful for retraining movement in a paralyzed limb when one side of the body is primarily affected. By using a mirror to reflect the functional limb, the brain perceives movement in the affected limb, promoting neural adaptation and restoring motor control.

6. Strength and Resistance Training

Strength-building exercises further support neuroplasticity by enhancing motor control and improving functional independence.

Elastic Bands

Elastic bands provide resistance without excessive strain, allowing for controlled strengthening of both upper and lower limbs.

Bodyweight Exercises

Seated push-ups, leg raises, and modified planks help engage the core and stabilize the trunk, improving overall control and balance.

Free Weights or Machines

For those who can use them safely, free weights and resistance machines offer progressive strengthening opportunities, enhancing endurance and stability.

7. Balance and Core Stability Exercises

Balance is crucial for all forms of movement. These exercises develop postural control and reduce fall risks.

Seated Balance Training

Seated balance drills improve stability, particularly for wheelchair users with limited core strength. Strengthening core muscles through controlled sitting exercises enhances coordination and posture.

Swiss Ball Exercises

Swiss ball exercises engage multiple muscle groups to build dynamic balance, ensuring smoother movement transitions and better posture.

8. Aquatic Therapy

Water-based therapy provides a low-impact environment for movement and strength training. The buoyancy of water supports movement while reducing the risk of injury.

Water Walking

Walking in water minimizes resistance and impact while promoting proper movement patterns.

Resisted Movements

Water resistance enhances muscle control and endurance without placing excessive stress on the joints.

Floating and Kicking Exercises

Floating and kicking can improve circulation, flexibility, and strength in the lower limbs, helping reintroduce leg movement in a controlled setting.

9. Visualization and Mental Rehearsal

Even when physical movement is limited, mental exercises can reinforce neural pathways and enhance recovery.

Guided Imagery

By imagining movement, individuals can activate similar neural pathways as actual movement, strengthening neural connections even when mobility is restricted.

Mindfulness and Focused Attention

Mindfulness techniques reduce anxiety and improve body awareness, complementing physical therapy efforts and increasing motivation.

Conclusion

Neuroplasticity-based exercises after spinal cord injury offer a pathway to recovery for individuals. Specifically, by combining movement-based, sensory, and cognitive strategies, individuals can maximize their rehabilitation potential.

The key to success is consistency—engaging in a structured, personalized exercise routine fosters neuroplasticity, leading to improvements in movement, coordination, and independence. With time and dedication, these exercises can significantly enhance quality of life and functional capabilities.

Talk with your physical and/or occupational therapist to learn more about which neuroplasticity exercises could be most effective for you after spinal cord injury.

The post 9 Therapist Approved Neuroplasticity Exercises to Help You Recover and Improve After Spinal Cord Injury appeared first on Flint Rehab.

In this guide, we will explore 7 proven strategies to help you regain hand function after spinal cord injury, including the MusicGlove which combines music with hand-based therapy for an engaging exercise experience.

Let’s jump in!

Understanding Hand Impairment After Spinal Cord Injury

The extent of hand function loss after an SCI depends on the level and severity of the injury. High level cervical injuries typically result in more severe hand and arm impairment. Lower cervical or high thoracic level injuries may allow for better hand movement, but can still cause weakness and coordination challenges. Generally, hand and arm function remain intact in individuals who have a T2 SCI or lower.

The most severe spinal cord injuries, referred to as complete SCIs, result in the loss of all sensation and motor function below the level of injury. Therefore, hand functions may be completely lost after a high-level spinal cord injury. However, many spinal cord injuries are incomplete, meaning some neural connections are left intact at the level of injury. Individuals with incomplete spinal cord injuries may lose some sensation and/or some motor function, but are likely to make improvements with therapy.

Common Hand Impairments After SCI

• Weakness or Paralysis: Loss of strength in the fingers, thumb, and wrist.
• Spasticity: Muscle stiffness and involuntary contractions that can limit movement.
• Loss of Sensation: Reduced ability to feel temperature, pain, or pressure.
• Poor Coordination: Difficulty with precise movements like gripping and pinching.

While these impairments can be challenging, targeted therapy, adaptive strategies, assistive devices can help restore function over time.

The Role of Neuroplasticity in Regaining Hand Function After Spinal Cord Injury

The spinal cord and brain have the ability to rewire themselves through neuroplasticity, meaning that repetitive movements and consistent training can help create and strengthen neural pathways. To take advantage of this, rehabilitation should focus on:

• Repetitive Movement Practice: Performing specific exercises consistently to reinforce neural connections.
• Task-Specific Training: Practicing real-life tasks, such as picking up objects, writing, or using utensils.
• Bilateral Training: Using both hands together to encourage the affected hand to regain movement. This is especially important when one side of the body is more affected than the other.

Recovery outcomes may vary depending on how many neural connections are left intact at the level of injury. More neural connections spared allows for more opportunity for neuroplasticity to occur, and therefore more potential for improvements. 

Since individuals with complete spinal cord injuries do not have any spared neural connections, they are unable to improve below their level of injury through neuroplasticity. However, they can use adaptive strategies to improve their functional independence. Furthermore, researchers are currently examining alternative recovery methods, such as stem cell therapy, to allow sensation and motor improvements even below the level of injury in individuals with complete SCIs.

7 Proven Strategies for Regaining Hand Function After Spinal Cord Injury (SCI)

1. Passive and Active Range of Motion Exercises

Enhancing flexibility in the fingers and wrists is key to restoring control and preventing long-term stiffness. In other words, keeping these joints mobile supports overall hand function and recovery. Incorporating regular range of motion (ROM) exercises helps maintain flexibility, prevent stiffness, and encourage natural movement.

Two common forms of exercise include:

• Passive ROM Exercises or exercises where the hands and fingers are moved without exerting the muscles. For example, these exercises could be done by a therapist or caregiver, or by using an unaffected extremity to move the hand and fingers to maintain flexibility.
• Active ROM Exercises or exercises where the individual attempts to move their hand on their own to strengthen muscles and improve movement. An example of an active ROM hand exercise is fully closing the hand into a fist, then straightening the fingers back out.

Both have their place throughout your recovery and depend on your capabilities at the time. Passive ROM exercises are generally most effective when mobility is severely limited, while active ROM exercises are a great way to begin regaining movement and gradually building muscle strength.

2. Strengthening Exercises

Building hand and wrist strength is vital for regaining hand function after a spinal cord injury. Targeted exercises can help you restore lost strength which can make everyday activities like holding a cup or turning a doorknob easier.

Some effective strengthening techniques for your hand include:

• Grip Strengthening: Squeezing a stress ball or therapy putty.
• Finger Extensions: Using rubber bands around the fingers to practice opening the hand.
• Wrist Flexion and Extension: Moving the wrist up and down while holding light weights or resistance bands. If you don’t have any weights, consider holding a filled water bottle or canned goods during this exercise to gradually build up strength. 

Try to work these exercises into your regular routine alongside active and passive range of motion to improve mobility!

3. Fine Motor Training

Fine motor training can improve your coordination skills and help with tasks like buttoning a shirt, writing, or handling small objects. Generally, the best way to retrain fine motor movements is to focus on small, deliberate hand movements that can improve coordination and refine control for detailed tasks.

Some ideas to help you get started include:

• Picking Up Small Items: Using tweezers or clothespins.
• Stacking Coins or Blocks: Encourages precise finger control.
• Tracing Letters and Shapes: Helps refine hand coordination.

There really is no limit except your imagination here. The key is to focus on activities that promote small, deliberate hand movements. Start with slightly larger objects, like puzzle pieces, and move to smaller items, such as dry beans, as your skills improve.

4. Electrical Stimulation Therapy

Electrical stimulation therapy is a powerful technique that uses gentle electrical pulses to stimulate nerves, helping to activate weakened or dormant muscles. This therapy can be particularly beneficial for individuals recovering from neurological injuries, such as stroke or spinal cord injuries, by reawakening muscle activity and promoting strength recovery.

One common form of this therapy is functional electrical stimulation (FES), which delivers targeted electrical pulses to the nerves, triggering muscle contractions that mimic natural movement. When combined with hand exercises, FES can enhance neuromuscular re-education, improve coordination, and encourage the brain and muscles to work together more effectively. 

While you can get electrical stimulation devices to use at home, it is recommended to consult with your therapist regarding which device and parameters may be most effective for you.

5. Mirror Therapy

Mirror therapy is an innovative and effective rehabilitation technique that leverages visual feedback to help retrain the brain and restore movement in an affected hand. It can be especially beneficial for individuals trying to regain hand function after spinal cord injury, particularly if only one hand was affected such as in cases of Brown-Sequard syndrome.

The process involves placing a mirror in front of the unaffected hand while concealing the affected hand behind it. As the individual moves their unaffected hand, the mirror creates the illusion that the affected hand is also moving. This visual trick helps the brain perceive movement in the affected limb, activating mirror neurons and stimulating neuroplasticity—the brain’s ability to reorganize and form new connections.

Over time, repeated practice with mirror therapy can lead to improved motor control, reduced pain, and increased confidence in hand movement. If both hands were affected, motor imagery, where you mentally visualize moving the hands, can also be an effective way to promote neuroplasticity.

6. Constraint-Induced Movement Therapy (CIMT)

Constraint-Induced Movement Therapy (CIMT) is a highly effective rehabilitation technique designed to encourage use of the affected hand by limiting reliance on the stronger hand. This approach, which is most appropriate for individuals with impairments primarily in only one hand, is based on the principle of neuroplasticity—the brain’s ability to rewire itself by forming new neural connections through repeated use and practice.

CIMT involves restricting movement of the stronger hand using a mitt, sling, or other constraint while requiring the affected hand to perform daily tasks and functional activities. This forces the brain to engage the weaker hand, gradually improving strength, coordination, and motor control.

One of the key benefits of CIMT is that it helps overcome learned non-use, a condition where the brain “ignores” the affected hand due to prolonged inactivity. By continuously challenging the weaker hand, CIMT strengthens neural pathways and restores movement patterns that may have been lost.

7. MusicGlove: A Fun and Effective Hand Therapy Solution

Merging music with therapy, the MusicGlove provides a fun, engaging and gamelike experience that keeps users motivated. Designed for individuals recovering from stroke, spinal cord injury, or other neurological conditions, this interactive therapy device helps improve hand function, coordination, and dexterity through music-based exercises.

How does it work exactly? The MusicGlove uses built-in sensors that track finger movements. Users wear the glove while participating in therapy exercises that are synchronized with an interactive rhythm-based game. As they tap their fingers in time with the music, they perform high-repetition hand movements essential for stimulating neuroplasticity and rebuilding strength. 

The major benefits of the MusicGlove include:

• Encourages High Repetition: Users complete thousands of functional hand movements in a single session, reinforcing brain-muscle connections critical for recovery.
• Increases Engagement: The interactive music-based gameplay makes therapy enjoyable, motivating users to stay consistent with their exercises.
• Proven Results: Clinical research has shown that regular use of MusicGlove can lead to significant improvements in hand strength and dexterity within just a few weeks.

For individuals recovering from SCI, MusicGlove offers a structured and engaging way to enhance hand rehabilitation at home or in a clinical setting.

Regaining Hand Function through Adaptive Strategies

While the techniques above focus on regaining functional motor control and sensation, there are a number of adaptive strategies that may be used to improve use of the hands after a spinal cord injury. These are ideal for those with complete spinal cord injuries, since they may not be able to restore motor control and sensation below their level of injury.

Universal Cuff

This versatile and affordable assistive device can be very beneficial for those who are unable to grasp items effectively, but can still move their arms. It consists of a band that can be fitted around the palm of the hand, as well as a holder that can support various utensils.

Universal cuffs can be used to help individuals hold a number of items, such as a spoon, pencil, or toothbrush. Using a universal cuff can greatly increase independence, as it provides a way to to hold everyday utensils that individuals would otherwise would be unable to use.

Similarly, individuals who have some use of their hands but are unable to grasp small items may benefit from adding built-up handles to commonly used utensils.

Tenodesis Grip

Spinal cord injury survivors who have lost control of their hands and fingers, but are still able to extend the wrist, may benefit from learning how to use a tenodesis grip. This is an adaptive technique that allows the fingers to passively close when the wrist extends, and open when the wrist is flexed.

Learning how to use a tenodesis grip can improve independence with daily tasks, allowing individuals to grasp items they otherwise would be unable to. Talk with your occupational therapist to learn more about whether you’d be able to use tenodesis to improve your hand function, and how to perform it.

