A: Everybody knows how important physical therapy is after a spinal cord injury. No matter your level of injury, it is critical to attend physical therapy for several months afterward. Nowadays, however, the many months are turning into years, and for many, they now consider physical therapy a lifetime activity. After all, if the spinal cord injury cannot be fully healed, physical therapy should be considered a lifelong maintenance tool.
That is the question at hand—how important are the first 12 months of physical therapy after a spinal cord injury? Should one attend physical therapy on a daily basis for the entire 12 months? For many people with new spinal cord injuries, this is something they would love to do, but insurance doesn’t usually comply. Many also believe that if you go to physical therapy daily and treat it like a full-time job, you will see amazing results.
Many therapists, nurses, and doctors stress the importance of doing this within the first as well. To read more on how important physical therapy really is in your first year, as well as how to procure more therapy if your insurance cuts you off, continue reading below.
After PT Says You’re “Done,” What’s Next?
When you go to traditional rehabilitation after a spinal cord injury, your length of stay determines the rehabilitation goals you set for yourself. Once you meet these goals, your therapist is obligated to inform your insurance company, who then decides when you should leave the hospital and the discharge to go home. Many people, feel this is unfair.
For anyone who's been able to go to some kind of extended therapy/exercise program after their injury at a long stay rehabilitation facility, insurance companies look at people in this situation as a liability and would rather not continue paying for physical therapy for months, even years, on end. This is why they created a goals system to disallow them and to discharge people on a regular basis.
The good news is that they don't have the last say on this subject. You can now go to a doctor and ask for "maintenance" physical therapy on a yearly basis. If they deny your request, simply find a new doctor. And in the meantime, while you wait, don't stop doing your therapy. There are several things you can still do at home with the help of a family member or friend. Many people will even hire a physical therapist to come to their house to help them with physical therapy several times a week.
For many, this is just enough to keep them in great shape, but for those who are interested in putting their heart and soul into physical therapy the first year, having a physical therapist come to your house on a regular basis is a good substitute if you can afford to hire one that is. If you are on Medicaid, they may still help.
And don't forget to do a range of motion twice a day while you wait to do any kind of therapy again. It is true that the first year is critical. You do not want your legs or arms to become contracted, since that can make physical therapy much more difficult.
Another thing you can do is ask your doctor for our recommendation to a spinal cord injury model center, like the Shepherd Center in Georgia, where they have some of the best physical therapy in the world. For many, all it takes is 2 to 4 weeks to begin seeing great gains.
If your insurance company does not allow you to attend therapy at an SCI model center, we instead recommend you move to a city that is near an activity-based rehabilitation center, like NeuroFit 360 in Miami. You don't necessarily need to be in one of the cities to take part in their exercises, but it helps.
Also, consider looking into water therapy, whether in a friend’s pool, your own pool, or in a rehab facility. If you are quadriplegic and the water is warm, it can have amazing healing properties. Getting out of one’s wheelchairs and getting in a pool is mentally fulfilling too. And don't forget to consider trying FES (functional electronic stimulation) on your legs or anywhere else that you desire, as this builds muscle tone.
Getting involved in adaptive sports is another great way to stay active and stay physically in shape after a spinal cord injury. Many people swear by this, even though it wasn't an intentional thought. Many sports keep you very physically active, such as training during the off-season. From tennis to basketball, check out a sport that may appeal to you and go from there.
Another way to stay physically fit once insurance says no more is to get accessible exercise equipment like a Theracycle, universal gym, or cuff Velcro wrist weights for quadriplegics.
Does Daily Therapy Really Make a Difference the First Year?
A lot of people will resort to creating a full home gym that is similar to a physical therapy gym, and will even hire a personal trainer to help them work out one on one several days a week. As one can imagine, this is very expensive, but those who have done this swear by the results. Within weeks, people report seeing massive physical improvements in their abilities after working with a trainer.
How long you're able to go to physical therapy depends on the state you’re living in and the reports your therapist is giving to the state. If they are able, they will extend your physical therapy as long as possible. For some, they had physical therapy for as long as 3 1/2 years. Once physical therapy is over, they transition to a regular gym, where they continue their exercises for the rest of their lives.
Above all, the truth is that many people report exciting gains by doing daily rehab, whether it’s with a personal trainer, an activity-based therapy center, or done via a PT. Recovery can be an extremely slow process and if you're not fully committed or patient enough, it will eat you up. Stay committed to working hard and try to put school or work off for as long as possible. Many people report amazing results by treating therapy like a full-time job.
