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Thread: Ask a PT

  1. #171

    Can FES cause nerve damage

    Not sure if this is a stupid question or not but can repeated FES use cause nerve damage?

    The he reason I ask is that I am motor complete but sensory incomplete and would use the FES leg bike roughly 3x/week. About a year ago i developed a terrible case of what they are finally diagnosing as peripheral neuropathy (ya gotta love doctors that just assume that because you have a SCI that it is automatically central pain).

    anyways just wondering if say overflow from stimming quads, glutes, hamstrings could cause peripheral Neuropathy?

    thanks

  2. #172
    That is not a stupid question. But I have not heard of FES causing nerve damage. In fact, it is a treatment recommended for those with diabetic neuropathy because the electrical stimulation is increasing the blood flow and should be keeping the nerves healthy.

    What were the symptoms that you developed? Did anything make the symptoms better or worse?
    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.

  3. #173
    The symptoms came on pretty fast. One day I pressed my foot down on the foot rest of my wheelchair and noticed some pain, the next day even more, and then the next day I couldn't even touch the foot it was so hot and sensitive. Since then it's just the normal burning pins and needles. I've been through most of the notable nerve pain Meds and then narcotics which only seemed to make things much worse. MRIs showed nothing wrong with my spine other than my initial injury of course.

    im just trying to come up with anything that could have caused this.

    thanks

  4. #174
    That's interesting... I'm sorry that you're dealing with that. Have you kept up with the FES despite the pain?

    You say that you're sensory incomplete - can you feel your feet if someone touches them? Have you tried TENS? This could be trialled either where you feel the pain, or along the spinal dermatome (I know you don't like to hear that it could be central...) The downside to TENS is that it only works while it is worn. But it may be more effective than medication.

    Also, do you stretch regularly? It is common for the hip flexors to get tight from sitting so much, and also from the work you're doing on the bike. The hip flexors attach to the lumbar spine, and could pull on it, causing some pain down the nerves that exit from this area. This is common even in people who walk. Also the hip rotator muscles are under the gluteal muscles can get tight and push on the sciatic nerves. These issues would not be seen on any imaging, but could contribute to nerve pain. Start adding some prolonged stretching to your regular routine, and see if that helps alleviate your symptoms.
    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.

  5. #175
    Here's what my radiology report said: There are 5 nonrib‐bearing lumbar type vertebral bodies.Levoconvex curvature is centered at the thoracolumbar junction. The
    vertebral elements are otherwise in anatomic alignment. There is no
    evidence for instability on flexion and extension views.
    Mild physiologic anterior wedging is demonstrated of the T12 vertebral
    body. Vertebral body height is otherwise relatively preserved.
    Intervertebral height loss is mild in degree, spanning from L3‐L4 through
    L5‐S1. Scattered mild to moderate facet arthropathy is demonstrated
    throughout the lumbar spine.

    My doctor said I have 'mild scoliosis'. Since my curvature is a "levoconvex curvature", which side is the weak side? Left or right. I read about a study showing that a plank exercise of the weak side (a simple yoga pose) can quickly help correct curvatures. Your advice would be appreciated. Thank you.

  6. #176
    Im 19 years old , t9 level 6 months post accident. Im doing physiotherapy every day 3 hours but we dont have too much information and he has not any experience with SCI.
    I have back stabiliztion which gives me discomfort working out and trying to work balance.
    Also most of the exercises to move the legs I am succesful doing only by giving a hard movement with my hips.
    I am afraid how caution should I be and if there is any limit in movement and working out because I dont want to danage anything.
    Good progress has been so far , burning sensation and little contractions.
    They are not easily visible but my physiotherapist is enthusiast about them.

    Very good thread , learned a lot here

  7. #177
    Generally, the concave side is the stronger side because the muscles are pulling on the spine without the muscles on the other side activating to provide opposition. So the C would typically open to the stronger side.

    Exercising everything you can is always beneficial. The difficulty comes when the weaker muscles simply have less innervation from the spinal cord injury... working to strengthen weaker muscles is always recommended, but even with all of the best exercise, you may still have some imbalances. Don't let that discourage you, but also don't think of the results as failure. Definitely be sure to stretch regularly! Especially those stronger muscles because they are more prone to getting tighter from working (when there's weakness, the stronger muscles tend to turn on even when you're not trying!) and then will pull more on the spine. Using the yoga poses to stretch would be great
    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. #178
    Keep up the good work, Martiniani! Sounds like you and your PT are learning together

    How to know when you're risking injury is tough to answer online and not knowing your body... six months post surgery should be sufficient for the bones to have healed. If you notice any increase in your spasms, that is a sign that your body is not liking the stress it's being put under. I would also be cautious of doing any weight bearing exercises (standing/walking) without the proper support/orthotics just to protect your joints. You may not be able to feel the strain you are putting weak muscles and joints under, and you don't have to have pain in ten years from the stress you put them under now. Standing frames help with this stabilization, as do orthotics, and the new robotics. Most body weight supported treadmill options keep this principle in mind as well.

    I hope that helps. If there's anything specific that you're trying that you think is questionable, give that example and we can try problem solving.
    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.

  9. #179
    Do you offer online personal training ?
    I read something about a personal course but found no contact information or website.

  10. #180
    I offer an online exercise program with videos-on-demand to get extra exercise in. It's a great adjust to any therapy or gym program, and also an option for people who have difficulty getting to other services. The business is my screen name - the webpage is also the same. Check it out; my direct email is kristin@scitotalfitness.com for anyone who has more questions.
    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.

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