Spinal cord injuries are one of the more obvious disabilities; there is no hiding the fact that the athlete is in a wheelchair. Spinal cord injuries are most often a result of a trauma (a car accident, a diving accident, a gunshot wound or a workplace accident). The majority of these incidents happen to people in the 15 to 30 year old age bracket. It is one of the most life-altering injuries that anyone can suffer.
The constraints to exercise for spinal cord injured athletes are dependent on the location of the injury, since the muscle mass below the injury is unable to contribute to active movement. Spinal cord injured athletes with a high injury (in the cervical or high thoracic vertebrae) will have fewer muscles and less muscle control. They may have steel rods surgically implanted in their back for posture control; because of this and because of restricted use of the trunk muscles, twisting in the chair (torsional movements) may be contraindicated.
Spinal cord injury causes several changes that are not just structural; spinal cord injured athletes with complete injury above T-6 may not be able to reach the traditional target heartrate level that we have all been taught is needed for central cardiovascular training. Not being able to involve the larger, lower-extremity muscles in the exercise may prevent the athlete from achieving the training heartrate levels. However, exercising at an elevated heartrate (albeit less than the traditional range) can produce training effects, including increase in aerobic capacity, increased exercise tolerance, increased muscle endurance, decreased risk of cardiovascular disease, decreased fat, and increased lean body mass.
Several physical aspects of the spinal cord injury athlete are consistent over the entire range of classes of injury; all will have bowel and bladder function impairment, so a good exercise in your relationship strength is to develop a class way to remind the athletes to empty their leg bag before exercise. Also, the natural thermoregulation functions may be impaired, increasing the possibility of overheating during exercise, so pay attention to the ambient temperature and the clothing that the athletes are wearing. When beginning the aerobics class, be certain to remind the seated athletes to make sure that no part of their body is rubbing against any part of their chair, since they will not feel friction from movement that could cause sores.
These athletes also may exhibit spasticity, uncontrollable muscle contractions. These sometime become more pronounced during exercise. Aerobic exercise for most spinal cord injured athletes will be performed in their wheelchair, although some will travel to class in a wheelchair and transfer to a sturdy chair for exercise.