Final Thoughts to Regaining Hand Function After SCI

Regaining hand function after a spinal cord injury is a gradual process that requires dedication and the right exercises. With consistent therapy, neuroplasticity can help restore movement and strength. 

Tools like MusicGlove can make the rehabilitation journey more engaging and effective. By staying committed to recovery, individuals can regain greater independence and improve their quality of life.

The post Regaining Hand Function After Spinal Cord Injury: 7 Proven Strategies to Boost Recovery appeared first on Flint Rehab.

When searching for spinal cord injury exercises to add to your home therapy regimen, it’s essential to find exercises most suitable to your level of ability. This article will discuss the benefits of spinal cord injury exercises and the various types you can use to promote recovery. Be sure to check with your therapist to make sure the exercises are safe for you.

Before diving in, let’s first go over the mechanisms behind spinal cord injury recovery.

Benefits of Exercise After Spinal Cord Injury

Every spinal cord injury is different, and the effects survivors may experience following their injury can vary widely. Depending on the level of injury and its severity, some survivors have only minor movement and/or sensation deficits, while others have more severe, lasting damage.

The spinal cord is capable of rewiring itself and adapting through the process of neuroplasticity, as long as some connections in the spinal cord remain intact. Therefore, in survivors with incomplete spinal cord injuries, neuroplasticity can  allow existing spared neural pathways  to become stronger and learn new functions. Thus, the more spared neural pathways, the higher the chances of recovery. 

Of note, as there are no intact neural connections at the level of injury after a complete spinal cord injury,  traditional treatments and exercises cannot enhance lost movement or sensation. However, researchers are continually studying innovative ways to promote functional improvements, such as stem cell therapy. Furthermore, some functional recovery using compensatory strategies can still be achieved.

When there are existing neural connections at the level of injury, neuroplasticity is best activated through high repetition exercises, or massed practice. Consistently practicing tasks involving movement of the affected muscles and stimulation of areas with altered sensation helps to stimulate the spinal cord and promote neurological adaptations.. Spinal cord injury exercises may also have other benefits, such as relieving spasticity (involuntary muscle tightness),improving blood flow, and reducing the risk of pressure sores, even in those with complete spinal cord injuries. The more frequently you engage in spinal cord injury exercises, the greater your chances of improving mobility and function.

Passive Spinal Cord Injury Exercises

While every spinal cord injury has different functional outcomes, most spinal cord injury survivors can practice passive range of motion exercises. These are essential for maintaining and improving mobility, reducing spasticity, enhancing blood flow, and preventing pressure ulcers.

Passive range of motion exercises can be especially beneficial for individuals with severe weakness or paralysis, as they do not require the survivor to exert a lot of energy. Instead, a therapist or caregiver moves the survivor’s body for them. 

Those who have more control of their movements should try to actively perform range of motion exercises, using their own strength as much as they can. For those with limited movement, mental practice (visualizing yourself moving independently) can also help promote neuroplasticity. It is recommended to practice passive range of motion exercises at least once per day to minimize stiffness and stimulate the nervous system.

Here is a video with examples of various SCI passive range of motion exercises you can try with a therapist and/or caregiver. Be mindful of doing these exercises on your own if you are still building up strength to avoid overworking yourself.

Shoulder Flexion

Begin with your arm relaxed at your side. Have a therapist or trained caregiver raise your arm out in front of you, reaching as high as possible without pain. Try to keep your shoulder from shrugging upward and keep the rest of your body aligned. Then your therapist or caregiver can support your arm as it comes back down to your side, and repeat.

Elbow Flexion and Extension

Starting with your arm relaxed and your hand facing your side, have a therapist or trained caregiver gently bend your elbow, rotating your forearm so your hand turns toward your shoulder. Bend your elbow as much as possible without pain. Then relax your arm and repeat. This exercise also includes elbow extension, supination, and pronation.

Knee Extension

While sitting, have a therapist or trained caregiver slowly move your leg upwards until your knee is nearly straight. Gently bring your legs back down into your starting position, and repeat. If you are able to actively help with this motion, you should feel the muscles on the front of your thighs engage when doing this exercise.

Ankle Dorsiflexion

Starting in a seated or laying position, have a therapist or trained caregiver raise your toes up toward your calf, then relax back to a neutral position. Again, stop if you feel any pain.

Wrist Flexion and Extension

Start by stablizing the foream. Then, with your free hand bend the wrist forward and back promoting a gentle stretch without too much pressure. If you feel any pain or discomfort you can ease back on the exercise.

These exercises are primarily intended to be used on tight, weak, or immobile areas of the body. While some individuals may experience full-body paralysis, others may only need to focus on passively moving the lower body. It is often recommended to practice approximately 10 repetitions of each applicable exercise, while holding the stretch for 5-10 seconds before relaxing and repeating.

Range of motion exercises should not be painful. Depending on your sensation, some individuals may feel their muscles stretching. However, it is important to never push to the point of pain. 

As you begin to recover, try to move through these motions with less help from your therapist or caregiver. If you improve and are able to complete these exercises actively but tire quickly, take a break or ask your therapist or caregiver to take over for the remainder of the range of motion exercises. Your endurance should also improve over time with more consistent practice. Talk with your therapist for more personalized recommendations.

Lower Extremity Spinal Cord Injury Exercises

There are various exercises you can do to strengthen the muscles in your legs and improve mobility. Additionally, SCI leg exercises help reduce muscle atrophy, improve circulation, and stimulate adaptive changes in the spinal cord.

However, before engaging in leg exercises for SCI, it’s important to warm up and stretch. The following video demonstrates various leg stretches you can try using a strap, resistance band, or large towel.

Spinal cord injury can also affect the ability to feel, therefore survivors need to be extra careful and pull gently when stretching to avoid injury.

Once you’re warmed up, try these helpful leg exercises for spinal cord injury:

Ankle Pumps

While also laying down, you can point your toes down so that the ankle is extended. Then raise your feet upwards towards the knees to flex the ankles. This exercise mimics the motions the ankles create when walking.

Knees to Chest

Place one hand on the upper leg just above your knee and the opposite foot. Bend one knee in so that it’s reaching towards your chest. Then bring your foot down and straighten the knee.

Straight Leg Lifts

Lay down with your legs straightened and lift one leg without bending at the knees. When the leg is as high as it can go, hold for a few seconds. Bring the leg back down and alternate with the other leg. Try to engage your core while doing this exercise to avoid putting undue stress on the lower back.

Seated Marching

Sit at the edge of your seat with both feet on the ground, then alternate lifting your knees one at a time. This leg exercise allows survivors to practice movements used while walking without added pressure on their joints.

Discover more leg exercises for spinal cord injury patients »

Upper Extremity Spinal Cord Injury Exercises

Spinal cord injury survivors with cervical or high thoracic level injuries may often experience weakness in the hands. Fortunately, various hand and arm exercises can help improve fine motor skills and reduce weakness after spinal cord injury.

Since activities for spinal cord injury patients are often more engaging than rote exercises, many individuals find that they are more motivated to practice them. Therefore, using activities can encourage individuals to practice more frequently and repetitive practice is essential for adaptive rewiring through neuroplasticity, consistently practicing activities can also lead to functional improvements.

Here are some upper extremity spinal cord injury exercises you can try:

Therapy Putty

Squeezing, molding, and stretching therapy putty can improve strength and coordination of the hands. Different resistances are available to match your current ability level.

Fine Motor Games

Games such as Mancala or Connect 4, which involve manipulating small objects, can improve hand mobility, dexterity, and coordination. This can be critical for individuals experiencing weakness in their hands.

Placing Objects in Overhead Cupboards

Grasping objects of different weights and sizes, such as cups, towels, or canned foods, can improve fine motor coordination and strength. Lifting these objects to an overhead cupboard can also enhance shoulder strength and mobility.

Self-Care Tasks

Practicing tasks such as getting dressed, buttoning buttons, or preparing food can improve fine motor manipulation skills and upper body mobility. These tasks can be easily integrated into your daily routine for consistent practice.

Tactile Stimulation

Rub various textured objects, such as a cotton ball, sheet, or towel, along your arm and hand. This tactile input stimulates touch receptors, encouraging improved sensation. Avoid anything abrasive, and ensure no irritation or redness occurs, particularly if you have severe sensation impairments.

Making O’s and Fists

Using one or both hands, alternate tapping the tips of each finger to the thumb. After touching each finger, you can also add closing the hand into a fist. Hold a few seconds or as long as you can and straighten the fingers back out.

Gamified Neurorehabilitation devices, such as the MusicGlove

While there are many neurorehabilitation devices available, the MusicGlove is a hand therapy device that combines music, gaming, and hand therapy exercises to help you stay engaged and practice high repetitions from the comfort of your own home. MusicGlove has been clinically proven to boost hand function in just 2 weeks!

While these hand therapy exercises may seem simple, they are extremely effective. However, practicing the same movements can get boring and cause you to lose motivation. To help keep you motivated and engaged you can use gamified neurorehabilitation devices.

For example, MusicGlove is a hand therapy device that combines music, gaming, and hand therapy exercises to help you stay engaged and practice high repetitions from the comfort of your own home. MusicGlove has been clinically proven to boost hand function in just 2 weeks!

Discover more hand therapy exercises for spinal cord injury patients »

Spinal Cord Injury Exercises for the Core

Core exercises after spinal cord injury are also essential because they help stabilize the trunk for better balance and posture.

The following video will guide you through some wheelchair-friendly exercises to strengthen the core. Before practicing these exercises, always check that the brakes on your wheelchair are set.

Speak with your therapist before engaging in some of these core exercises if you still have spinal precautions, or have certain movements that need to be avoided after your SCI.

Back Extensor Isometric Hold 

Sit at the edge of your seat and lean back, pushing gently against the back of your chair. Hold for a few seconds or as long as you can, then use your core muscles to sit up straight again.

Seated Trunk Extension 

While sitting in a chair, slowly lean forward as far as you comfortably can and try reaching your hands to the floor. Then, use your back muscles to slowly sit back up. If you have trouble with your sitting balance, be sure to have someone nearby to spot you during this exercise.

Trunk Rotation

Start by laying down and keep your knees bent and feet flat on the floor. Try to keep your shoulders and upper body firmly on the floor. Tighten the abdominal muscles and slowly relax the knees down toward the floor on one side of your body, then use your core to bring the knees back to center before relaxing toward the other side.

As your core strength improves, therapists may recommend trying more challenging exercises, such as sitting on an exercise ball or carefully holding specific yoga poses. For safety, talk with a therapist before completing these types of exercises and ensure you have a spotter nearby.

Discover more core strengthening exercises for spinal cord injury patients»

Engaging in Spinal Cord Injury Exercises

The best way to improve mobility after SCI is to consistently practice spinal cord injury exercises. This helps stimulate neuroplasticity in undamaged regions of the spinal cord and strengthen the pathways that control movement.

Every spinal cord injury is different and every survivor will have different functional outcomes so try not to feel discouraged if an exercise is too difficult. A therapist can help you adjust and provide SCI exercises for your specific needs and abilities.

We hope this article has inspired you to engage in spinal cord injury exercises to promote recovery.

The post Spinal Cord Injury Exercises: Improving Mobility After SCI appeared first on Flint Rehab.

Exercise after spinal cord injury is essential because it helps promote circulation and maintain range of motion, bone density, and muscle mass. Movement is also necessary to avoid additional complications after spinal cord injury and to maximize your ability to participate in daily activities.

In this article we will discuss the importance of exercise after quadriplegia as well as examples of exercises for passive range of motion, upper body strength, and mobility. You can use these links to help you navigate through this article: 

• The importance of exercise after quadriplegia
• Breathing exercises
• How to prepare for passive exercises
• Passive range of motion exercises
• Upper body exercises
• How to improve mobility

The Importance of Exercise After Quadriplegia

As we know, exercise is a vital component of overall health, both physical and mental. This is just as true for individuals following spinal cord injury, even if that injury results in quadriplegia. Since active motion becomes limited with quadriplegia, it is necessary to find alternative ways to incorporate movement into your daily life.

Regular exercise can benefit individuals with quadriplegia in a variety of ways. For example, exercise has been shown to have a positive impact on respiration (breathing) and circulation following spinal cord injury. Movement can help prevent secondary complications such as pressure sores, leg swelling, or edema and prevent infections like pneumonia. Regular exercise can also improve digestive function and reduce risk of constipation or urinary tract infections.

