Sunday 6 October 2013

Gym -Self Directed Therapy

Well, its been a while since I've added any content to this blog.  I just don't wish to whine about the same issues, but then again, those issues are with me daily and perhaps some others might benefit, sympathize, understand or commiserate.

Disability Transport Strike:
I endured a disability transport transit strike since last writing.  While I considered several strategies to cope with the disruption, in the end there was little impact on service.  Local taxi companies were able to meet the demand and quite often I found that I had better times than with the dedicated disability transport service.  After about six weeks on the picket lines, not much was won or lost by the unionized drivers other than their pay cheques for that period

New Powerchair Update:
Got my new powerchair but can't say I'm totally pleased with it, however I'll leave that for another post.

Gym Rat:
After the hospital's outpatient physiotherapy closed down, I went to a private physiotherapy clinic in hopes of continuing therapy & hopefully progress.  Those who have followed my posts know that what I found in the general community was rather disappointing.  (Read about that here) Most private clinics are geared towards treating sports injuries, home injuries (trips, falls, sprains, motor vehicle accidents, etc.) and have little or no resources, if not experience, in treating patients with serious injuries brain or spinal cord injuries.  While the therapists were quite professional, there was little more they could offer.

Last October (2012) I joined a local gym in hopes of maintaining my strength and flexibility, if not improving on them.  I also wanted a facility that had a pool where I could  use the water's buoyancy to work on my balance and walking.  Finally, with the reduced physical activity associated with being trapped in a wheelchair and the refrigerator always shouting out invitations to your boredom, I wanted to persuade my metabolism to at least try to fight my weight gain.

Facilities:
The Gym I chose is quite impressive!  The first of this franchise in Canada.  58,000 square feet with three swimming pools -one huge outdoor leisure pool for summer fun. and indoor multipurpose pool and the third with lanes for swimming lengths or perhaps buoyancy assisted walking in my case.  Second floor is all gym equipment as far as the eye can see.  Treadmills, stationary bikes, an apparatus for every muscle, free weights, etc, etc.  Top floor has basket ball & squash courts plus special function rooms for group activities.  They have a three story rock climbing wall/structure.  A life lab can monitor your progress through physiological testing.  Pilates, massage, whirl pools and all the rest.  When the body is satisfied, you can reward yourself with an on-site hair salon, nails & facials, and even a small restaurant serving only the healthiest of choices.  Oh, the towels are included as are amenities such as shampoo, razors, shave cream and such.  Beautiful upscale facility

I hired a personal trainer for one session to introduce me to some of the gym equipment that they though I could use.  After that, I made an effort construct a routine primarily focusing on leg strength and flexibility for starters.  The routine takes between 1 & 1/2 hours to 2 hours per session and I try to attend every second day.  While I make an honest effort to attend, life often has other ideas - for the most part I do stick to this schedule.  It can be a bit of a challenge on weekdays when I've already spent eight hours at my job.  Tack on up to three hours more in wait & travel time to and from work although I live only about 12 minutes away from my workplace.  After an 11 hour workday, it is not always easy to motivate yourself to head to the gym for another 2 hours.

Anyways, it has paid off to some degree.  Muscle mass has significantly increased and my wife claims I have lost weight although I fail to see it.  I wanted to gain strength and lose some weight before adding the pool routine. Unfortunately, the increased strength alone really hasn't translated into additional stability.so I will have to add the pool very shortly and see if that will help.

It is quite frustrating!  I can stand.  I can just about take a few steps without holding onto anything.  However the stability is still rather week.  If I feel I'm starting to go over, it is difficult to recover and straighten up to the vertical once more.  I have excellent plantar flexion (standing on toes) but much less dorsi-flexion (turning  foot up at the ankle).  I can even wiggle some toes to some degree -a bit of improvement after being totally paralyzed from the waist down when discharged from the hospital.
Pain however, is another matter.  It remains my constant companion!

Gym Equipment:
Okay, below are some photos taken at my gym of some of the equipment I currently use.  In addition to the pool, I hope to add some upper body equipment to my routine in the following months.

This contraption has no name printed on it and I'm not sure what the proper name of it is.  Regardless, I use this pedal  contraption to warm up.  While you can exercise both legs and arms with it, I tend to use the foot pedals alone.  20 minutes on this, currently at level 9 of 30, raises quite the sweat,

After the warm-up I generally find which apparatus is free and don't worry about the order of the exercise.

With the Seated Leg Curl, you place you legs over the padded bar in the foreground and with the chosen weight, you curl your legs towards the floor.  I won't go into specific anatomy but it strengthens the backs of the legs up to the butt and I even feel it in my lower back.  I currently use it at about 100 pounds resistance and do about 3 sets of 20 repetitions.

Leg Extension Apparatus - This one is kind of like the opposite of the one above.  Place your legs under the padded bar and lift the weight up.  You feel it in your thighs.  I currently use it at about 90 pounds and try to do 3 sets of 20 repetitions.

Abductor Apparatus - On this one you sit on the seat and place your knees against the two pads.  With the weight set you spread your legs, pushing out against the pads with your knees
I have this set at 190 pounds and do upwards of 150 repetitions in total.  These are big, strong leg muscles, even with my injury and I find it rather easy to do at this weight and repetition number.

Abductor Apparatus -This one is the opposite of the one above.  When seated, you put your knees on the outside of the pads and open the pads up so that your legs are spread.  With your chosen weight (resistance), you squeeze you knees together and release.  Again, I set this at 190 pounds and do about 150 repetitions.  I usually do about 75 repetitions to start and then follow with 50 and 25 as I get fatigued.

Calf Apparatus -Simple sit and place feet against the curved metal plate.  Using your calf muscles, you rotate your feet at the ankles and rock the plate forward and back.  I use this equipment to stretch out my Achilles tendons by dropping my feet down towards the bottom of the plate and let the resistance stretch your tendons.  The first time I tried this it felt like someone had lit one of the magnesium Christmas sparklers inside of my calves - fireworks were going off inside my legs.  Felt great!  I have this set at about 120 pounds and really have no set number of repetitions.   I do it for as long as it feels good and time allows.

The Stationary Weights - the arms can be moved up or down, closer together or further apart.  Backing my chair between the arms, I alternate, grabbing one hand grip (dangling from the arm) and using both hands, pull the resistance from the upper left to my lower right (or upper right to lower left with the other arm) -one at a time. I find this helps loosen and strengthen the torso with the twisting action.  I have the weight set at 13.5 which I believe is 135 pounds (?) seems a bit much.  I do 3 sets of 20 repetitions.

I don't have photos of the few other pieces of equipment I currently use.  One is the Inclined Leg Press, where you are seated in a chair on some rails.  Placing your feet on a platform raised directly in front of the seat, you push against it and push your seat up the inclined rails.  Basically, you are pushing your seated weight up hill.

I also use an Abdominal Apparatus where you basically sit and pull on some straps that come over your shoulders - using your abdominal muscles to lift your chosen amount of resistance.  I do three sets of 25 repetitions.  Once in a while I also try out a bicep curl machine and a rowing machine.

Finally, I am new to the gym environment so please forgive me if this equipment has more appropriate names that what I've called them.

Because I am able to stand, any piece of equipment that I can step onto or into, I can use -I just need someplace i can hold onto to stabilize myself.

I really feel this self directed physical exercise therapy is very helpful.  I would urge anyone with a physical disability to join a gym and do, no matter how small, whatever you can do. I know there will be improvement in physical ability and in the mind.