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Thread: Ask a PT

  1. #101
    I definitely respect exercise as therapy - maybe you can make some days focused on arm strengthening or cardio with the arms as a way to let your weak leg muscles recover? I'm sure you did this before the injury too.
    I wouldn't worry about learning to walk with a walker - as you get stronger, you'll advance. It is much better to walk safely and not risk falls. Just keep your program well rounded, and don't forget (or underscore the importance of!!) stretching!!
    BTW - I'm in California

  2. #102
    Sorry, not sure why I thought Texas. Even farther from me though. I let stretching slip early on and got back on it a few months ago. I will keep you posted and thanks again.

  3. #103

    Wrist Tendonitus? DeQuervains? OOS?

    49 yo male, 26 years post sci, bilateral cts surgeries and have been having wrist pain since 10/2011 also I've been doing corporate IT work for 17 years... Dr originally dx'd flexor radialus tendonitus which is swollen and painful but I suspect I have both flexor and DeQuervains issues. ie Finkelstein's test is painful.

    pain is annoying enough that it is affecting concentration and work performance.

    Dr's don't seem to have any useful advice and resting is difficult to achieve...
    and when I've suggested they support me in filing for disability they don't seem interested.

    time to change careers? or go on the dole?
    I have about 4 weeks of fmla left...

  4. #104

  5. #105
    Wrist problems are difficult because it's inflammation around the nerves as well as the tendons. I'll have to look into the latest research and treatments, but the simple immediate things that could be helpful are:
    1. wrist splints. keeping your wrists neutral during work,and/or during sleep would help cut back on the friction that causes an increase in inflammation every time you move your hands. You should start during waking hours, with an hour at a time to make sure you don't get any red spots and build up time before you wear them while you sleep.
    2. work station modification - which I believe should be supported and provided by an employer? There are people who have the specific job of setting up your environment to cut down on overuse. They are "ergonomic specialists" and you could look for a local one and talk to your employer.
    3. ice. I know everyone hates it, but it will decrease some of the inflammation and hopefully the pain. Try 20 minutes during lunch and 20 minutes after work.

    I will look into other research for you.
    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  6. #106
    I've been through all that already, hot and cold therapy, wrist splints etc at night... I took a medical leave this Spring which helped some but now I'm back at the 925 and its the same chronic pain.
    My fear is I'm doing more damage by continuing this type of work (bad pun there) that will catch up to me and be more debilitating than having lost use of my legs... ofcourse the employer just wants the work done and I don't want to get fired. At what point is 'disability' justified? Its already making me less active and having pain and difficulties with adl stuff. This could easily take a year to rehab properly.

  7. #107
    Okay Tim - I put the question out there to an international group of therapists, and here's what I got:
    First and foremost, everyone said to get a power chair (I assumed you were in a manual?) Look for a rental for a couple of months as a way to decrease one stress. It would also be helpful if you can decrease the number of transfers you do throughout the day, and see if there is a way to do them without the typical wrist extension.
    Second, are there any devices that would help you do your job with less typing, i.e. voice command software.

    Australia has a surgical program that requires 6 weeks to recover... I obviously have heard of surgical options, but I always think this is a last option and it should definitely be done only by surgeons who have experience with SCI. It is a huge risk to lose grip strength. Talk to others who have had it done before considering.

    Alternative medicine was also suggested - Thai massage by the Thai therapist (PT is clearly different over there!) and acupuncture.

    So again, everyone said to modify your lifestyle for a couple of months as your "rest" while pursuing treatment, because as you said, with the same stresses, it will never get better. I am sure your doctor could also give you a prescription for OT/PT and you can get additional treatment as well as life modification advice. I would hate to think this is the end of your career, I'm hopeful that you can get better even if that means making some undesirable life changes...
    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  8. #108
    scifitness- I have another question if you don't mind. As you may recall i am a T-12 and have had tremendous return. I currently walk with the use of fore arm crutches and very rarely use my wheel chair anymore. For the most part things are going great. I do have some remaining deficiencies that I am working on.

    My question is my abductor on my left side appears weak. It seems want to move but I think it might be fighting tightness in my groin muscle which is very strong. Are there any stretches you can recommend that may loosen that groin muscle? I do the butterflies but they are not really working that great. I have begun surfing on my knees and I cannot straddle a board anymore. I am using one of my short boards as well so it isn't that wide. I never had a problem sitting on my board prior to my injury so I am guessing the muscles have tightened up and need a good stretching and the butterflies aren't cutting it.

    Any thoughts?

  9. #109
    No mind at all - ask away
    You could be very right about groin tightness - these are your adductors, and they can also help with hip flexion (as a compensation for weakness.) So with a lot of use, as well as their large size, they can certainly get tight and strong. The abductors are small and generally weak in comparison.
    Butterflies are a great stretch, but you are targeting your internal rotators more than your adductors. You want to straddle to stretch those muscles. Sitting with your legs in a V, or using a strap to bring a leg as far out to the side. The key is to keep your toes/knees pointed towards the ceiling. If they turn out, you're again getting the rotators. Or if you can do it standing with your legs wide - lean your hips to one side. You will probably easily feel the tightness if you're stretching the adductor if you put your hand on the inside of your thigh during the stretch. Remember to hold it for a prolonged time to allow some lengthening.
    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  10. #110
    Senior Member flying's Avatar
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    Hello Scitotalfitness
    I have been riding a stationary bike at home for about a year. I do not have any muscles that work below my knees. I strap my feet, shoes and all, into some Velcro deals so that I can peddle all the way around. Coming around the top of the circle, I have to be careful not to push at some point, or my toes get pointed forward, and then flop back to about the 90 degree point. Well now I have a trike that I am peddling outside, with my old clip-on bike shoes. I have tried riding with just the clip-on shoes, and then tried riding with my AFOs in my clip-on shoes. With the AFOs I can peddle all the way around, with helps a little bit, with speed, but noting to wright home about. Bear in mind that my legs are pretty weak (I can walk about 450 feet with arm crutches). My question is do you think that since I can't feel my lower legs very well, that I could be doing any harm to my ankle tendons, by not riding with my AFOs. Seems like I would have notice something by now. Its very hard to get my AFOs into my riding shoes, but could come up with some other way to do it, if necessary. What do you think?
    T12L1 Incomplete Still here This is the place to be 58 years old

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