Furthermore, regular exercise can have a positive impact on mental health and self-esteem for individuals with quadriplegia. In one study, for example, researchers found that increased participation in daily activity was associated with lower incidence of anxiety and depression for individuals affected by spinal cord injury. This highlights the importance of exercise after quadriplegia and will hopefully encourage you to stay motivated to pursue rehabilitation.

Breathing Exercises After Quadriplegia

Breathing function and overall respiratory health are incredibly important following a spinal cord injury, especially for individuals with quadriplegia. Depending on the level of injury, the muscles of the diaphragm and abdomen are often affected. This means it is vital to perform daily breathing exercises to help maximize respiratory function. Here are some breathing exercises to get you started:

• Deep Breathing: Take a deep breath in through the nose, working to expand the lungs and chest. Hold this breath for 2-3 seconds, then release slowly through pursed lips.
• Air Stacking: Start by sitting upright or recline slightly with support behind your back. Take a deep breath in and hold, then breathe in more air and hold. Continue this 4-5 times without exhaling and hold 2-3 seconds, then exhale slowly to finish one cycle of the exercise.
• Number Counting: Take a deep breath in, then release the breath slowly while counting out loud. Try to gradually increase the number you can reach to improve your breath control.

Additionally, another great breathing practice is the Active Cycle of Breathing Technique (ACBT). Talk with your rehab team to create a breathing program that is optimal for your specific needs. Your physical therapist can also assist you with stretches for your trunk to improve chest expansion and make breathing easier.

How to Prepare for Passive Range of Motion Exercises for Quadriplegia

All individuals with quadriplegia can practice passive range of motion exercises. This type of exercise requires no active muscle contraction or intense physical exertion. Instead, a physical therapist, occupational therapist, or trained caregiver will facilitate your movements for you to make sure your joints move through their full range of motion.

The benefits of passive range of motion exercises include improved blood flow, flexibility, and reduced pain after spinal cord injury. Furthermore, passive range of motion exercises provide a perfect opportunity for your therapist or caregiver to check for any skin integrity issues that may develop, helping to prevent pressure sores.

Please note that these exercises may not be appropriate if you have been given specific precautions due to your SCI or other injuries you may have sustained. For example, some individuals will have a neck or back brace and “spinal precautions” after their injury, which are specific ways they should NOT be moving their spine.

These types of precautions are typically necessary for around 12 weeks after injury, but your doctor will be the one to remove these precautions when it is safe and appropriate. Be mindful of these precautions when looking through these exercises.

These specific exercises are designed for someone else to be performing the movement for you. However, as you continue practicing these passive range of motion exercises, you may find that you are able to actively help with some of the movements. This is a great sign of recovery! Even if you are unable to move independently, however, these exercises are still beneficial for your joints, muscles, and circulation.

Getting Started with Passive Range of Motion Quadriplegia Exercises

Generally, each of these exercises for quadriplegia should be completed on both sides of the body, ideally every day or at least multiple times per week. A slow stretching motion with a 5-10 second hold at the end range of motion is typically the most effective. Some passive range of motion exercises you and your caregiver can practice at home include:

• Finger Flexion and Extension: Curl the fingers inward towards the palm, creating a fist, and extend them back so that they are straight. Keep the wrists neutral (straight) while doing this.
• Finger O’s: Touch the tip of each finger to the tip of the thumb.
• Finger Abduction (Splits): Separate any two adjacent fingers by moving them away from each other, then bring them back together.
• Wrist Flexion and Extension: Bend the wrist so that the palm moves towards the inner arm and makes a 90° angle. Then, extend the wrist in the opposite direction. If the individual has some hand movement preserved and is working on use of a “tenodesis grasp” in therapy, then be sure to keep their fingers curled in rather than fully extended while performing this wrist exercise.
• Forearm Rotation: Start with the elbows bent at 90° at the individual’s sides with the back of the hands facing up. With one hand, hold just above the elbow and with the other, flip the hand over so that the palm faces up. Forearm rotation can also be completed with the arms straight and positioned at the individual’s sides.
• Elbow Flexion and Extension: Bend the elbow so that the hand can touch the shoulder. Then extend it so that the arm is fully straight.
• Shoulder Flexion: Start with the arm relaxed at the individual’s side so that the palm is facing inward. Keeping the elbow straight, raise the arm forward slowly, gradually bringing it up so that the hand is reaching up and the arm is as close to the ear as possible.
• Shoulder Abduction (Snow Angels): Start with the arm straight with the palm facing forward. Slowly bring the hand and arm outward to the side, away from the center of the body. The arm should be level with the shoulders or higher. Then, bring the arm back to the starting position. When done consecutively, it will look like you are making a snow angel.
• Ankle Rotations: Put one hand just above the ankle to stabilize the leg and the other hand on the foot. Then move the foot in circular motions as well as “gas pedal” motions to stretch the ankle and calf.
• Toe Flexion and Extension: Bend the toes in towards the sole of the foot and bring them back out to neutral. Then extend them upward toward the shin to stretch the bottom of the foot.

The following hip and knee passive range of motion exercises should be performed lying down.

• Lower Trunk Rotation: For this exercise, the individual should be lying down on his or her back with knees together and bent. Tilt the knees gently towards one side and then the other. Make sure the shoulders stay in place and don’t move. If you wear a back brace or neck brace of any kind or have been told you have “spinal precautions,” do NOT perform this exercise and talk to your therapist and/or doctor about when you can try it.
• Hip Rotation: Bend one knee so that the thigh is perpendicular to the mat/bed and there’s a 90° angle at the knee. Start to rotate the hip in the socket by holding the thigh just above the knee and moving the foot inward toward the opposite leg. Then reverse the direction of rotation and move the foot outward, keeping the thigh perpendicular to the mat the whole time.
• Hip Abduction: The legs should be straight. Pull one leg to the side (away from the midline of the body), creating separation between the feet until there’s slight muscle resistance. Then, bring the feet back together. It should look like you are performing the leg portion of a snow angel.
• Knees to Chest: With one hand on the upper leg just above the knee and the other hand holding the foot, bend one hip so that the knee is reaching towards the chest. Then, bring the foot back down and straighten the knee before performing this motion on the other side.

For a demonstration of how passive range of motion exercises are performed, watch the video below.

As you progress, you may be able to increase your participation in these exercises. This will allow you to become more comfortable performing range of motion exercises on your own, requiring less assistance from a therapist or caregiver. Although quadriplegia affects all four limbs, individuals with an incomplete or lower level of injury may be able to perform some passive range of motion exercises independently.

Upper Body Quadriplegia Exercises

Individuals with quadriplegia and their rehabilitation teams will often focus on improving upper-body mobility. By doing so, individuals can significantly increase their independence with activities of daily living and use their arms and hands to assist with mobility of the lower body. That being said, it’s important to practice exercises for your lower body (such as passive range of motion) as well, to whatever degree possible.

Here we will discuss additional exercises that focus on developing upper body strength and mobility for individuals with quadriplegia. Keep in mind that muscle function after SCI depends on the level of injury, so you may need to modify or scale these exercises to fit your abilities.

Talk with your therapy team to help create an optimal exercise plan for you. Additionally, you can take a look at this strengthening program to give you some ideas or follow along with the following exercises we have provided for you:

• Neck Tilts: Tilt your neck so that your left ear moves towards your left shoulder and then do the same for your right side, keeping the shoulders relaxed. Important note: If you wear a neck brace of any kind or have been told you have “cervical spinal precautions,” do NOT perform this exercise and talk to your therapist and/or doctor about when you can try it.
• Neck Rotation: Turn the head from side to side slowly as if looking over your shoulder or signaling ‘no’; the eyes should stay level the entire time.
• Shoulder Shrug: Shrug your shoulders up towards your ears and then bring them back down.
• Shoulder Rolls: With your arms relaxed at your sides, roll your shoulders forward and backward in slow circles.
• Shoulder Blade Rows: With your arms in front of you or at your sides, squeeze your shoulders together like you are pinching a pencil between your shoulder blades.
• Shoulder Flexion: Start with your arms at your sides so that the palm is facing inward. Keeping the arm straight, raise the arm forward slowly, gradually reaching upward and aiming to have the arm as close to the ear as possible. If you have cervical spinal precautions, do not raise your arms any higher than shoulder-height.
• Shoulder Abduction (Snow Angels): Start with the arms straight at your sides with palms facing forward. Slowly bring the arms out to the side, away from the center of the body and toward your ears. Then, bring the arms back to the starting position. When done consecutively, it will look like you are making a snow angel.
• Arm Circles: Raise your arms to the side so that your body makes a “T” shape and move them in little circles forward and backward.
• Crossbody Reach: Take one arm and reach across the opposite side of the body, working to control your trunk at the same time. Then return to neutral and repeat on the opposite side.
• Chest Press: Lying down, bend your elbows to 90° and “punch” your arms forward toward the ceiling, thinking about bringing your armpits toward each other. Then lower slowly; the more slowly you lower your arms, the more challenging the exercise will be.
• Forearm Rotation: Put your arm out straight in front of you with your palm facing down and then flip it so that your palm faces up. This can also be completed with your elbow bent at your side.
• Gripping: Make a fist and squeeze all your fingers together. Then, open your hand and stretch out your fingers as much as you can. You can add therapy putty or a stress ball in your hand for some resistance.
• Sitting Balance: With someone nearby, try sitting up as straight as possible on the side of the bed or in a chair/wheelchair. As you are able, slowly decrease support from your arms to challenge your balance and the strength of your posture muscles. Again, this should be performed with someone nearby to “spot” you.

These exercises focus on building strength and stamina for individuals with quadriplegia. Again, every injury is different depending on the level and severity, so understand that it is okay to modify exercises based on your specific needs. To help inspire you, here is another upper body exercise program created by an individual with quadriplegia:

Improve Mobility with Quadriplegia Through Exercises

There are many negative secondary effects that occur following spinal cord injury that can lead to additional complications. As we discussed before, these complications can include blood clotting, pressure sores, and bone thinning, which can all be made worse by a sedentary lifestyle. Therefore, it’s essential for individuals with quadriplegia after spinal cord injury to move frequently in order to prevent these complications.

Even you have minimal voluntary movement, it is vital to seek help and ask a caregiver to passively move your body for you. However, this does not mean you should be idle during passive exercises. Instead, focus on those passive movements and be alert for any changes in sensation or motor control. It is important to participate as much as you can to maximize your recovery.

Individuals with incomplete quadriplegia have the potential to improve function below their level of injury because the spinal cord can utilize neuroplasticity to heal. Neuroplasticity refers to the central nervous system’s ability to rewire itself and strengthen functions weakened by injury. Consistently repeating exercises and movement patterns helps stimulate neuroadaptive changes in the spinal cord and strengthen new connections. The more you practice, the more efficient your movements will become.

By participating in intensive rehabilitative therapies and practicing high repetitions of targeted exercises, individuals with incomplete quadriplegia may be able to promote neuroplasticity and recover movement. Additionally, all individuals should practice the exercises they learn at physical or occupational therapy at home. To stay motivated, gamified neurorehabilitation devices like FitMi home therapy can help make rehab engaging to encourage consistency.

Exercises for Quadriplegia: Key Points

It can be challenging for individuals with quadriplegia to participate in exercises since all four limbs are affected. However, an active lifestyle is incredibly important to help prevent complications and promote independence.

Following a spinal cord injury, there are many ways to incorporate exercises into your daily routine. This can include breathing exercises to improve respiration as well as passive range of motion to maximize mobility. Additionally, individuals with quadriplegia can participate in strengthening exercises and even some cardio to help improve overall health and performance of daily tasks.

Exercise does not necessarily have to be strenuous to be effective, and frequent, purposeful movement can make a huge difference in recovery. We hope this article helped you understand what individuals with quadriplegia can do to incorporate more physical activity into their daily routines and the benefits these exercises provide.

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Mat exercises are a good stepping stone for developing core strength and improving posture, especially for individuals using a wheelchair. In addition, it provides an opportunity to practice fundamental positions and movement patterns that will aid in functional activities such as transfers and bed mobility.

Rehabilitation exercise is an important element in spinal cord injury recovery that should be performed on a consistent basis to promote neuroplasticity (central nervous system’s ability to rewire itself) and improve mobility.

To ensure your safety during spinal cord injury exercises, we’ve gathered 10 of the most effective mat activities for spinal cord injury, including exercises for patients with hemiplegia (paralysis on one side of the body) or paraplegia (paralysis of the lower limbs) to do at home.

