Life on Wheels (7 page)

One benefit of a specialized rehab center is the chance to share the experience with others who are facing the same challenges and process. This bonding is encouraged by rehab staff, who are often surprised by the deep friendships that develop. Friendships are also a source of some fun in rehab, particularly during an inpatient stay. This quadriplegic man was injured at the age of 14 in 1977:

Not all rehab centers allow people freedom to come and go from the property, but people have a way of finding places to meet. Bonnie Sims notes that Craig Hospital has a Friendship House where families, friends, and patients meet, away from the hospital atmosphere.

Our strength and mobility are the main concerns of physical therapists. The physical therapist will work with you in areas such as:

Exercising specific muscles and muscle groups

Stretching and range-of-motion exercises

Developing balance

Wheelchair skills

Transfer training

Bed mobility

Aquatics

Standing programs

For some people, gait training

As a wheelchair user, you will need a certain level of strength for many activities. For people with paraplegia or quadriplegia who have sufficient upper body function, your arms will take on much of the work that you used to do with your legs. Not only will you push a wheelchair, but you will also do “transfers”—lifting your body into and out of the wheelchair.

The strength you have will substantially influence how much you can do on your own, without assistance. A sufficient level of strength will allow you to perform daily functions with less fatigue, handling your body and the wheelchair with less exertion and strain.

Physical therapists know your anatomy and what muscles allow you to move or balance. Based on the nature of your disability and an evaluation, the therapist will know exactly what muscles you have control of, and will design exercises and use equipment to make the most of what you have.

Physical therapy is a precise process. To exercise a certain muscle in your arm, you need to apply resistance to that muscle in a particular direction in order to make it work and become stronger.

Each person and each condition involves some special need. Many wheelchair users will need to develop strength for pushing wheels and for pressure-relief pushups in their chair. Someone with quadriplegia might have control of only some muscles in the upper arm that can be strengthened enough to lift the forearm at the elbow. Someone with a traumatic brain injury and resultant cognitive difficulties needs to have a simply designed program that he can remember. Someone with a lower limb amputation will need a program for the residual limb, so that the muscles do not contract or get weak. (The muscles in the limb are not getting used for walking during the acute and rehab stages; if a prosthetic leg is to be fitted, it cannot happen until later so that healing of the socket can take place and swelling can be reduced.)

In rehab, you will need to do some serious stretching. Your muscles, tendons, and ligaments have a natural tendency to shorten when they are not used. The initial period after a traumatic injury is marked by very limited physical activity during which your tissues tighten up and become weak. You might not have been in great shape before the injury. The physical therapist will do stretching work with you, to soften up these tissues and increase the range of movement of your joints. Stretching is also part of the strength program. Elastic muscles that can travel a greater distance during a contraction are stronger.

Being immobilized for a period of recovery compromises your sense of balance. The physical therapist will help you recover and increase your sense of balance, strengthening the muscles that will help you achieve greater upper body stability. An activity as simple as playing catch with balls of various sizes is a common physical therapy technique for improving balance: