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Thread: How do you know when to stop?

  1. #1

    How do you know when to stop?

    I'm L3-L4-L5 S1 CES, or something like that. Still a bit confused. I want to exercise harder. i do about 1 1/2 hrs. of floor exercises a day, Bosu, workout ball, rubber bands, rubber cord thing, leg weights, hand weights, and sometimes a biggest loser workout. these are my doctors notes- he ambulates but has to keep his center of gravity postierior to his hips because of bilateral hip extensor weakness. His gait is asymmetrical with a lot of twisting movements and difficulty with control of the left lower limb more than the right lower limb, putting abnormal rotational stresses on his low back. When he walks with a cane carried in his right hand, the degree of twist and the precarious appearance of the excessive posterior posture of his shoulders is noticeably improved. When i look at him stand in bare feet, he has difficulty maintaining standing balance without a wide base and with again a very exaggerated posture of the upper back held backward because of the hip estensor weakness. I did manual muscle testing and I would grade his left hip abductors as certainly only 2/5. Hip extensors on that side are no more than a 3- and are associated when tested prone with pain in his lumber spine, worse on the right. Hamstrings on the left are also only 2+/5. The ankle on the left has week dorsiflexion that is probably 3-/5 but only 1-2 strength in the evertors and the toe extensors, leaving his dorsilflexion imbalanced toward inversion. Too much typing. it goes on for awhile, anyways Where ? am i at. i got new walking poles and took about a two mile hike with them, had knee ankle and mild lower back pain for about two days, climbed a small mountain about 2 1/2 hrs in a blizzard on shoeshoes, hurt for a coulple of days. is it good to work my legs hiking or is it doing more harm? i dont mind paying some price for staying active and outdoors. can i strentghen the rest of myself enough to keep me from wearing out to fast? if anyones been in a similar situation i would like to hear about it. i know i will never stop exercising, my question should have said, when exercising how much is too much and how do you know? I need to find the line were i'm doing max exercise, mininum wear and tear.
    Last edited by lonecoaster; 05-14-2011 at 11:05 AM.

  2. #2
    Hi LoneCoaster! You are a Rock Star! I love to see you up and around and especially like your snowshoe photo.

    I'm not sure when your injury happened but the description from your Dr on your hip weakness, etc, is exactly what mine seems to be. I have weak hips, in general, but one is weaker than the other. I'm more comfortable using two canes for support and balance but can walk with one when I'm feeling brave.

    I work out every day and have trouble taking the rest days suggested by my PT. I've always been active and a 5 mile hike was nothing for me. Now, getting to the end of the block is exhausting. So, I understand your need to keep going.

    I guess my gauge is pain. If I have muscle pain similar to what an AB would have after a new workout, I don't let it curtail me much. I work around it. However, if the pain seems other than that, I try to take a rest day or two so that I'm not injuring something in the process. As we know, rest is good, too, but I've always had trouble taking that advice.

    You're obviously doing very well and I take my hat off to someone who won't give up.

  3. #3
    Lonecoaster, that is the $64,000 Question! It's such a tough thing to determine how much exercise is enough (or too little, or too much); and it's just as hard to discover which kinds of exercise build us up, and which ones do more harm than good. For me, both issues seem to fluctuate on a daily basis - I have to pay strict attention to what my body is capable of doing in the moment, and resist the temptation to push beyond that into debilitating fatigue or pain (as opposed to the satisfaction and mild tiredness that come from a good workout).

    There are many different views represented on CC, with some members exercising vigorously and as much as possible; others seem to do best with gentle maintenance routines. One suggestion might be that if you feel drained and exhausted and can barely move because of pain after a hike or exercise session, some modifications might be in order. My personal rule of thumb is that it's fine to move very slowly toward the edge of pain in a spirit of discovering where that boundary actually is; and once I know, I stop. For me, the boundary is fluid and my path is not one of steady progress in a single direction.

    I don't personally know of any way to find the optimal balance without a lot of experimentation, and that can be a painful process in and of itself! This is one of the most frustrating aspects of SCI, and I have yet to meet a doctor, PT or OT who has an adequate understanding of risks v. benefits where exercise (either amount, or type) is concerned.

  4. #4
    Quote Originally Posted by Bonnette View Post
    Lonecoaster, that is the $64,000 Question! It's such a tough thing to determine how much exercise is enough (or too little, or too much); and it's just as hard to discover which kinds of exercise build us up, and which ones do more harm than good. For me, both issues seem to fluctuate on a daily basis - I have to pay strict attention to what my body is capable of doing in the moment, and resist the temptation to push beyond that into debilitating fatigue or pain (as opposed to the satisfaction and mild tiredness that come from a good workout).

    There are many different views represented on CC, with some members exercising vigorously and as much as possible; others seem to do best with gentle maintenance routines. One suggestion might be that if you feel drained and exhausted and can barely move because of pain after a hike or exercise session, some modifications might be in order. My personal rule of thumb is that it's fine to move very slowly toward the edge of pain in a spirit of discovering where that boundary actually is; and once I know, I stop. For me, the boundary is fluid and my path is not one of steady progress in a single direction.

    I don't personally know of any way to find the optimal balance without a lot of experimentation, and that can be a painful process in and of itself! This is one of the most frustrating aspects of SCI, and I have yet to meet a doctor, PT or OT who has an adequate understanding of risks v. benefits where exercise (either amount, or type) is concerned.
    Very well said Bonnette!

  5. #5
    Yes, I like Bonnette's take on this and think I'll apply that advice to my own situation. I'm glad to know I'm not the only one who's been confused by this. I knew what to do before the accident but the rules have all changes and there doesn't seem to be a rule book!

  6. #6
    Thanks Bonnette And thanks Truly, you motivated me to get outside today.

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