The Upper Body Myth

September 22, 2011

I would like to take this opportunity to dispel a myth. A myth that is so predominant in the world of paraplegia that even many paraplegics are taken in by the illusion. Considering how far we have come with the rebuilding of my damaged body it is understandable that people now make this mistake with me, but this has been going on since I left hospital fourteen years ago. I will state, quite categorically, that it is impossible for a paraplegic to have a strong upper body!

It is true that within a year of injury I had built up muscle bulk in my arms and shoulders that made my body look stockier than the scrawny young man I was in my twenties (before spinal injury), but superficial muscle built up through enforced poor use of the body does not amount to strength and closer examination will always reveal the fundamental weaknesses. It must be remembered that paraplegia is the result of injury to the spine, the trunk of the body, and that paralysis of the legs is a consequence of damage to the core of the body. Although paralysis of muscles is initially caused by nerve damage in the spinal cord, the ability to recover from this nerve damage is prevented by the collapse of the intrinsic structure of the body, that structure which not only supports the use of the legs, but also the proper use of the arms. The legs themselves are rarely damaged in a spinal injury.

To understand the intrinsic nature of the body, we must see that we are more than the traditional view of external muscles attached to a skeletal frame, within which are housed our internal organs for their protection. We must see that those internal organs, from the brain to the bowels, are in fact all that make up the primary strength to our bodies. All living tissue has a density, pressure and volume and collectively the internal organs, and connective tissue, combine to produce the curvaceous form to our bodies, with the alternating convexity and concavity to the head, neck, chest, abdomen and pelvis. It is this entire structure that pulsates to produce breathing, an involuntary action that is impossible to consciously stop, and this structure that provides the stability (resistance to compression) upon which the strength of our bodies are founded. The skeleton is a secondary level built around this structure, a connective structure of hydraulic joints with the bones being formed as sedimentary deposits along the force lines between the joints. Finally we are encased by the external skeletal muscles, which work as the actuators for the movements of the hydraulic skeleton. So our strength is based primarily upon our core pneumatic structure, which, through its resistance to compression, provides the stability necessary to support skeletal movements. If this structure is weak then it will collapse under pressure, causing deformation in the skeleton and preventing proper movement of the body.

When I damaged my spine I near enough snapped my body in two under extreme force, but the physical injury resulting in paraplegia is more often than not much less severe. The damage is caused, not so much by the initial impact, as by a combination of the trauma of the accident, the following period of bed rest and poor use of the body afterwards (predominantly through wheelchair use). It is as though, in that initial trauma, the switch is turned off and the primary systems of the body shut down. Bed rest prevents those systems from starting up again causing collapse of the pneumatic structure resulting in severely depleted resistance to compression. Rehabilitation follows, through conventional physiotherapy, where the patient is expected to learn to use a body, that is not only paralysed through nerve damage, but suffering from a collapse of core strength. Inevitably, the core structure cannot support proper use of the upper body resulting in poor use of the skeletal structure, so deforming and ingraining changes in that structure. With no attention paid to turning the switch back on, during the period of bed rest, and re-establishing integrity to the primary core structure, the deformed structure you see in all paraplegics is inevitable and regaining use of the legs impossible through natural recovery.

My body is really shaping up lately, and so it should be with the amount of hours of ABR Therapy put into it, but ten years ago, before starting my therapy regime, it was a different story. From the front I looked fairly good, but when you looked at the side, my body was only just wider than my arm. It was possible to feel my spine through my stomach; there was so little quality to my trunk. There was no spinal valley and the protrusions on my vertebrae poked out from under my skin. The shoulder blades were sunk deep into the trunk, providing no anchorage for the shoulders, and there was so little resistance to compression that my trunk hinged in the middle with every push of my wheelchair, deforming my rib cage. These days I am far closer to having a strong body, but I am still missing depth to my back, still needing more work to form that true barrel shape to the chest and still struggling, at times, with profound weakness in the shoulders, particularly the left one.

Anyhow, I think I’ve made my point. Paraplegics do not have strong upper bodies!

One comment

  1. I’m just beginning to understand the complexity of your therapeutic work and wish you the best success from the depth of my heart.

    Love Fanny xx

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