Benefits of Exercising on a Mat After Spinal Cord Injury

Mats provide many benefits during exercise, especially after a spinal cord injury. Mats can make it smoother to exercise because of its protective layers such as reducing the risk of falling or further injury. Studies have also shown that performing core exercises on a mat can help improve spine stability and increase the control of the affected limbs.

Each type of mat has their own unique benefits. For example, a Pilates or yoga mat is a non-slip mat that provides traction and a little bit of cushioning for the body, helping prevent injury and falling. These are usually light-weight and can be rolled up or folded for better portability and storage. Thicker exercise or gym mats provide extra cushion, are usually heavier but more durable, and help prevent muscle aches and pains while exercising.

Some factors to consider when thinking about purchasing a mat include portability, whether it’s easy to clean, and affordability. Most are light-weight, sweat-resistant, and durable meaning they can last you all throughout your spinal cord injury recovery journey, although materials between mats may vary.

Choosing the Right Mat for Spinal Cord Injury Exercises

Choosing the right mat for spinal cord injury exercises is essential. To find the most suitable one for you, it helps to take into account a couple of factors including what type of workouts you are aiming for.

For instance, exercise mats usually provide more support for advanced or higher intensity workouts, while yoga or Pilates mats tend to focus on improving balance and grip, both which are extremely important. In fact, studies indicate that the most effective workout mat is one that provides balance, grip, and comfort.

When buying a mat after spinal cord injury, it helps to keep in mind the:

• Size of the mat: Smaller mats can help with core exercises and stretching, while larger mats offer a bigger area to do other workouts. Also take into account the thickness of the mat. Thinner mats are lighter and easier to transport, but thicker mats provide more cushion and support after a spinal cord injury.
• Durability: Some mats are easier to clean and offer more traction and durability depending on the materials, such as foam, silicone, or rubber. Certain mats may also feature a protective coating and resistance against shoes, equipment, odor, and wear.
• Portability: lighter-weight mats can often be rolled up and easily transportable, but usually provide less cushion. On the other hand, heavier and thicker mats aren’t as portable but typically offer more durability and cushion.

Lastly, an ideal mat is one that matches your individual needs. Take into account its intended use, whether you plan to take it when travelling or going to therapy sessions, or will use it solely at home and can keep a heavier exercise mat in a designated space. Having a mat that is quick and simple to use is essential during your home exercise program for spinal cord injury recovery.

Mat Exercises for Spinal Cord Injury Survivors

Exercise after a spinal cord injury is crucial to stimulate the central nervous system and activate neuroplasticity, which helps strengthen the neural pathways that may have been affected after a spinal cord injury.

Exercising and moving the affected muscles as much as possible is key to activating neuroplasticity and improving overall function. When neglected, lack of activity can increase the risk of complications after spinal cord injury such as pressure ulcers, weight gain, reduced metabolic rate, poor circulation, and muscle atrophy.

To lower the risk of complications, it’s important to perform high repetition of exercises, or massed practice. Practicing a skill consistently will train the nervous system to recognize that skill and strengthen its neural pathways.

While mat exercises can be quite challenging, do not feel discouraged. Every spinal cord injury is different as well as the outcomes for each person. Intensity is one of the variables that increases neuroplasticity. However, the goal is to feel challenged and not frustrated.

Many of the mat exercises can be modified and adjusted to your ability level. Your therapist is also a great resource and can provide you with more mat exercises tailored to your condition; and the following mat exercises should be performed only with your therapist’s approval.

Here are 10 effective mat exercises for spinal cord injury:

1. Trunk Twist

For this first mat exercise for spinal cord injury, begin by lying on your back with your knees together and bent. With your feet flat on the mat, slowly tilt your knees to one side using your abdominal and hip muscles. Your shoulders should stay on the mat and not move the entire time. If you have sensation, a gentle stretch may be felt along your back. Hold for 20-30 seconds and then tilt to the other side.

2. Bicycle Kicks

Lying on your back, raise and bend the right leg while the left leg is extended. Then, make pedaling motions with your legs, as if riding a bike. Try your best to keep your abdominals engaged and your back flat against the mat. The legs should alternate between bending and extending. If you have trouble holding your legs off the mat, try marching one knee up at a time instead. Repeat for 20 total (10 each side).

3. Bridges

Lie on your back with your knees bent and your feet flat on the mat. Slowly lift your hips but keep your shoulders, arms, and head on the mat. Hold for 5 seconds and then gently lower your hips. Repeat 10 times.

4. Side-Leg Raises (Hip Abduction)

This exercise will help strengthen your gluteus muscles, stretch out your inner thigh, and reduce hip joint stiffness. Lie on your right side of the body and raise your left foot up towards the ceiling as high as you can. Hold the position for a few seconds before lowering your leg. If lifting with a straight leg is too difficult, try it with your knee bent as you open and close your leg like a clamshell. Another modification is to lay flat on your back as you move your leg out to the side and back in. Repeat 10 times alternating with the other side.

5. Superman

This mat exercise is excellent for developing strength of your back muscles and improving posture. Lie on your stomach with your arms out front. You can place a pillow under your stomach and hips for comfort. Lift your arms, legs, and head up until you’re mostly balancing on your torso. Make sure that your arms and legs stay straight and focus on stretching them outwards. Hold for 10-15 seconds, then repeat 5 times.

6. Cobra Stretch

Use this mat exercise to improve spine mobility and strengthen your back, shoulders and triceps. With your hands by your side, press through your palms as you lift your head and chest upward. Work towards being able to fully straighten your elbows. Your lower body and hips should remain on the mat, creating a slope with your body. If pressing through your hands is too difficult, try doing the same movement on your forearms and elbows instead. Hold for 15-20 seconds, breathing deeply. Repeat 5-10 times. If you feel any pinching or pain in your lower back, stop immediately.

7. Quadriceps Stretch

While laying on your side, reach for your foot or ankle and pull to bend your knee. A stretch should be felt along the front of the thigh. Hold for 20-30 seconds, remembering to breathe. You can also try this quadriceps stretch on your stomach, using a belt loop or strap to hook around the foot. Be careful not to over-stretch, especially if you have impaired sensation.

8. Hamstring Stretch

Having good hamstring flexibility is critical for spinal cord injury survivors to make changing positions, transfers, and dressing easier. Sit with your legs straightened and together in front of you. Slowly lean forward toward your toes and hold for 20-30 seconds. For more balance, bend one knee so that the bottom of that foot is touching the side of your other thigh. This will create a more stable base, but you’ll need to stretch one hamstring at a time. Then, lean towards the foot of your straightened leg. Repeat for both sides.

9. Calf Stretch

While in a seated position, place a towel around the ball of your foot and pull your ankle back until a stretch is felt on your calf area. Keep your knee in a straightened position during the stretch. Hold for 20-30 seconds and then switch sides.

10. Knee Push-Ups

This advanced exercise may require more strength and mobility. Only perform if you feel comfortable. To start, get on your hands and knees and move your hands and upper body forward, creating a slope in your back all the way to your knees. 

Facing the floor, bend your elbows to a 90° angle to lower your body. Push against the ground, straightening your elbows to raise yourself back up. For an added challenge you can lift your feet off the floor.

Bonus Advanced Mat Exercises

If you’re looking for a bit more challenge, here are some additional, more advanced mat exercises to try. As always, make sure to consult with your physical therapist beforehand to determine if they are safe for you to do.

11. Shoulder Reaches

This mat exercise is excellent for promoting shoulder stability, strength and mobility in a weight-bearing position. Start by laying on your stomach propped on your elbows. Make sure that your elbows are positioned directly beneath your shoulders. Slowly alternate lifting one arm straight forward and back down, without letting the shoulder on your down arm sag or collapse. Repeat for 20 repetitions.

12. Prone Snow Angels

For this challenging mat exercise, start on your stomach with your forehead resting on a rolled up towel to allow you to breathe. With both arms, slowly sweep them out to the side, overhead, and back down to your hips. It’s okay if your arms are grazing the floor, but bonus points if you can do the full motion without letting your hands touch the ground at all! Perform 10 repetitions, slow and controlled.

13. Rolling

Practicing rolling as a mat exercise not only is good for bed mobility, but also to help you learn how to maneuver your body using your arms and trunk, if applicable. To roll to the right, start by lying on your back with your left leg crossed over the right ankle. Using momentum, quickly lift your head as you reach your left arm across your chest for the roll. Use your left hand on the floor/mat in front of you to stabilize yourself once you are laying on your side. Push through your left arm to roll onto your back again. Repeat 5 times for both sides.

While the mat exercises vary in intensity and difficulty, they can all be adjusted to your ability level. Remember to only do what you can and take breaks or stop when necessary. Also, be sure to consult with your doctor and/or therapist to check if the mat exercises above are safe and suitable for your condition.

Promoting Spinal Cord Injury Recovery Through Exercise

Motor control (mobility) is often impaired after a spinal cord injury, the severity of which depends on the type of injury (incomplete vs. complete) and level of injury. With a complete SCI, survivors do not preserve movement or sensation below the level of injury.

However, with an incomplete SCI there are usually some motor and sensory neural pathways remaining, which are capable of neuroplasticity. Neuroplasticity helps strengthen these existing pathways and also create new ones.

Still, it’s important for survivors with a complete spinal cord injury to perform mat exercises to promote proper blood flow and improve oxygen consumption. For individuals with an incomplete spinal cord injury, mat exercises are essential to activate neuroplasticity and restore mobility in the affected limbs. For those with a complete spinal cord injury, the above mat exercises can help you preserve joint and muscle health, increase strength and mobility, and relearn how to maneuver your body. The more you practice, the higher the chances of regaining overall function.

Effective Mat Exercises for Spinal Cord Injury

Though it may seem like just another piece of exercise equipment, mats are incredibly useful and versatile. Various types of mats provide their own unique benefits, making it an attractive therapy tool for spinal cord injury survivors.

Exercising after a spinal cord injury can be challenging for a number of reasons, including lack of strength. Fortunately, mats help survivors exercise more freely by limiting stress on the joints, stretching the muscles, and increasing core strength.

We hope this article helped you understand the importance of exercising, the benefits of using a mat, and encouraged you to engage in mat exercises for spinal cord injury.

The post Mat Exercises for Spinal Cord Injury: Promoting Safe Recovery appeared first on Flint Rehab.

Therefore, movement, shoulder health, and injury prevention are crucial. Practicing shoulder exercises consistently can help improve strength, increase range of motion, relieve stiff muscles, and reduce pain. This article will discuss some of the most effective spinal cord injury shoulder exercises you can try with your therapist or at home.

To have a better understanding how these exercises are beneficial, it’s important to understand how a spinal cord injury affects the shoulders and muscles.

How a Spinal Cord Injury Affects the Shoulder Muscles

The presence of shoulder pain and weakness often depends on the type of spinal cord injury (complete or incomplete) and the level of injury. Typically, movement and/or sensation below the level of spinal cord injury are affected.

For example, an injury at C5 or higher causes weakness in the shoulders. With a C6 level of spinal cord injury or lower, the shoulders may not be directly impacted. However, many may still struggle with weakness or paralysis in the legs, potentially requiring the use of a wheelchair. As such, the arm and shoulder muscles may become overworked during wheelchair use, possibly resulting in pain or injury. 

Fortunately, exercise can help reduce pain and improve muscle strength and mobility in the shoulders. Exercise stimulates the spinal cord and activates neuroplasticity, the nervous system’s ability to heal and rewire itself. Neuroplasticity is most effective through high repetition of exercises, or massed practice. The more you practice, the higher the chances of rebuilding shoulder muscle strength and increasing movement.

Not only does exercise activate neuroplasticity, but it also directly increases or maintains lean muscle mass, strength, and mobility. Furthermore, exercise can also help prevent other shoulder complications such as joint subluxation (partial dislocation) or other conditions.

Therefore it’s essential to find the most suitable spinal cord injury shoulder exercises for you. You should consult with your physical therapist to make sure they are safe for you, and you can also ask your therapist for more exercise recommendations to match your specific needs or goals. 

Performing SCI Shoulder Exercises Safely in a Wheelchair

As previously mentioned, a lower-level spinal cord injury (typically T2 or lower) doesn’t usually affect the upper body. However, some may still experience shoulder pain due to overuse of the muscles, particularly survivors with paraplegia who must rely on their upper extremities for wheelchair propulsion, transfers, and reaching overhead especially during activities of daily living.

