Keep your body moving

This content is from
pages 88 to 95 of A Health Handbook for Women with Disabilities

All women need exercise to keep their bodies strong, flexible, and healthy. Exercise helps your muscles, your heart, and your lungs stay strong, and it helps prevent you from getting high blood pressure, weak bones, and constipation. Exercise will also help prevent you from becoming too fat. To be very fat is not healthy and will make all of your daily activities more difficult.

Sometimes a woman’s disability does not let her use or move her body, or parts of it, well enough to get the exercise she needs. Muscles that are not used regularly become weak or can develop spasms. Joints that are not moved through their full range of motion get stiff and can no longer be completely straightened or bent. If you have a disability that affects your body, make sure to move all the parts of your body through their full range of motion. Sometimes you may need help with this.

Exercise can also help women who feel depressed. Some kinds of exercise can actually help you feel less pain. Many people sleep better if they exercise regularly. When your body is strong and healthy, you have more energy, feel better, and hurt less.

Most women get all the exercise they need through ordinary daily activities, such as preparing and cooking family meals, cleaning, working in the fields, collecting wood and water, and carrying children. As much as possible, women with disabilities can get their exercise in these same ways.

If it is very difficult for you to move your body, try to change your position often. If you usually sit all day, change your position by lying down for a while.


If you are often bent forward...	...try to stretch the muscles in your chest.

Exercise does not have to be hard work in order to be good for you. It is best to start slowly, especially if you do not move much now, or if you cannot move a part of your body, if it is weak or painful, or if you spend a lot of time in the same position. Not moving much can make joints and muscles stiff and painful, or can make the body freeze in a certain position. As your body gets more used to moving, you will be able to do more.

For many women with disabilities, swimming and moving in the water is a very good way to exercise. Because your body weighs less in the water, women who have a hard time moving or walking can often move better in the water. Or they have less pain in the water. Swimming is the best exercise for someone with arthritis.

	Make sure the water is not too cold. Cold muscles can get hurt more easily.
	Lifting heavy objects over and over again can help make your muscles and bones strong.

If you use a wheelchair, try to push it around your community by yourself.

If this is not possible, try lifting objects (such as rocks, cans of food, or a bottle filled with water) over and over again. This will help keep the muscles and bones in your shoulders and arms strong.

How to lift: Before you lift, sit up as straight and tall as you can. Take a deep breath in, and then out. As you blow out, pull your shoulder blades back toward your spine as you lift the object. Take another deep breath in as you hold the object, and then blow out as you lower the object back down slowly.

Stretch your muscles

Stretching your muscles makes them more flexible, so you can bend and move more easily. For many women with disabilities, stretching regularly means they feel less pain. Stretching also helps prevent injuries.

Always stretch before you begin hard work or exercise. Stretching and starting gently will help keep you from hurting yourself and hurting your muscles. It is also a good idea to stretch after doing exercise or hard work. Stretching can also help keep your body flexible, and prevent pain and weakness as you grow older.

To stretch a muscle:

Find a position where you feel secure and are not likely to fall. The stretch should be gentle. It should not hurt. For example, to stretch your lower back, lie
down on a mat with your face up. Bend your knees and pull both legs toward your chest as far as you can without causing pain.
Hold your body in this position, while you count slowly to 30 (or count to 10 three times). Do not bounce or move your body back and forth.
Remember to breathe while you are stretching. If the stretch starts to hurt, try moving the part you are stretching so that the stretch is more gentle. If this does not stop the pain, try a different position.

Sana's leg is paralyzed from polio. While she prepares food, she stretches her leg to prevent it from getting locked into one position (a contracture).

Women with limited movement may have to experiment to stretch certain muscles. Sometimes, you may need another person to help you. If someone else helps you stretch, make sure they move the muscle slowly. Then, you can tell them to stop when you feel a stretch.

Some people like to put ice, or a warm cloth or towel, or a heat pack (if available) on their muscles before stretching. You can try this yourself to see if it makes your body feel better.

Many women with tight muscles stretch every morning before they start the day's work, so they do not hurt as much during the day. At night, they stretch again to help sleep better and to have less pain after a long day.

Other women find they can stretch a muscle while doing some other task. If you can, find ways to include stretching in your everyday activities.

Maria has cerebral palsy. She is stretching her muscles at the same time as she is doing her daily work. The rock keeps her legs apart, allowing her to stretch the muscles inside her legs while she works. This helps to prevent muscle spasms. She keeps her back as straight as she can while she stretches her arms, legs and neck.

If you have tight muscles, paralysis from cerebral palsy or a spinal cord injury, or joint pain

Women who have painful joints or tight (spastic) muscles should be careful with exercises such as running or lifting heavy things. These kinds of exercises can put too much stress on the muscles and joints. They can hurt your muscles instead of making them stronger.

Relaxing tight (spastic) muscles

Women with cerebral palsy, multiple sclerosis, or spinal cord injuries often have muscles that are very tight and stiff (spastic muscles). A muscle may get very stiff or shake, and the woman may not be able to control how it moves. To help with tight spastic muscles:

Do not pull or push directly against the spastic muscle. That makes it tighten more.
Do not massage spastic muscles. Rubbing or massaging spastic muscles usually makes them tighter.
To manage spastic muscles, find a position that helps the body relax. Rolling or twisting gently from side to side can help. Sometimes, moving a different part of the body will help ease the spastic muscles. You can also use warm cloths (wet or dry) to help relax spastic muscles.

If you use a wheeled cart, crutches, or wheelchair

If you use a wheeled cart, crutches, or wheelchair, you may start to have trouble with your shoulders or wrists because of using your arms so much. Your arms and shoulders can hurt and wear out more easily. To help prevent this, stretch your arms and shoulders often. For example:

Women who use wheelchairs often have strong arms. But it is important to keep all the muscles in the arms and shoulder strong, not just the muscles you use to push your chair. To prevent overusing your arms and shoulders, try not to do the same thing for a long period of time. For example, change or alternate how you pick things up. First use your left hand, then the right.

A good way to strengthen the other muscles in your shoulders is to push your wheelchair backward.

Injuries from overuse

Joints are places in the body where bones come together. At these joints, tendons connect the muscle to bones. If you repeat the same movement over and over again, such as pushing your wheelchair or cart, or walking with crutches, the tendons in your wrists can be damaged.

You will feel pain in your hand, or here, when your wrist is gently tapped.

Treatment:

Rest: Rest your wrists and hands in a comfortable position as much as possible. If you must continue to move or push yourself around, wear a splint to keep your hands and wrists as still as possible.
Splint: To make a soft splint, wrap your wrist and lower arm with cloths so the joint does not move. Wrapping the cloth around a thin piece of wood first can help keep the joint straight. The cloths should be wrapped tightly enough to keep your
wrist from moving, but not so tightly that the blood flow is blocked or the area gets numb. If you can, wear the splint while you are moving around, and also while you rest or sleep.
Water: Fill one bowl with warm water, and one bowl with cold water. Place your hands and wrists in the cold water for one minute, and then in the warm water for 4 minutes. Do this 5 times, ending with the warm water, at least 2 times a day (more often if you can). The warm water bowl should always be the last one your hands go into.
Exercise: After each water treatment, exercise your hands and wrists. This will help prevent more damage to the tendons. Count to 5 as you hold your hands in each of these positions. If you feel pain in any of these positions, try to change the position a little to make it more comfortable. Repeat these movements 10 times.
Medicine: If your hands or wrists are painful or swollen, take aspirin or another pain medicine that reduces inflammation.
Operation: After 6 months, if the pain is constant, if you feel weaker, or if you lose feeling or notice tingling in your hands, get medical help. You may need to have medicine carefully injected into the wrist, or you may need an operation

Prevention:

If you can, try to push or move yourself in a way that bends your hands and wrists less and puts less pressure on them.
If possible, ask someone else to push your wheelchair or cart from time to time, to give your hands and wrists a rest.
Try to exercise your hands and wrists every hour, by moving them through all of the motions they can make. This will stretch and strengthen the tendons and muscles. If exercise causes pain, move slowly and gently.

If your hands and wrists are red or hot, they might be infected. See a health worker right away.

Using crutches

3 fingers of space between the crutch and your armpit

slightly bent elbows

full
weight
on
hands

Crutch

Elbow crutch

If you want to use crutches, make sure they fit properly. When you use crutches, most of your body weight will be felt in your hands. So follow the advice on page 93 to prevent damage to your hands.

If possible, always use elbow crutches to prevent
possible damage to the nerves in your armpits. But
if you prefer or can get only tall crutches, make sure
they do not press up into your armpits. Your elbows should be slightly bent, and there should be 3 fingers of space between the crutch and your armpit. If tall
crutches press up under your armpit, in time the pressure
on the nerves there can cause paralysis of the hands.

Contractures

contractures

An arm or a leg that has been bent for a long time can get locked into one position (a contracture). Some of the muscles become shorter and the arm or leg cannot fully straighten. Or short muscles may hold a joint straight so that it cannot bend. Sometimes contractures cause pain.

If you have had contractures for many years, gentle movement and stretching can prevent the joint from getting worse. It will be difficult to straighten the joints and muscles all the way. But gentle exercises can make your joints a little less stiff and keep your muscles strong.

To prevent contractures and keep your muscles strong, try to exercise your arms and legs every day. If necessary, find someone who can help you move different parts of your body.

Examples of exercises that prevent some contractures and help keep muscles strong
To exercise the front of the upper leg	1. bend	2. straighten
To exercise the back of the upper leg	1. bend	2. straighten
To exercise the lower leg	1. point the toe up	2. and then relax
To exercise the arms
bend	straighten	lift straight up

IMPORTANT! If a joint has been bent for a long time, be gentle. Do not try to force it straight.