Topic Overview

A spinal cord injury (SCI) makes movement difficult. Movement is what keeps your muscles and joints flexible and helps prevent spasticity. If you cannot move your muscles and joints easily, you may lose some of your range of motion. This will make it harder to perform daily activities, such as getting dressed or moving between your wheelchair and another location. Flexibility exercises can help you retain your range of motion.

Most people work hard to stay flexible. But it is possible to stretch too much. This can make it harder to balance and to do activities such as dressing yourself. Work with your rehabilitation team to come up with a stretching program that is right for you.

You may be able to do some of the flexibility exercises yourself. A loved one or therapist can help you with others. It may be convenient to do your stretches in the morning or evening at the same time you inspect your skin for pressure injuries.

Self-stretches

When you do these stretches, make sure you have something solid behind you that does not move. You can try the stretches in your wheelchair (make sure it is firmly locked) or in a bed against the headboard. Different locations might be better for different exercises. Experiment to see what works best for you.

Do all stretches gradually, and never force the stretch. Do not push or bounce the stretch. You should feel a "stretch," not pain. Breathe out as you begin the stretch, and breathe in while you hold the stretch. Breathe out as you relax the stretch.

How long and how often you do a stretch may vary. The information below shows general guidelines. Always ask your doctor about what is best for you.

• Lie on your back and extend your arms straight out to the sides with your palms turned up to stretch the front of your chest. Stay in this position for at least 15 to 30 seconds, and repeat 2 to 4 times. Or you can just lie in this position for about 3 to 5 minutes if it is comfortable for you. You can also stretch the front of your chest when you are sitting in a chair or wheelchair. With the chair in a doorway, raise your arm to the side and bend your elbow. Put your hand and forearm against the doorway and lean forward to stretch your chest and the front of your shoulder. Hold the stretch at least 15 to 30 seconds. Repeat 2 to 4 times with each arm.
• Lie on your back and raise your arms straight up and over your head to stretch your shoulders. Stay in this position for at least 15 to 30 seconds, and repeat 2 to 4 times. Or you can just lie in this position for about 3 to 5 minutes if it is comfortable for you. You can also stretch your arms up over your head while you are sitting up.
• Place your left hand or wrist under your left knee, and pull your left knee up toward your chest. Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4 times. Do the same exercise with your right hand and right knee.
• Sit with your left knee bent up toward your chest. Put your left hand and lower arm on the left side (outside) of your knee. Gently push the knee toward your right leg. Do not force the stretch. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times. Do the same exercise with your right hand and right knee.
• Sit with your left knee bent up toward your chest. Put your left hand and lower arm on the right side (inside) of your knee and gently push it away from your right leg. Do not force the stretch. Hold for at least 15 to 30 seconds. Repeat 2 to 4 times. Do the same exercise with your right hand and right knee.
• Face a bed or chair that is about the same height you are sitting at. Put one leg on the bed or chair and keep it straight. Do not bend your knee. Do not bend forward as you do this, as it will stretch you too much. Hold this position for 3 to 5 minutes on each leg.
• Sit with your legs stretched out in front of you. Lean forward, and loop a strap around the bottom of your foot. Pull on the strap gently, and continue to lean forward while keeping your knees straight. Do not turn your foot to either side. Hold this stretch for about at least 15 to 30 seconds. Repeat 10 times.
• Spend time lying on your belly each day. People with SCI who are sitting most of the time can get tight muscles in the front of their hips and the back of their legs. Lying on your belly with your legs stretched straight out will help stretch these muscles. Try to relax all your muscles and stay in this position for at least half an hour. Some people even learn to sleep on their belly, so they are in this position all night.

Passive stretch

A passive stretch is a stretch where someone stretches a muscle for you. This type of stretch can be done for upper and lower body muscles. Your rehab team will be able to teach a loved one how to do these exercises. They include:

• Flexing and extending the hip, knee, shoulder, wrist, fingers, and elbow.
• Stretching the hamstring (the muscle on the back of the thigh) and foot and ankle muscles.
• Rotating the hip and shoulder.