Paralyzed below the waist after a spinal cord injury? This is a type of paralysis called paraplegia.
Essentially, you only experience paralysis in your legs and your upper body has completely normal function.
SCI patients that are paralyzed from the waist down typically have a lower level thoracic spinal cord injury.
This article will go over what you can expect with paraplegia and how to recover function in your legs.
What Can You Do When You’re Paralyzed Below the Waist?
While it might be upsetting that you can’t walk (yet!), paraplegia still allows you to have a good amount of independence.
Because you have normal upper body functions, you just have to learn to adjust the way you do things.
With the help of adaptive equipment like reachers and grab bars, you can still perform a lot of tasks and activities on your own.
If you’re a sports lover, consider joining an adaptive sports program. Over 50 sports have been adapted for people with disabilities to enjoy.
The main difference is that you’ll have to learn to be more dependent on your arms to compensate for poor leg function.
Is it Possible to Recover from Paraplegia?
There are two types of paralysis: complete and incomplete.
Complete paralysis is when the spinal cord gets completely severed.
This means that no neural circuits between your brain and body survived the injury, so every function below the site of injury should not work.
In contrast, incomplete paralysis is when you only experience partial paralysis.
If you experience tingling, spasticity, pain, or anything really, that means there are still connections between your brain and body!
As long as the connections exist, recovery is possible.
Ever heard of spinal shock?
It’s essentially a result of your spinal cord going into defense mode.
Your body’s inflammatory response triggers a bunch of biochemical processes that result in swelling of the spinal cord.
When there’s too much swelling, blood supplies (that are essential for cell activity) get cut off and areas below that site of injury start to dysfunction.
Spinal shock is when you temporarily lose motor and sensory functions due to excessive swelling of the spinal cord.
Luckily, functions will gradually return as swelling dies down.
Many people think that they have complete spinal cord injuries when in fact, they are just in spinal shock.
It can last anywhere between a couple of days to several months.
Only after spinal shock will you have an accurate idea of how much you can or cannot move.
What to Expect When You’re Paralyzed Below the Waist
Paraplegia will affect functions in the lower half of your body.
You might not experience all of these (depending on the severity of your injury), but here are some of the most common outcomes of paraplegia:
Bladder and Bowel Dysfunction
The muscles that control waste removal may go flaccid or spastic, which can cause accidents.
Bladder and bowel dysfunction can also cause diarrhea, constipation, urinary incontinence, and stomach aches.
In order to manage bladder and bowel dysfunction, you may need to:
- change your diet
- use a catheter
- implement a bowel program
- take medications to relax contracted muscles
- get surgery to enlarge your bladder
Muscle Atrophy in the Legs
Think ‘use it or lose it.’
If you can’t walk and are sitting in a wheelchair most of the day, you’re going to lose a lot of muscle mass in your legs.
Some ways to help combat muscle atrophy is to exercise those muscles (yes, passive exercise counts!), eat a healthy diet, and activate movement through functional electrical stimulation.
If your bladder and bowel functions aren’t working properly, chances are, your sexual functions won’t either.
However, 80% of men are able to regain some erectile function within 2 years of injury and most women are able to get pregnant.
Generally, sexual activity decreases after spinal cord injury, but the need for intimacy often remains.
SCI patients with sexual dysfunction may need to use medications, implants, or devices.
Spasticity is when your paralyzed muscles tighten and get extremely stiff. This can be painful and cause spasms.
Treatment for managing spasticity include stretching, physical therapy, muscle relaxants, Botox, or surgery.
Generally, spasticity, pain, and tingling are all good signs of recovery. They indicate that the neural circuitries between your body and brain are still intact!
Recovery Goals for Paraplegics
The main recovery goal for people with paraplegia is to walk again, but is it a realistic goal?
This depends on a lot of different factors but we’ve seen plenty of paraplegics walk again and believe that if you’re willing to put in the work, you will improve.
One of the most important things you need to do to recover leg function after a spinal cord injury is to move what you can.
Nothing is going to activate neuroplasticity in the spinal cord like massed practice.
You’re essentially reteaching your body how to move again through repetitive, task-specific training.
Concentrate on areas where you have weakness and keep repeating exercises that force those muscles to move.
The more you repeat, the easier the movement will get.
Both of these treatments have gotten SCI patients back on their feet and require intensive gait training.
So while these treatments are developing, why not work on the gait training part?
You might even find that you can recover leg function without them!