What is a spinal cord injury?
A spinal cord injury is damage to the bundle of nerves inside the spine, caused by a road accident, a fall, a sports or work injury, or an illness. It interrupts messages between the brain and the body below the injury.
What a person can still do depends on the level of the injury and whether it is complete or partial. Two people with the same diagnosis can be very different, so the plan always starts with the individual.
What does a physiotherapist work on?
The aim is the most independence and safety the injury allows. In practice that means:
- Sitting balance and trunk control, the base for everything else.
- Strengthening the muscles that still work, especially the arms and shoulders.
- Transfers between bed, chair, commode and car.
- Moving and stretching the joints that cannot move on their own, to prevent stiffness.
- Breathing and chest care when the injury is high.
- Standing or walking practice when the doctor and the injury allow.
- Wheelchair positioning, with the occupational therapist.
Where the person has spasticity, which is stiffness and sudden muscle tightening, we help manage it with positioning and stretches. See the glossary on spasticity.
How is home different from the ward?
The ward is built for care. A home is built for living, and the first weeks back are when the gaps show.
In an Ipoh terrace house the bedroom may be upstairs, the bathroom door is narrow, there is a step at the front, and the car boot is at hip height. Each of these needs a plan: where the bed goes, how the person gets to the toilet, how they get in the car for the hospital appointment.
We assess these on the first visit and practise the real transfers in your own space. See transfer training for what that means.
What do family carers learn?
You will be doing part of this every day, so you learn it properly.
- How to move the person safely in bed, and when to change position.
- How to do a transfer without hurting your own back.
- A daily stretching and movement routine.
- How to check the skin for red or broken areas, especially over bony points.
- What counts as a warning sign, and who to call.
Our page on pressure injury explains the skin side. Carers’ own backs matter too, so see caregiver strain and back care.
Is there local rehabilitation in Perak?
Yes. A rehabilitation centre run by the Social Security Organisation (PERKESO) in Ipoh offers structured physiotherapy, an intensive programme and robotic rehabilitation [1]. Eligibility is not stated in that report, so ask your hospital team or PERKESO whether you qualify.
Home physiotherapy can sit alongside or follow such programmes. We help with the day-to-day practice and the home setup, and we work with the plan your hospital team gives.
What are the warning signs at home?
Go to the emergency department or call for help for a sudden, severe pounding headache. Sweating or a flushed face above the level of the injury can come with it, especially in a high spinal injury. Follow your discharge advice too.
Also seek urgent care for new chest pain or breathlessness, a swollen red calf or a fever with new pain. A spreading skin sore or sudden new weakness or numbness needs the same. Tell the spinal team about any change in bladder, bowel or sensation.
What can you do this week?
Start with safety and routine.
- Ask the hospital for the discharge summary, spinal precautions and equipment list.
- Decide where the bed will go and clear the path to the bathroom.
- Check the skin morning and evening, and change position on the schedule you were given.
- Keep a short diary of pain, spasms and tiredness for us to review.
- Look after your own sleep and back as a carer.
How do we arrange it?
Home physiotherapy across Ipoh is available now, and our Canning Garden centre near Fatimah Hospital is opening soon. For a spinal cord injury, we usually start at home, because the transfers and set-up are the first hurdles.
Message us with the injury level if you know it, the hospital and the date of coming home. We reply with how a first visit would run and a quote. Home and centre prices differ, and no price list is published yet. See also bedridden patient physiotherapy.