James H. Rimmer, Ph.D., Director

I have learned over the past 30 years that exercise is a wonderful relaxant, mood synthesizer, and energy-enhancer. But I have also learned that pain won't go away unless you give the joint, muscle, ligament, tendon or bone time to heal. I have been through a few bouts of Achilles tendonitis, knee tendonitis and some back tightness, all causing me to curtail my running distance at various times in my life. Fortunately, there are other activities that I can do while I wait for the injured or overused body part to recover. Sometimes it's an extensive stretching program for 15 to 20 minutes followed by several weight training activities and calisthenics. Other times it's riding a stationary bike, using the elliptical cross-trainer, a great machine for reducing the impact on the knees and hips, or running in the pool with a flotation device wrapped around my waist that keeps me in a vertical position.

Modifying an exercise program during times of injury may be a lot easier for people who are ambulatory and have access to a host of other kinds of exercise equipment and programs compared to people who have lower-extremity impairments and a limited number of "upper-body" exercise options. Many wheelchair users end up with overuse injuries to their shoulder joint resulting from years of pushing their chair and using these same muscle groups to exercise (an arm cycle ergometer is the most common piece of exercise equipment for wheelchair users). While it is difficult enough for many people who have use of their lower and upper limbs to switch exercise regimens during times of injury, it is even more cumbersome for people with lower extremity impairments who have significantly less options.

Exercise professionals are continually striving to find more ways to achieve the "runner's high" without having to pound away at the same joints day in and day out. As we discover more ways to exercise with our lower bodies without placing undue stress on the hip, knee, ankle, and back joints, so must we begin to develop innovative ways to exercise the upper body without displacing undue stress on the muscle groups used during wheelchair ambulation. Today there are a number of low-impact exercise machines and programs available to reduce stress on various joints. These include shock-absorbing treadmills, elliptical cross-trainers, recumbent bikes and low-impact aerobics classes. But complementary machines and programs for wheelchair users are lacking.

Upper body exercise machines and programs that would not require the same muscle groups used to propel a wheelchair would allow the exerciser to obtain a great workout without having to overload tender joints and muscles in the arms and shoulder region. Innovative rehabilitation professionals could easily come up with several cardiovascular exercise routines that target muscle groups not extensively used during wheelchair ambulation. Several of these exercises could involve movements that have greater use of the back musculature and posterior arm muscles. These exercises could have an immense benefit to the wheelchair user in terms of "balancing" the body by using opposing muscle groups to those used during wheelchair propulsion. The new exercise routines would also allow wheelchair users to protect the joints and muscles that are needed for wheelchair ambulation and exercise more frequently on days when they needed to rest certain muscle groups that were tender or sore. Overuse injuries are the major reason why many people with and without disabilities drop out of exercise programs and providing alternative exercise routines for wheelchair users will ensure greater compliance to an exercise program.

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