Shoulder pain in SCI survivors is commonly due to injured rotator cuff muscles or tendons. The rotator cuff is a group of four primary muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) and provide support to the shoulders to stabilize the shoulder joint and help it move properly.

With inappropriate shoulder mechanics, the rotator cuff, specifically the supraspinatus tendon, can become overcrowded or pinched (impingement syndrome). This condition can be painful and can cause further wear and tear of the tendon.

Spinal cord injury shoulder exercises can help reduce pain and strengthen the tendons. However, because the shoulders are being used excessively, it’s crucial NOT to overwork them even more. Performing daily activities should not feel overly strenuous or create more pain.

Working with physical and occupational therapists is important because they can provide realistic solutions to perform daily tasks more comfortably, while you work on improving your strength.

In addition, do not underestimate the value of incorporating rest in order to prevent and allow recovery time for overuse injuries in the shoulder. It is important to recognize that rest does not mean the same as disuse or neglect of the upper extremities. Instead, rest could mean a relative reduction of stress on the shoulder or taking breaks during repetitive tasks such as propelling a manual wheelchair.

Once cleared by your therapist, you can try the following spinal cord injury shoulder exercises to boost mobility. Just be sure to take precautions such as taking necessary breaks and stopping immediately if you feel fatigued or any pain or discomfort.

11 Spinal Cord Injury Shoulder Exercises to Boost Mobility

Spinal cord injury shoulder exercises can be done passively or actively depending on the severity of the injury and your ability level. Passive exercise involves assisting your affected muscles through a movement. You can use your unaffected side to assist you or a trained caregiver or therapist can help.

Active exercise involves making the movement on your own and is usually done without assistance. Both passive and active exercise helps stimulate neuroplasticity in the spinal cord, promote circulation, and improve range of motion.

You should start with slow, controlled movements and work your way up to more challenging exercises. It is always recommended to consult with your therapist before adding weight or resistance during these shoulder exercises. 

Here are 11 spinal cord injury shoulder exercises to help boost strength and mobility:

1. Arm Circles

For this first SCI shoulder exercise, spread your arms out to the sides to create a “T” shape. Then, move your arms in circular motions going forward and backward. Alternate each arm making small and large circles. This can help promote range of motion in your shoulder joints.

2. Snow Angels

Start by sitting up straight in your chair; or, you can also do this exercise lying flat on your back. Bend your elbows at a 90° angle and have your forearms facing forward. Slowly reach your arms overhead while keeping the elbows bent, then gently back down as though you are making snow angels. This exercise will help with shoulder mobility while the rotator cuff muscles work to control the movement.

3. Chest/Pectoral Stretch

Hold one arm straight out to the side and lean the inner part of that arm against a wall. Slowly turn your body in the opposite direction (i.e. if your right arm is against the wall, your body should turn left). Hold for 30 seconds and then stretch out your other arm. Stretching can help relieve tightness in the chest and shoulders, which can also improve posture.

4. Arm Across Chest

Wrap one arm across the chest and use your other arm for support. Hold for about 20-30 seconds and then switch arms. Repeating this stretch can help improve range of motion in the shoulder joint and flexibility in your deltoids.

5. Overhead Tricep and Lats Stretch

To stretch the triceps and latissimus dorsi (or “lats”), bend one arm behind your head and use your other arm to gently press the elbow back (you can think of it as lining your elbow with your head). Keep your chest up as you hold for about 30 seconds, then release and switch arms. This stretch will help maintain the mobility necessary for overhead reaching.

6. Shoulder Blade Squeezes

First, take a deep breath as you lift your chest and sit upright. Then, move your arms back, squeezing the shoulder blades together down and back. You should feel a slight stretch in the front of the shoulders, upper back and across your chest. Aim for 10 repetitions with 3 to 5 second holds. This exercise is beneficial for shoulder and upper extremity mobility because it helps with movements used in daily activities such as pushing, pulling, and holding objects, along with improving posture.

7. Shoulder Shrugs

To practice shoulder shrugs, lift your shoulder blades up towards your ears, and then slowly lower them. Repeat about 10 times. To increase the challenge, try holding the shrug a few seconds longer or hold a light weight in each hand. This shoulder exercise can help strengthen your trapezius (upper back) muscle, which is responsible for shoulder blade mobility and stability.

8. Shoulder Rolls

After mastering shoulder shrugs and shoulder blade squeezes, you can try combining the motion into shoulder rolls by rotating your shoulders forward and backward in a circular motion. Aim to do 5 forward shoulder rolls followed by 10 backward shoulder rolls.

The forward motion in shoulder rolls is similar to that of pushing a wheelchair. Since many SCI survivors in a wheelchair already practice rolling their shoulders forward, it can be beneficial to focus on backward shoulder rolls. Shoulder rolls help loosen up tight muscles, improve coordination of the shoulder blades, and develop better posture.

9. Seated Upper Back Stretch

Before getting started, make sure that the brakes on your wheelchair are set and your feet are flat on the ground. Place one hand on your armrest and one on the outside of your knee or thigh. Then, gently press down with your hands as you slowly rotate your shoulders and trunk. Keep your chest upright as you breathe deeply and hold for about 15 seconds. Repeat for both sides. Upper back stretches are great for improving posture, lowering muscle tension, and reducing stiffness.

10. Half Jumping Jacks

Carefully swing your arms above your head and bring them back down, making jumping jack motions with your arms. This helps promote shoulder abduction, which is the ability to lift your arms away from your body. As well as adduction, lowering your arms back down towards your body. You can do sets of 10 to 20 repetitions, or go for intervals of 30 seconds at a time.

11. Punches

For this last spinal cord injury shoulder exercise, get into a seated position or try to position yourself in your wheelchair. Turn diagonally ensuring that one arm is facing forward and the other one is behind you. Then, slowly throw 10 punches straight forward, alternating with each arm. For an added challenge, change your target. For example, throw 10 punches upward, 10 punches downward, and 10 punches diagonally. This is a great way to work out your shoulder and trunk muscles.

Any shoulder exercise can be done actively or passively with the assistance of your therapist or trained caregiver. Practicing consistently is a key component in rehabilitation after SCI. Also, continue to increase the challenge of your exercises as you improve.

How You Push the Wheelchair Matters

For manual wheelchair users, spinal cord injury survivors utilize their upper extremities to propel themselves. While this activity itself develops outstanding shoulder strength over time, it also puts survivors at risk for overuse injuries if done excessively or with improper body mechanics. Having a properly fit wheelchair, as well as practicing optimal push stroke technique, can significantly reduce the risk of shoulder injury and pain.

First and foremost, it is always best to have a custom wheelchair that is designed to meet your specific size measurements and needs. Work directly with your therapist, an assistive technology professional, and/or the wheelchair vendor to make sure you have a proper fit to optimize comfort, function, and performance.

For example, adjusting the rear axle as far forward as possible without compromising wheelchair stability allows for more efficient propulsion. When the hand is placed at top dead-center on the pushrim, the angle between the upper arm and forearm should be between 100- 120 degrees.

When it comes to push patterns, wheelchair users have been observed to demonstrate four primary techniques:

Image source: Archives of physical medicine and rehabilitation

According to the research, implementing a “semicircular or oval” shape push pattern (the top left pattern in the image above) encourages better shoulder biomechanics and avoids putting the shoulder joint in a compromised position. It is also important to practice propelling the wheelchair using long, smooth push strokes.

These strategies take a lot of practice and patience. It is recommended that you work together with your therapist to ensure you have the appropriate wheelchair fit and push mechanics to maintain shoulder health and reduce injury risk.

Practicing Shoulder Exercises After Spinal Cord Injury 

A spinal cord injury can often cause shoulder pain or weakness, especially in individuals who use their arms constantly to move their wheelchair. To prevent further injury or complications, it’s important to perform shoulder exercises after spinal cord injury.

However, it’s also imperative not to overwork your shoulder muscles while exercising. Your therapist can provide more guidance regarding the types of SCI shoulder exercises you should do based on your ability level.

We hope this article encourages you to practice shoulder exercises after spinal cord injury to boost upper extremity strength and mobility.

The post Spinal Cord Injury Shoulder Exercises: Boosting Upper Extremity Strength & Mobility appeared first on Flint Rehab.

We use our upper extremities all throughout the day for activities of daily living, including dressing, eating, carrying, lifting, and reaching for objects. To improve function and maintain independence, survivors must engage in upper extremity exercises for spinal cord injury rehabilitation.

This article will explore various types of upper extremity exercises for spinal cord injury survivors, including wheelchair-friendly exercises, and requiring little to no equipment. First, let’s take a look at the benefits of exercising after spinal cord injury and how a home exercise program can help you stay motivated throughout recovery.

Why Is Exercise Necessary After Spinal Cord Injury?

The spinal cord serves as a communication pathway between the brain and the rest of the body. When this pathway is disrupted, the brain is unable to send signals to move specific muscles, resulting in impaired movement. The specific muscles affected depend on the level of injury.

Low-level injuries affect the lower extremities, whereas high-level injuries affect both the upper and lower extremities. For example, individuals with lumbar-level injuries may experience weakness in the legs while individuals with cervical or high-thoracic level injuries may experience weakness in the hands, trunk, and lower extremities.

Fortunately, the human body and spinal cord are  extremely adaptable and can regain function via neuroplasticity, the central nervous system’s ability to rewire itself. Neuroplasticity is essential for recovery and is best activated through high-repetition of exercises, or massed practice. 

The more demand for a function, such as movement, the more the nervous system strengthens its neural pathways. Therefore, to improve function and maximize recovery, it’s important to practice spinal cord injury exercises as much as you can. The more you use it, the more you improve it!

Types of Upper Extremity Exercises for Spinal Cord Injury

Every spinal cord injury is different, and survivors may experience various motor difficulties that require a unique rehabilitation plan. However, there are a few key elements that should be included in your upper extremity exercises after spinal cord injury. This includes stretching, passive range of motion, strength-training, and aerobic exercises.

Each type of exercise targets different muscle groups and helps stimulate neuroplasticity to promote recovery. Be sure to work with a therapist to make sure these exercises are safe and suitable for your ability level.

Here are the types of upper extremity exercises for spinal cord injury:

Stretching Exercises for Spinal Cord Injury

After a spinal cord injury, some survivors may experience increased muscle tone or tightness, also known as hypertonicity, that can be uncomfortable and restrict movement.

In some cases, spasticity may develop, a condition in which the muscles are hyper-reflexive and tense up more in response to pressure, a stretch, or movement. When hypertonicity and spasticity are unmanaged, it can lead to joint contractures where the muscles and joints are permanently shortened, becoming immobile and painfully stiff.

A great way to prevent contractures from developing is to stretch and move your upper body joints frequently through their full range of motion. If you have not done any stretching in a while, it may be uncomfortable at first. However, over time, your muscles will adapt and it will get easier as you regain the mobility.

Stretching can also help promote blood flow in the body after spinal cord injury. Therefore, it’s highly encouraged to begin every workout with a gentle stretching routine as part of a warm-up.

It is also important to note that stretching does not need to be aggressive or painful. As long as you’re in the right positions and getting a gentle pulling sensation, you’ll get the benefits!

Upper extremity stretching exercises after spinal cord injury can include:

1. Shoulder Rolls

For this exercise, move your shoulder blades in a circular pattern. Start by shrugging your shoulders in an up, back, and down direction. Perform small circles if needed for comfort. You can then try doing the circular motions in a forward direction. The main focus is trying to squeeze your shoulder blades back as you go through the motion.

It’s even better if you can isolate your shoulder blades by not moving your arms at all!  This exercise is good for developing control of your scapular muscles, which are necessary for injury prevention and all upper extremity movement.

2. Arm Circles

This stretch can be done using one arm at a time or both. Spread your arms out to the sides and align them with your shoulders. Then, slowly make large circles forward and backward for a couple of seconds. Just like the above exercise, you can start with smaller circles and work your way up to doing larger ones as you regain strength and control. You can target your shoulder muscles a bit more if you keep your elbows straight while doing the circles.

3. Cross-Body Shoulder Stretch

First, sit up tall with your chest up and back straight. Reach one arm across your chest and bend your other arm to hold it in place. Gently pull your arm further across your body until you feel the stretch in the shoulder and then hold for about 20 to 30 seconds. Then switch with the other arm.  Remember, you control the strength of the stretch, so stop or pull more gently if you’re feeling any pain.

