Spinal Cord Injury Range of Motion Exercises

We all know that exercise is important and we should try to do enough of it each week to remain fit and healthy. Exercise is also really important for individuals who have sustained a spinal cord injury (SCI).

Many people think that it’s all but impossible to exercise effectively after an injury like this, but there are several ways to stay active, even with significantly reduced mobility.

Here we take a closer look at range of motion exercises and how they can benefit people with spinal cord injuries.

What are Range of Motion Exercises?

Spinal cord injury range of motion exercises are designed to improve flexibility and mobility in the joints. Even if an individual has no mobility at all in a specific limb, it is still important to try and regularly undertake ROM exercises.

They help maintain flexibility and can prevent joints from becoming stiff which, in some cases, could cause pain. Range of motion exercises also reduce the risk of problems such as spasticity, where a muscle twitches or spasms involuntarily. 

There are two types of range of motion exercise:

• Passive ROM exercises: These are manipulations and exercises that are performed on the individual by someone else such as a physiotherapist or caregiver. This is important if an individual is unable to move their arms or legs.
• Self-ROM exercises: For those with some movement in their joints and muscles, self ROM exercises can be performed by the individual on their own.

Benefits of Range of Motion Exercises Following a Spinal Cord Injury

The joints, muscles and ligaments are still very important, even if an individual has lost the ability to move as result of an injury to their spinal cord. Over time and with inactivity, the ligaments contract and stiffen and muscle mass is lost. This is likely to happen with any type of spinal cord injury.

Even for people who have some range of motion in a joint like the knee, it’s important to have a fixed exercise regime for each area. If these regular, daily exercises are not employed, the individual may find their ability to perform simple daily tasks difficult, such as getting dressed.

Examples of ROM Exercises

It’s important to put together an exercise regime as soon as possible after a spinal cord injury and this should be done in conjunction with a suitably qualified health care professional, like a physiotherapist who specialises in working with SCI patients.

Whether an exercise is passive or the patient can perform it on their own will depend on the level of injury and disability.

Here are just a few examples:

1. Passive ROM Exercises

Shoulder Flexion and Extension

• The physiotherapist or caregiver stands to the side of the patient. One hand holds the forearm, the other supports the elbow joint.
• With the elbow straight, the caregiver lifts the arm slowly up and then down.
• This exercise can be performed with the patient seated or lying down.
• The exercise is repeated several times.

Elbow Flexion and Extension

• The caregiver holds the patient’s wrist and supports the upper arm.
• The elbow is bent slowly and then straightened.
• The exercise is repeated several times.

Hip/Knee Flexion and Extension

• The patient lies face up and the caregiver supports the bottom of their knee and the heel.
• The leg is bent and pushed gently back to the stomach with everything kept in line with the hip.
• The leg is returned to the normal position and the exercise repeated several times.

2. Self-ROM Exercises

Neck Flexion and Extension

• The patient can perform this exercise either standing or sitting.
• Bring the chin down slowly towards the chest.
• Hold for a few seconds. You should not push the movement beyond what is comfortable as this could cause damage.
• Gently raise the head back to the upright position.
• Some individuals may need support while performing this exercise.

Lying Shoulder Stretch

• The patient lies down on a supportive floor with their palms out to the side and facing upwards.
• They gently press their shoulders into the floor and hold the position for as long as it remains comfortable.

Hamstring Stretch

• The patient will need two chairs for this.
• They will sit in one chair and place or lift their foot on to the other, so it is positioned at about at the same height.
• The position is held for as long as is comfortable.
• Patients should avoid bending forward to get a deeper stretch as this could cause damage.
• Once finished, the patient can repeat the exercise with their other leg.

ROM exercises play an important part in maintaining mobility and should prevent health problems such as stiffening of the joints in the future. Above are just some of the exercises that can be incorporated into a ROM regime and attempted everyday.

As always, it’s essential to seek professional medical advice before one decides to proceed with a new exercise routine following a spinal cord injury.