Posture problems associated with SCI range from chronic pain and fatigue to skin and respiratory conditions.
Posture problems associated with SCI range from chronic pain and fatigue to skin and respiratory conditions. When left unaddressed they magnify, possibly worsening over time.
Evaluation:
-Do you have chronic pain in the neck, lower back or trunk?
-Do you experience fatigue in the upper trunk and back throughout the day?
-Do you sit crooked, leaning to one side or another?
-Is one hip higher or more forward than the other?
-Does your ear lobe, shoulder joint and hip joint form a vertical line above the chair axle?
-Do you experience breathing difficulties or have trouble getting full breathes?
A yes response to any of these questions is a clue that further attention may be in order.
Poor posture makes the lungs work harder, compromises respiratory function, puts undue strain on the neck and spine, causes pain and discomfort and increases the risk of pressure ulcers. The more you slump, lean or slouch in response to pain or fatigue, the more pain or fatigue is produced.
Causes:
-Lack of trunk muscles (cause the body to slump)
-Muscle imbalance (pulls body to one side or the other)
-Manual-chair wheeling (produces kyphosis, an abnormal curvature of the spine or forward lean)
-Inactivity or lack of exercising (drastically decreases physical fitness and can cause fatigue or chronic pain)
-Habitual functional activities, such as hooking the same arm on the chair-back for support, done the same way every day (can cause contractures and severe muscle imbalance)
-Poorly fitted equipment (places the body in a less than desirable position)
Look in the mirror or ask someone to take a close look at precisely how you are sitting. It’s often difficult to always recognize or feel the small changes that can result in big problems.
Once you’ve determined it’s necessary, seek the opinion of a professional therapist or a physician trained in SCI.
Possible solutions:
-New or modified cushions can provide proper weight distribution and begin to solve hip unevenness.
-Solid chair backs can furnish the necessary support to compensate for trunk weakness.
-Lateral supports (wings) provide torso support.
-Chest belts ensure stability and help with balance.
-Corsets worn under clothing counteract muscle imbalances, straighten the trunk, reduce fatigue and aid balance.
Bodies change with age. Responding to these changes with appropriate equipment can allow you to avoid future problems. The rewards of making changes are many: reduced fatigue, more energy, decreased pain, fewer skin problems, reduced spinal curvature or hip obliquity, and, in general, overall better health and appearance.
**Courtesy of the Rehabilitation Research & Training Center on Aging With Spinal Cord Injury, a joint project of Craig Hospital (Englewood, Colo.) and the University of Colorado (Denver) Health Science Center’s Department of Rehabilitation Medicine. Excerpted from PN article “Sitting Pretty.”