4. Overhead Triceps Stretch

To stretch your triceps, raise one arm up over your head, then bend your elbow until your hand is behind your head or back. Use the other arm to press down on the elbow and slowly stretch. You can add a stretch for your latissimus dorsi, aka “lats,” by adding a small side-bend in your trunk. Hold for about 20 to 30 seconds, then repeat with the other arm.

5. Wall-Chest Stretch

For this stretching exercise, position yourself next to a wall or by a doorway. Extend your arm out to the side and place the palm and inner arm against the wall with your elbow slightly bent. Gently lean forward and rotate your body to the opposite side until you feel a gentle pull across the front of your shoulder and chest.

Hold for 20 to 30 seconds, then repeat with the other side. If you’re doing this exercise in the middle of the doorway, you can place both arms on the doorframe to get a stretch on both sides simultaneously.

Try this stretch in different positions as shown below. The higher your hands are, the more intense the stretch.

6. Wrist Flexion & Extension Stretch

For this stretching exercise, place one arm straight out in front of you and with your other hand, push the back of the palm down to make a 90° angle facing the floor. Hold for a few seconds and then push the palm back up with your fingers facing the ceiling. Then alternate with the other wrist. If at first it’s difficult to practice this stretch with your arm out in front of you, you can complete it with your elbow bent at your side to build strength.

7. Interlocked Fingers Stretch

Lastly, stretching your fingers can also help prevent stiffness and promote blood flow in your hands. For this exercise, bring your hands together and interlock your fingers. Then slowly straighten your arms out in front of you and gently twist your wrists so that the backs of your hands are facing you. Hold for at least 15 to 20 seconds, but make sure not to exert more force than you can tolerate.

Range-of-Motion Exercises for Spinal Cord Injury

To improve movement after spinal cord injury, individuals must repeatedly practice affected movements to encourage neuroplasticity. You can think of the phrase “use it or lose it” to motivate yourself to practice.

Neuroplasticity is occurring all the time, but to enhance it after an injury you must engage in massed practice. The more a skill or function is practiced, the more the brain will strengthen its neural pathways to improve that function. Therefore, range of motion exercises are extremely beneficial in restoring motor skills after spinal cord injury.

Passive and active-assisted range of motion exercises do not require you to use excessive force or energy. Rather, a therapist or caregiver assists you by moving your body for you. Or, you can use one side to help the other.

Passive refers to the limb being completely relaxed while it’s being moved, while active-assisted means that your muscles are still working but may just be getting a little extra help to get through the motion. However, as long as you pay attention to the movement while you practice, passive and active-assisted exercise still helps activate neuroplasticity.

Furthermore, individuals who have more control over their movements are encouraged to try to actively perform these range of motion exercises on their own, once cleared by a therapist.

Here are some of the most effective passive range of motion exercises you can try with your caregiver or therapist:

8. Palm Up, Palm Down

First, start by placing one hand on a table or surface with your palm facing up. Then use your opposite hand to help you push your palm back down. Practice flipping your palm a few times, then alternate with your other hand.

Your caregiver can also help flip your palm as you continue to build strength and regain mobility. This exercise may seem simple, but it helps improve hand and wrist coordination. We use this movement all the time for opening doors, turning keys, and fastening buttons on our clothing when we dress.

9. Elbow Flexion

Gently bend your elbow to bring your handtoward your upper arm as much as you can without pain. Then extend your arm and slowly return to the starting position with your elbows as close to the side as possible. Try to keep your palm facing towards you throughout this exercise. Then, repeat with your opposite arm. Your caregiver or therapist may assist this movement by supporting you at the wrist.

10. Table Slides

This exercise is great for shoulder mobility in multiple directions. Start by sitting in a chair in front of a table. Clasping your hands together, slowly reach forward and return to sitting tall & upright. Then repeat to the left and to the right. You can place a  water bottle or some other object to act as a target to reach for on each repetition.

Repeat a few times or as much as you can, and try to stretch a bit further each time. Tip: put a small hand or dish towel underneath your hands to reduce friction and make the sliding easier!

11. Circle Movement

Lace your fingers together and wrap both hands around the water bottle on the table. Then, slowly make large circular movements with your arms. As you move in a circular motion, focus on stretching your affected arm. After moving in one direction, also try to reverse. One direction helps build strength, while the opposite direction helps reduce tension.

12. Shoulder Flexion

For this exercise, interlace your fingers or clasp your hands together. Keeping the arms straight and, with the help of your caregiver or on your own, raise your hand forward and up overhead  to stretch your shoulders. If this is too challenging, you can do the exercise while laying down on your back and work your way up to doing it while sitting. This exercise is important for reaching overhead, like you’re trying to get something from a high shelf.

13. Cane Reach

For this exercise, grab a cane and hold both of the ends. Then, gently lift your affected arm up using your other hand for assistance (you can rest the cane on your leg for extra support). Hold this arm stretch for a few seconds or as long as you can and gently release it. 

For an added challenge, turn your head and rotate your trunk towards that side. This is a great upper extremity exercise for the shoulders. However, it’s important to take breaks and only do what you can handle to avoid overstraining your shoulders. 

Ask your therapist or caregiver to take over if you tire out quickly. As you practice more consistently, your endurance will improve.

Strength-Training Upper Extremity Exercises for Spinal Cord Injury

Generally, everyday movements such as walking, standing, and lifting objects are enough to maintain your current level of muscle mass. However, after a spinal cord injury, these daily activities can be more difficult to accomplish. This lack of activity can cause muscles to shrink (muscle atrophy). Fortunately, survivors can engage in strength-training exercises that help lower the risk of muscle atrophy and stimulate neuroplasticity.

You can rebuild strength by adding weight or resistance to any of the upper extremity exercises mentioned above. For example, when doing elbow flexion, you can hold a dumbbell, water bottle, or canned food to increase the difficulty and stimulate muscle growth. Be mindful to do exercises with added weight slow and controlled to avoid the risk of injury or overworking your muscles.

Here are some upper extremity exercises for spinal cord injury that help rebuild strength:

14. Wheelchair Dips

For this exercise, first and foremost, make sure the brakes are engaged and your wheelchair is secured. Then, put your hands on the armrests and straighten your arms. Slowly lift yourself up from the seat of the chair and slowly lower back down. This exercise is excellent for strengthening the triceps and shoulders, with a movement that is great for position changes in the chair, transferring in and out of the wheelchair, and doing pressure reliefs to decrease the risk of pressure ulcers.

15. Bicep Curls

Place your arms as close to your trunk as possible while holding a dumbbell in either one or both hands. The palms and inner arm should be facing up. Without moving your upper arm, bend the elbows to bring the dumbbell up towards your shoulder, hold it for a second if you can, and then bring it back down.

16. Triceps Extensions

This exercise is important for carrying or lifting loads overhead. Hold a weight such as a medicine ball or dumbbell with both of your hands and slowly raise it over your head. Then gently lower the weight behind your head to bend your elbows. Lift the weight back up and straighten out your arms. Start with a light weight and work your way up as you build more strength.

Aerobic Upper Extremity Exercises for Spinal Cord Injury

Aerobic exercise is a great way to promote blood circulation throughout the body, develop cardiovascular endurance, and stimulate the nervous system. Aerobic exercises for the upper body tend to be more advanced, but there are ways to slowly work your way up to more difficult exercises.

Below are some of the most effective aerobic upper extremity exercises that mimic the same movements used in sports. These exercises can be done in a sitting or standing position, but make sure to stop if you feel any pain or discomfort. For more guidance and assurance, ask your therapist which aerobic exercises are right for you.

Because these are meant to be aerobic, aim to perform these exercises for a prolonged duration at a sustainable pace. Start with what you can handle, even if it’s only for 1 to 2 minute intervals at a time. Over time, try to build up your endurance to being able to do the exercise continuously for at least 10 to 15 minutes, taking rest breaks as needed.

Here are some upper extremity aerobic exercises for spinal cord injury:

17. Rowing

This upper extremity exercise mimics the movements done in rowing. You can do the rows while holding a cane, broomstick, or umbrella. Place your arms out in front of you and then slowly bend your elbows and pull your arms back in towards your body. Keep an upright posture and focus on  squeezing your shoulder blades back as you row.

18. Swim Strokes

Mimicking swimming strokes can help stimulate blood flow and rebuild arm strength. These can include backstrokes, butterfly, freestyle, and breaststrokes. You can practice different swimming strokes sitting down in your wheelchair or wherever you feel the most comfortable. For instance, take one arm and slowly push it forward and alternate with your other arm as if you were in a swimming pool.

Swimming is one of the best aerobic exercises because it targets a variety of muscle groups. Once cleared by your therapist, you may be able to try aquatic therapy for spinal cord injury.

19. Boxing

Just like swimming, boxing involves a variety of different arm motions that help exercise the upper body. For this exercise you don’t need a punching bag. You can shadowbox by simply mimicking the different types of arm motions, or punches such as the jab, hook, uppercut, and cross. These motions can get your heart pumping and strengthen your arms.

20. Hand Cycling

Handcycles are bikes where individuals pedal with the arms instead of the legs. This is a great upper extremity exercise for spinal cord injury survivors because it mimics the same arm motions and helps stimulate the heart and brain.

Strength-training, aerobic exercises, and stretching techniques are all essential to improve upper body mobility and overall function. While your therapist can provide the equipment you need to engage in upper extremity exercises for spinal cord injury, it can be helpful to invest in your own physical therapy tools. This way, you can practice however much you’d like from the comfort of your own home, and at your own pace.

How to Stay Motivated While Exercising at Home

After your therapy session, your therapist may provide you with sheets of exercises you can do at home. While these sheets are helpful, it can be difficult to stay motivated and practice high-repetition of exercises by yourself. 

Therefore, to help you stay extra motivated to practice upper extremity exercises at home, you can try gamified neurorehabilitation devices such as FitMi and MusicGlove. Both are interactive home exercise programs that are great for spinal cord injury survivors to engage in in between therapy sessions.

MusicGlove is a hand-therapy device designed to improve dexterity in the hands. This device is especially attractive because it combines music, gaming, and hand therapy exercises to help you stay motivated and practice high-repetition exercises. MusicGlove encourages individuals to practice 100 repetition exercises in a 30 minute session. In fact, MusicGlove has been clinically proven to boost hand function in just 2 weeks!

FitMi is another neurorehab device designed to improve mobility after spinal cord injury. It provides survivors with full-body rehab exercises that target a variety of muscle groups including the arms and shoulders. FitMi motivates you to practice high-repetition of upper extremity exercises based on your ability level. It also unlocks more challenging exercises as you improve and keeps track of your progress. 

MusicGlove and FitMi are popular neurorehab devices that promote high-repetition exercises in a fun, engaging way. They provide a great way to stimulate neuroplasticity in the spinal cord and boost motor recovery.

Engaging in Upper Extremity Exercises After Spinal Cord Injury

While a spinal cord injury can cause a variety of secondary effects such as paralysis, limited mobility, and spasticity, there are many ways to improve function. To rebuild strength and restore movement in the upper body, survivors must engage in upper extremity exercises for spinal cord injury.

Exercise in general has many benefits such as developing strength, endurance, promoting blood flow, and stimulating the brain to activate neuroplasticity, which is necessary to improve function. High-repetition of exercises, especially, are essential to strengthen the neural pathways for all functions.

The more you practice consistently, the more you engage your muscles, and the more familiar the nervous system becomes with the movements. Remember to start with exercises based on your ability level and work your way up to more complex exercises.

We hope these upper extremity exercises for spinal cord injury encourage you to stay engaged in the rehabilitation process and maximize recovery.

The post Upper Extremity Exercises for Spinal Cord Injury Survivors to Improve Mobility appeared first on Flint Rehab.

This article will explore some of the most popular and effective hand exercises for spinal cord injury that help rebuild strength and flexibility. Be sure to check with your therapist before adding any new exercises to your regimen to make sure they’re safe and appropriate for you.

Benefits of Therapy Exercises After Spinal Cord Injury

Through rehabilitation, many survivors can use therapeutic exercises to stimulate neuroplasticity, the central nervous system’s ability to rewire itself, and improve function.

Neuroplasticity is essential to restore function after neurological injury, and is best activated through high-repetition of exercises, or massed practice. The more a skill is practiced, the more the nervous system will learn to recognize its importance and strengthen that skill.

