Yes You Can - Fourth Edition - 75

2.c | Limb Preservation and Posture 2.c [ Section 2 ] Daily activities—such as sitting, transferring, or pushing a wheelchair—put people with SCI at risk for injuries to their limbs and postural changes to their spine. This section describes some of these conditions and what you can do to prevent them. joints and the muscles that cross them loose and ﬂexible. However, the weakness caused by your spinal cord injury [SCI] may restrict the range of motion of your joints. Because of this loss of movement, you have to learn other ways to stretch your muscles and maintain ﬂexibility in your joints and surrounding structures. If you don’t move a joint through its full range often enough, the tendons and joint capsule will begin to tighten. Over time, tightness of the structures around a joint can lead to a permanently shortened range of motion. This is called a “contracture.” Contractures can cause problems such as pressure ulcers, postural changes, and loss of ability to perform some physical activities. For example, contractures can signiﬁcantly interfere with hygiene. Limited range of motion in your joints can make it diﬃcult for you or your caregiver to reach certain areas of your body during bathing. The treatment for contractures includes static stretching [prolonged positioning and stretching of the muscles and joints] and heat treatments. Severe contractures sometimes require surgery. The best plan is to work to prevent contractures. Loss of motion often shows up in predictable patterns after a spinal cord injury. Sitting in a wheelchair shortens the muscles that cross the front of the hips and the back of the knees. If you’re not sitting in a fully erect posture—if you’re slouching—you may develop tightness in the front of the shoulders and neck. Blankets can cause your feet to point downward while you’re lying in bed, which can shorten the muscle at the back of your ankle. It’s important to stretch these muscles to prevent shortening, or the tightness can become permanent [a contracture] and can limit your ability to move. Tightness of your joints— Limb Preservation Both the upper limbs [arms] and the lower limbs [legs] are at risk for injury after SCI. Active use of your nonparalyzed limbs requires strong muscles and a working nervous system. Paralyzed limbs need special care to avoid injury and other conditions. Limb injury can have serious eﬀects on your health and well-being. It can lead to postural deformity, skin ulcers, and chronic pain. It can cause you to lose functions, such as the ability to feed yourself, to transfer, or to propel a wheelchair. Limb preservation means keeping your arms and legs in the best possible health by protecting the joints, nerves, muscles, and bones. Limb protection is important for both paralyzed and nonparalyzed limbs. Range of Motion The ﬂexibility of a joint—how far it will move in any direction—is also known as “range of motion.” All the joints in your body are surrounded by muscles, tendons, ligaments, and a joint capsule that provides stability. The muscles that cross a joint create movement of the bones on either side. How tight or loose the structures surrounding your joints are will determine the available range of motion in each joint. For limbs with normal strength and mobility, everyday movements are enough to keep your Section 2: Maximizing Your Function! | [ 75 ]

Yes You Can - Fourth Edition

Table of Contents for the Digital Edition of Yes You Can - Fourth Edition