An Initial Session for a Client with a Spinal Cord Injury

Check out the video below for a glimpse into an initial session for a client with a Spinal Cord Injury.

Sometimes as strength and conditioning coaches and personal trainers we can play a role in bridging the gap between rehab and performance. We’re transparent with our skillset and our limitations and consult with the qualified medical professionals to make sure there are no safety concerns and that our programs effectively supplement a client’s recovery process.

When first interacting with a new client, it’s important to have a conversation to learn what the client wants help with physically and what they can do independently. If you’re concerned about doing or saying the wrong thing, open and genuine communication should alleviate that.

This initial conversation should also discuss what the client’s specific goals are so that we can set realistic expectations and determine what exercises would have the greatest impact. In most cases, the client will be able to share what they were working on in PT and what the goals were.

From here, we can build what we call a trainable menu to determine what movements the client has access to. We can look at passive and active range of motion through the upper and lower extremities, what movements the client has control over, and what ranges they can achieve with some assistance. The location and severity of the spinal cord injury will determine the impact on motor control. It’s important for wheelchair users to train as many joint actions as possible to build strength and prevent contractures.

We can look at fine motor skills and grip strength to determine what pieces of equipment a client is able to use. We can try out different types of gripping aids to hold cable machine attachments, dumbbells, and cardio equipment like the Rowing Machine and handcycle. This will require some trial and error. The exercises we have access to will also depend on whether the client can transfer in and out of their chair, and the feasibility and logistics of doing so. If we have a limited amount of time with the client, we don’t want to dedicate too much of our time on set-ups and transfers.

Once we know what range of motion the client possesses, the equipment that they can use, the positions they can train in, and what they want to work on, then we can begin to build a library of exercises to include in a program.