The more you use it, the more you improve it. In addition, the exercises must be meaningful to you; think about why you’re doing the specific exercise and how that movement relates to an important activity or goal.

By engaging in massed practice with movements that relate to specific functional activities or goals, individuals with incomplete spinal cord injuries (partial damage) can maximize neuroplasticity to improve mobility, coordination, and overall hand function.

However, even survivors with complete spinal cord injuries (meaning the spinal cord is completely severed) with severe hand weakness can benefit from passive exercises.

How to Adapt Hand Exercises for Individuals with Quadriplegia

Passive exercise involves assisting your affected limb through a movement. Even though passive exercise does not involve direct effort by the muscles in the affected limb, it helps stimulate neuroplasticity.

Depending on the level of the spinal cord injury, and whether it’s complete or incomplete, individuals with quadriplegia can use passive, active-assisted, or even resistance exercise to capitalize on neuroplasticity to regain as much movement as possible.

Even for those with no voluntary control or strength in their hands, passive exercises have been shown to help prevent contractures, maintain joint range of motion, reduce pain, and manage spasticity. In spinal cord injury rehabilitation, passive exercises are often used to improve mobility and range of motion in people with quadriplegia.

Passive range of motion exercises can also help improve blood flow, flexibility, and overall function. You can either practice yourself, or your therapist or caregiver can assist you to facilitate the movements. With consistent practice, this may help reintroduce movement into your hand.

How the Spinal Cord Injury Level Matters

The level of spinal cord injury is an important factor to consider when creating a rehabilitation exercise program because it determines which functions are affected. For example, high level injuries, such as cervical spinal cord injury (which affects the neck area), can result in weakness or paralysis in both the arms and legs (quadriplegia).

Movement is only affected from the level of spinal cord injury down. Meaning, lower level spinal cord injuries may leave arm function unaffected. Thus, individuals looking for hand exercises after spinal cord injury have likely sustained high-level SCIs.

For instance, survivors of a C1-C4 complete spinal cord injury may have no hand function, whereas those with a C8-T1 injury may have full wrist and hand control.

We want to make sure that the exercises match your ability level. If you are unable to perform a particular exercise actively, then try it active-assisted or passively with the help of your family or caregiver. With time and a lot of repetition (remember, massed practice), you can progress towards doing the exercises more independently.

Hand Exercises for Spinal Cord Injury: Getting Started

Engaging in high-repetition exercise is essential to improve fine motor skills. Start with simple hand exercises for spinal cord injury and work your way to more challenging movements, depending on your ability level. Remember, you can turn any of the hand exercises below into passive or active-assisted exercises by asking a caregiver to help move your hand through the movements.

Just make sure that they are physically assisting only as much as you need to complete the movements. The more that you are actively and physically engaged in the exercise, the more it will stimulate nerve regeneration and rewiring.

Be sure to consult with your therapist before attempting new exercises that may not be safe. Your therapist can also provide guidance and a tailored rehabilitation plan suitable for your ability level.

Here are some great beginner hand exercises for spinal cord injury:

1. Palm Up, Palm Down

For this exercise, take your hand and place it on the table with your palm facing upwards (ie. supination). Then use your other hand to rotate the palm down (ie. pronation). Repeating this exercise can help improve hand and wrist mobility.

If you are unable to do this on your own, your caregiver can also help flip your palm as you continue to build strength and regain mobility. Isolate the movement using only your wrist and forearm (try not to twist and turn using your shoulder and body to compensate).

This exercise may seem simple, but it helps improve hand and wrist coordination. We use this movement all the time for opening doors, turning keys, and fastening buttons on our clothing when we dress.

2. Wrist Flexion and Extension

Place your forearm on a table for support with your hand over the edge. Gently bend your wrist fully upward (ie. wrist extension) and downward (ie. wrist flexion). You can make this exercise more challenging by holding a light weight; a water bottle or can of beans works well.

If you’re unable to lift your wrist against gravity yet, then turn your forearm so that you’re flexing and extending your wrist sideways back and forth. This exercise helps improve wrist flexibility, which is necessary to increase hand movement and range of motion.

3. Grip and Release

Objects of varying sizes and shapes require us to use different types of grips with our fingers and hands. While sitting, place a variety of items of different shapes and sizes on the table. This can be anything like a pen, spoon, water bottle, tennis ball, keys, or marbles.

One by one, grab the item and practice gripping on it with your affected hand. Lift or move it across the table and release. After moving each object across, practice bringing them all it back to the other side of the table.

4. Finger Opposition

For this exercise you can either use one or both hands at the same time. You are going to practice “making O’s” by alternating tapping the tips of each finger to your thumb. This can be a difficult exercise as it requires some fine motor coordination, so if you can’t touch your fingertips precisely at first, keep trying.

You will improve through consistency and practice. Even just thinking about or visualizing the movement can help stimulate neuroplasticity.

5. Therapy Putty

Therapy putty is a simple, affordable physical therapy tool that helps individuals improve hand dexterity. It can also help rebuild hand strength and restore mobility. With therapy putty you can practice exercises such as pinching, gripping, rolling, extension, and even molding it into shapes. The possibilities are endless.

Occupational Therapy Hand Exercises for Spinal Cord Injury

Practicing hand exercises that mimic daily activities such as opening and closing doors, turning the lights on or off, and eating. Here are a few examples of occupational hand exercises you can try:

6. Turning Door Knobs

Opening and closing doors is a necessary part of our daily lives, therefore practicing turning door knobs is a great occupational exercise to practice. Turning the door knob helps you to develop more coordination and strength in your wrist. Even when you are opening a door during your daily routine, pay extra attention to the movement to turn it into therapy.

As best as you can, focus on trying to turn the door knob using just your hand and wrist without twisting at your shoulder or trunk. When attention is paid to a movement, it helps stimulate the nervous system.

7. Flipping Light Switches

Turning the light on and off is another way to practice daily routine activities. Flip the light switch using your affected hand. You can even try alternating each finger. This helps develop fine motor control and build strength in your hand.

8. Holding Utensils

Utensils are often essential for eating, an extremely important daily activity and one of life’s greatest pleasures. You can practice by grabbing a utensil like a spoon to practice grasp and release movements. Utensils that are slightly heavier and have larger or thicker handles are easier to manage.

You can also lift the utensil up and down to add arm movement too. As you practice your hand and arm movements over time, you can improve control and feel more comfortable using a utensil for eating.

9. Container Lid Twists

Place several containers with different sized lids on a table. While seated, remove the lid of each container one-by-one. After you have removed each lid, screw the lid back on each container one-by-one. One hand should be used to stabilize the container, while the other hand is managing the lids.

After completing the set of containers, try switching hands. If this exercise is too challenging, you can have a caregiver loosen the lids partially or help stabilize the containers so you can focus on the lid twisting.

10. Pouring Water Into a Cup

Staying hydrated and drinking water is crucial for spinal cord injury recovery and overall health. While there are various ways to drink water, such as from a bottle or a straw, it helps to practice the skill of holding and using a cup. You can practice this by pouring water into a cup but try not to make it too heavy.

The weight of the water will help add resistance as you practice holding the cup by gripping your fingers. Another good exercise is holding a small cup in each hand and slowly pouring water back and forth. If you’re just starting out, consider using plastic cups for safety.

Intermediate, Fun Hand Exercises for Spinal Cord Injury

More advanced hand exercises can be fun but also more difficult. When choosing hand exercises to add to your regimen, be sure to choose movements that make you feel challenged but not frustrated. If you give these a try, be sure to take breaks in between and not overwork or overwhelm yourself. 

Some advanced hand exercises for spinal cord injury can include:

11. Playing Card Games

Card games can help individuals with quadriplegia improve fine motor skills while playing a fun game. You can shuffle a card deck, pick a single card out of the pile, and practice holding it or placing it down. You can also practice flipping cards one by one, or practicing dealing by sliding cards off the deck one at a time. There are also card holders that can help make things easier as you work your way up to playing without assistance.

12. Popping Bubble Wrap

The squeezing motion needed to pop the bubbles adds resistance, which helps build strength in your fingers. With this exercise you can practice a tripod grip (using your thumb, index, and middle finger) which is the motion most often used to pick up an item.

13. Painting

Painting is a great hand exercise for spinal cord injury recovery because of the coordination, delicate targeted strokes, and dynamic movements it requires. You can practice hand control with long, fluid strokes and repetitive short strokes. It also gives you creative freedom to use all kinds of shapes and colors, making it a fun and therapeutic hand exercise.

14. Coin Flips

This exercise requires a lot of fine motor coordination using just the fingertips. Place various coins on a table and flip each coin with your hand. You can also practice creating a tall stack of coins without knocking it over, then repeating.

15. Tracing

Take an image of something you like, place a piece of paper over it, and try your best to trace it. Tracing requires meditative focus, which helps improve the mind and body connection. For this exercise, you can practice tracing from the outside in and then trace it again from the inside out.

16. Braiding

Braiding is an intricate process that requires control over your fingers. The repetitive motions of folding each strand over while holding others in place help build endurance as well as in-hand manipulation skills. You can practice braiding with hair, or three pieces of rope. The thicker the strands that you’re braiding, the easier it will be.

17. Playing Jenga

Jenga is a game that can be played with multiple people to make it more fun. It requires extra attention and focus which helps stimulate neuroplasticity. Pushing the blocks and carefully removing them with your fingers also helps develop stability and fine motor control.

How to Motivate Yourself to Be Consistent with Your Hand Exercise Regimen

Practicing the same exercises over and over again can get redundant and at times, boring. To help you stay engaged and motivated you can use gamified neurorehabilitation devices such as MusicGlove. 

This is a fun, interactive hand therapy device that contains lots of hand exercises you can practice from the comfort of your own home. MusicGlove is especially popular because it combines music and hand exercises into a therapeutic game and can be adapted to your ability level. User’s can choose to focus on just one finger at first, and work their way up to targeting all fingers for an intensive workout.

MusicGlove keeps track of your progress and motivates you to achieve the high repetition of exercises necessary to spark neuroplasticity. On average, users are motivated to accomplish hundreds of repetitions per half hour session. This is one reason why MusicGlove has been clinically proven to improve overall hand function in just 2 weeks.

Here’s a story of a spinal cord injury survivor that has been using MusicGlove for just one week:

“My 17 year old daughter had a SCI and suffered 2 strokes. She has minimal function on her right hand and no function on her left. She’s been using the Music Glove for a week now and her pinch grip on her right hand has gotten stronger. I’m excited about the possibilities Music Gloves gives her to regain more mobility and usage of that hand. Definitely worth the investment.“

-Chelsea

When time with a therapist is limited or grows too expensive, at-home therapy devices like MusicGlove can help bridge the gap. They inspire motivation to exercise on a consistent basis, which is the key to recovery after spinal cord injury.

Using Hand Exercises for Spinal Cord Injury Recovery

While every spinal cord injury is different, many survivors with high-level SCI often have difficulty with hand dexterity. Thus, hand exercises for spinal cord injury are beneficial to improve hand function and promote/maximize recovery.

Exercise stimulates neuroplasticity which is vital for the central nervous system to repair itself. Neuroplasticity is best activated through massed practice, therefore survivors must engage in high repetition exercises.

Remember to work with your therapist to find the most effective hand exercises for your ability level. Lastly, remember to practice hand therapy exercises you enjoy and are meaningful to you to stay motivated. We hope this article has helped you explore various hand exercises for spinal cord injury and encouraged you to practice as much as possible.

The post Hand Exercises for Spinal Cord Injury: How to Improve Fine Motor Skills appeared first on Flint Rehab.

To help you stay active, we’ve put together a guide to help you create your best home exercise program after spinal cord injury. You’ll find plenty of example exercises, many wheelchair-friendly, that you can do with your therapist or caregiver from the comfort of your own home.

The Importance of a Home Exercise Program for Spinal Cord Injury

Practicing exercises daily helps activate neuroplasticity, the central nervous system’s ability to rewire itself. This helps improve mobility and restore function.

Neuroplasticity is best stimulated through high repetition, or massed practice. Therefore, having a home exercise program for spinal cord injury is essential to achieve the consistency and repetition necessary for promoting neuroplasticity and recovery.

Every spinal cord injury is different, therefore every survivor will experience a different outcome. Every home exercise program for spinal cord injury should be tailored to your specific skills and challenges in accordance with your level of injury. Your exercise regimen should also include a mix of stretching, aerobic exercise, and strength training when possible.

