Ramblings on healthcare, medical education, and life with a spinal cord injury
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Grip Strength Returning

Grip strength.  It’s an interesting indicator.  One thing I didn’t realize prior to my injury (among many things) about SCI is how many systems are affected.  My injury level would suggest that I would have much more limited upper body movement than I do.  Despite good mobility, the movement I do have is affected.  But it is getting better.

The effects of a C6 SCI include (but are far from limited to):

Complete paralysis of body and legs. No finger movement, no elbow extension, no wrist flexion. Good wrist extension, good elbow flexion.

A passive key grip may be present by flexing the wrist backwards, but will be weak.

Electric wheelchair can be controlled with a hand control for uneven outdoor surfaces. A manual wheelchair may be used for short distances on flat surfaces.

The person will require total assistance when transferring from floor to chair. Assistance will vary for transfer from bed to wheelchair, and wheelchair to car. A sliding board may be used in assisting with the transfer

Ability to feed self using feeding strap and fork or spoon during mealtimes. Food will need cutting.

Ability to shave, brush hair and brush teeth is possible with palm straps.

A computer may be operated using a typing stick or voice recognition. Telephone can be used using voice recognition and headset.

That’s a lot of limitations, and that’s not the entire list.  And those are all limitations that do not apply to me.  I know I haven’t gotten to grip strength yet at all, but I’m getting there.

Many of the people who’ve been around here for a long time assume that my injury is in the area of T4-T5.  The effects of a T5 level injury are drastically different:

Full head and neck movement with normal muscle strength. Normal shoulder movement. Full use of arms, wrists and fingers.

Complete paralysis of lower body and legs. Upper body strength will vary depending on level of injury, but the lower the level, the stronger the upper body strength and balance.

A manual wheelchair may be used for everyday living, with the ability to go over uneven ground.

Ability to transfer independently from bed to chair, and chair to car. Car transfers may need assistance depending on upper body strength.

Quite different.

When I first arrived at Mount SinaiDr. Stein tested my strength in various parts of my body.  My right was definitely stronger, but I had to use all the strength in my triceps to keep him from being able to collapse my arm (forearm bending back onto upper arm) when extended outward.  My left was simple for him to collapse.  No strength at all.  Or in the fingers.  It was almost impossible for me to open the plastic wrap the plasticware came in with the awful hospital meals.

There is a device here that tests hand grip strength, and when I first got here my left hand was around 18 psi and my right was at 30 psi.  What’s normal for a man?  “Before the injury, you probably would have easily pulled above 100 psi,” Dr Stein told me.

Wow.  From 100 to 18.

A few weeks ago, my right was up to 40 and the left 30.  Long story short, after no increase between two weeks ago (50 right, 45 left) today was much better.  60 on the right, and 50 on the left.  Makes my left almost three times as strong as when I got here, and my right literally double.  The more I hit the weights, the better the grip will get.

Part of the reason for the detailed explanation is simply to demonstrate one example of how my strength was significantly diminished and is now making progress.  One day at a time.

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