Be sure to consult your therapist before trying any new exercises. It’s important to ensure the exercises are adjusted to your ability level to best promote recovery and prevent further injury. 

While some of these rehab exercises can be challenging, try not to feel discouraged if you can’t perform them just yet. Remember that any movement is better than no movement, and to just keep doing your best.

Stretches for SCI Recovery At Home

A spinal cord injury can often cause muscles to tighten up, a condition known as spasticity. One of the best ways to prevent this from happening is to stretch and move your joints through their full range of motion. Well-stretched muscles and flexible joints help prevent strain and further injury.

To help jumpstart your SCI home exercise program, here are some examples of stretching exercises you can try. This includes:

• Posterior Shoulder Stretch: Put one arm out in front of you and keep it straight. Then move it across your chest. Bend your other arm at the elbow and use it to support the straight arm and gently pull it close to the chest. This will help stretch the back part of your shoulders.
• Overhead Shoulder Stretch: Raise both arms above your head and bend one of your elbows behind your head. Then place your other hand on your elbow and gently pull down. This will help stretch your triceps and deltoids.
• Lateral Stretch: Lean your torso to the side gently. You should feel a stretch on the opposite side. Make sure to hold onto something for support or have someone spot you for this stretch if you have any balance difficulties.
• Hamstring Stretch: Use a chair or something similar to raise one leg off the ground and keep it straight. Then slowly lean forward towards your foot without hunching your back.
• Calf Stretch: If you’re able to stand, place both arms on a wall and move one of your legs a step back. Try to get the heel of that foot as close to the ground as possible. You should feel the stretch in the back of your calf. If you’re in a wheelchair, you can try putting your toes up against the wall (while keeping your heel on the ground), and leaning toward that leg.

Stretching should be gentle, and if you experience numbness in the affected area, it’s extra important to focus on gentle movements. Do not force anything against your body’s natural resistance.

If you have trouble completing these stretches independently, your therapist or a trained caregiver can also help you. Even if you are not actively completing the exercises, passively stretching with the help of someone else can be a great way to combat spasticity.

Mobility Training Exercises for At-Home Rehabilitation

Along with stretching your affected muscles, it’s important to practice high repetition of therapeutic exercises to help stimulate the nervous system and encourage better mobility.

To achieve this, you can work with your therapist to pick specific exercises for spinal cord injury that target your affected muscles, like these exercises focused on the upper and lower extremities.

Here are some examples of exercises your therapist may recommend adding to your home therapy regimen after SCI:

• Seated Marching: Sit at the edge of a chair with both of your feet on the ground. Lift one knee slowly and place it back down, then alternate legs.
• Wrist Extension: With your palm facing down, hold one arm out in front of you. Gently raise your palm and fingers upward, then bring them back down slowly.
• Arm Circles: Spread your arms out to your sides and align them with your shoulders. Then slowly make circular motions (either large circles or small circles) forward and backward.
• Trunk Rotation: Lay on your back with your knees bent and feet flat on the floor. Then try to tighten your abdominal muscles and gently lower your knees toward one side of your body, then the other.
• Toe Taps: While laying or sitting, slowly raise the toes on one foot then lower them back down. Alternate legs.  

While these exercises may seem simple, they are extremely effective when practiced consistently because they help activate neuroplasticity and improve mobility over time.

Strength Training Exercises for SCI Recovery

Rebuilding strength can also help improve mobility after spinal cord injury. Therefore, strength training can be included in your home exercise program for SCI once your therapist clears you. 

Here are a few strengthening exercises for spinal cord injury that you can incorporate into your home regimen:

• Shoulder Press: Spread out both of your arms to the side so that you’re making a “T” formation. Then bend your elbows to a 90-degree angle so that your palms are facing forward. Move your hands up to the ceiling, straighten your elbows, and bring them back down to 90-degrees.
• Arm Curls: Keep your arms straight at your sides and then bend your elbow. Bring your forearm up so that your hand approaches the shoulder, then lower it back down to your starting position.
• Heel Raises: Heel raises mimic the movements made when taking steps. For this exercise, sit at the edge of your seat with your feet planted on the floor. Then slowly lift your heel. You should feel both your calves and ankles extend.

If you would like to increase difficulty and resistance, you can use a free weight dumbbell or cuffed weight. Again, be sure to exercise caution and avoid overstraining yourself, especially if you experience numbness or impaired sensation in your affected limbs.

Motivation for Your Home Therapy Program After Spinal Cord Injury

Exercising at home can be challenging especially when you’ve been used to working with a therapist. However, it is essential to remain engaged in between therapy sessions to keep stimulating neuroplasticity. Thus, investing in gamified, neurorehabilitation devices can help.

For example, FitMi is an interactive home exercise program that motivates you to perform high repetition of full-body rehab exercises after SCI. It keeps you motivated by tracking your progress and adapting to your ability level. 

FitMi is ideal for staying engaged in therapy between visits with your therapist because it can be used from the comfort of your own home, on your own time, for as long as you want.

Here’s an inspiring story from a spinal cord injury survivor that uses FitMi in their home therapy program:

“My husband had a spinal infarction in November. Believe me when I say it was touch and go for months. After extensive medical care and in hospital rehabilitation he was able to come home 8 weeks ago. He is paralyzed on left side and has all the spinal ailments that come with spinal cord accidents and also all the ailments that come with stroke patients. This program AND the MusicGlove are life savers. Not only is he regaining movement but it gives him purpose. He gets up at 7 am every morning and works with the pucks and the gloves until noon. We are seeing improvement. It’s slow but it IS improvement. ”

-Rockey

FitMi is the ultimate home exercise program for spinal cord injury survivors looking to improve mobility.

Adopting a Home Exercise Program for Spinal Cord Injury

Rehabilitation is an important part of spinal cord injury recovery. Therefore, it’s essential for survivors to find the most suitable home exercise program for spinal cord injury. This can include stretching and specific rehab exercises that target your affected limbs. For motivation you can use interactive, gamified neurorehabilitation devices like FitMi.

We hope this article has motivated you to adopt a home exercise program for spinal cord injury to help you stay engaged and promote recovery.

The post Home Exercise Program for Spinal Cord Injury: How to Create Your Best Regimen appeared first on Flint Rehab.

This article will share some effective seated and mat exercises to improve sitting balance after spinal cord injury. They can help strengthen your core, increase body awareness, and improve posture.

Before beginning a new exercise routine, be sure to talk to your healthcare provider to ensure safety in engaging with increased weight bearing activities because of the risk of fracture. Never attempt new exercises without proper clearance from your doctor or therapist.

Preparing for Balance Exercises After Spinal Cord Injury Patients

Sitting balance is the ability to sit upright and a skill learned early in life. After a cervical or thoracic spinal cord injury, maintaining sitting balance becomes difficult due to weakened and/or lost control over the core and leg muscles.

During your time with a physical and occupational therapist, you will learn ways to improve your balance after spinal cord injury by targeting the core and full-body. This time with your therapist is valuable but often limited. Therefore, it’s essential to keep up with your rehab exercise at home to keep the nervous system stimulated and promote recovery.

Before we dig into the mat and seated balance exercises for spinal cord injury, we’d like to share a few tips and tricks:

• Work out in front of a mirror: Practicing exercises in front of a mirror provides great visual feedback to help with form and posture.
• Choose a firm surface: Practicing the seated and mat exercises on a firmer surface like your wheelchair or a yoga mat on the ground rather than a sofa/bed will help create extra stability.
• Be mindful of skin problems: Be careful with all your transfers on and off equipment and look for areas that could cause friction, pressure, or shearing.  Be mindful of protecting and monitoring your skin throughout whatever exercise you choose to do.
• Be aware of autonomic dysreflexia: Be aware that certain stimulation, pressure, or tight clothing may lead to autonomic dysreflexia. This is a potentially life-threatening condition if not properly managed. This is why you must consulting with your therapist before beginning any new exercises.

Now that you’re prepared to make the most of your balance exercises, let’s dig into some way to engage your core and improve stability.

Sitting Balance Exercises for Spinal Cord Injury

Seated exercises require activation of core and abdominal muscles; usually thoracic level spinal cord injuries and below. Please speak with your healthcare provider to see if these exercises are appropriate for your level of injury.

1. Trunk rotation

For a simple balance exercise, actively reach in various directions while seated. Be sure to maintain core engagement and trunk balance throughout exercise while you reach forward, rotating side-to-side, and in circles.

If you’re doing this exercise with a friend, have them move around you with their hand out and tap it with your right hand, left hand, or both hands.

To get creative, number some sticky notes 1-12 and place it in the order of a clock. Tap the sticky notes in order, backwards, only odds, only even, etc. Start with a small diameter clock and get progressively bigger for a greater challenge.

2. Trunk flexion, extension, side bend

While seated with core engagement (belly button pulled toward spine), lean down to the side and forwards and backwards. Safely reach towards the floor while keeping bottom planted in seat.

To add more challenge when your therapist agrees that you’re ready and safe, try adding a weight in your hands or adding a small exercise ball between mid- and low-back. This will add extra instability during training to help develop your sitting balance after spinal cord injury.

During the exercise, add an extra foam pad on your seat to create instability further challenging core and abdominal muscles.

3. Seated Marching (L3 SCI and below)

An L3 spinal cord injury refers to an injury near the base of the spine which typically results in paraplegia. A great balance exercise for paraplegia is seated marching, because it mainly involves the legs while keeping the core engaged.

To perform this exercise, start seated with core engagement (belly button pulled toward spine) with your feet flat on the floor. Lift one leg from the ground and place it back down, then repeat on the other leg like you are marching.

Maintain an upright position without moving upper body to increase spinal stability. For extra challenge, cross your arms across your chest.

Seated marching is one of the 40 exercises included in FitMi home therapy, an interactive rehab device that spinal cord injury survivors can use at home. These exercises are designed by physical therapists to help survivors regain balance and mobility in a fun, engaging way.

Mat Exercises for Spinal Cord Injury

Mat exercises require activation of core/abdominal and some leg muscles. These exercises are usually appropriate for thoracic level injuries and below, but please speak with your healthcare provider to see if these exercises are appropriate for your level of injury.

4. Pelvic Tilt (T6 and below)

This mat exercise is generally appropriate for spinal cord injuries at the T6 level and below.

Start by lying on a mat with your knees bent so that your feet are flat on a stable surface. Roll your hip back while drawing your belly button towards your spine. Keep your back flat and core engaged while slowly moving arms up overhead. Try to keep your arms straight and raise them until your hands are above your head. For extra challenge, add some weight in your hands.

5. Pelvic Tilt with Marching (L3 and below)

This balance exercise is generally appropriate for T3 SCI and below.

Start with your back flat against the mat, knees bent, and feet flat on the ground. Your legs should be making a 90 degree angle. Then, while maintaining the same bend in the knee, lift your leg partially up toward the chest and alternate legs. Try to initiate the movement from your core to help promote better balance.

6. Half Spinal Rotation (T1-12 spinal cord injury)

Start by lying on your side with your shoulders stacked on top of each other and your legs also stacked on top of each other. Keep a 90 degree bend in your legs, and reach your arms straight out in front of you. While keeping your arms straight, twist your body open while moving your top arm across your body and try to touch the other side of the mat with the back of your hand.

7. Full Spinal Rotation (L1 spinal cord injury and below)

Lying on your back with your knees bent (in the same position as the previous exercise), gently rotate your spine as you move your knees to the side. Keep your knees glued together and at a 90 degree angle as you move from side to side through a comfortable range of motion.

8. Plank on elbows and knees (T1 spinal cord injury and below)

For this mat exercise, start lying face down. Then, do a modified plank by lifting your body up onto your elbows and knees while doing your best to maintain a straight spine.

9. Side plank on knees

Start by lying on your side with your knees bent at 90 degrees and stacked on top of each other. Your thigh should be flush against the ground. Prop yourself up on your forearm so that your elbow is directly under your shoulder. Then, lift your body up into a modified side plank and maintain a straight spine.

Safely Getting Started with Balance Exercises for Spinal Cord Injury

Dealing with prolonged sitting after a spinal cord injury can be arduous, but incorporating some core and sitting balance exercises can be helpful in training up the endurance of your muscles to provide greater stability during everyday activities.

Be sure to take great care not to attempt exercises that are too difficult for your level of spinal cord injury by checking with your therapist to make sure the exercises are suitable for you.

The post Effective Balance Exercises for Spinal Cord Injury Patients appeared first on Flint Rehab.