Programme Information

PHASE III (Strength: Eccentric/Concentric Muscle Contractions)

Moving into Phase III doesn’t mean that your body has stopped  relearning. It hasn’t. Your body will continue going through Phases I  and II throughout the entire improvement process. You don’t just  graduate from one phase to another, it is more like a gradual change  that happens over months and sometime years. We have clients that are  walking but still have paralysed areas of their bodies in Phases I and  II. By having different Phases, you can see where you are during your  improvement which helps to educate you on what lies ahead. It also  gives milestones to achieve and reasons to celebrate a success.

Let’s take a look at today’s mind set

Traditional Approach to SCI

• No hope for recovery
• Medicate the symptoms (pain, burning, pins and needles, spasms, etc.)
• Your improvement is determined by your level of injury
• Though your instincts tell you that spasms are good, you are otherwise educated that your spasms need to be eliminated

Results

• Many people who have tone and spasms are so heavily medicated that they  can’t think or function. We have clients that have been on anti-spasm  medication for over five years and still have all the symptoms that  they had on day one.
• Withdrawal from medications can take months and in some extreme cases, a year
• No improvement in function
• The body becomes tighter with more spasms
• Anger and frustration

Project Walk’s Idea of the future:

• Hope of recovery. In the centre at any given time there may be several  people (your peers) that have been where you are right now with tone  and spasms. They can give you an understanding of their progress and  you can watch them control their legs. One question we are frequently  asked at this point is, “So these clients are controlling their  spasms?” We find this disturbing because it means you have been incorrectly educated. You  can’t control spasms because they are uncontrolled muscle contractions.  What our clients are doing when they move their legs is simple, they  are controlling them.
• By eliminating anti-spasms and pain medications (under a doctor’s  supervision) and replacing them with exercise that stimulates the  nervous system, we reduce tone and spasms, create a mature nervous  system, and boost your overall health.
• The Dardzinski Method creates a strong, mature nervous system that  results in controlled movement and at the same time reduces or  eliminates tone and spasms.

Phase III is where muscle contractions begin. When you contract a  muscle thousands of times with the right stimulation, the nerves and  muscles will gain continued strength but more importantly,  coordination. This is why our clients start with simple exercises to  stabilize their joints in the earlier phases of training. In time, the  muscles are performing isometric contractions. With the right skills, a  Specialist can take these contractions and teach the client how to turn  them on and off on command. Controlled muscle contractions are one  giant step closer to walking. During this phase of the programme, you  will continue putting on muscle mass (some clients have bigger leg  muscles now than before their injury) and as you move out of this  phase, you will be able to control some movements in certain positions.

Results of Phase III Strength: Eccentric/Concentric Muscle Contractions

• Increased function
• Increased muscle control
• Increased daily activities
• Increased ability to think
• Increased bone density and circulation
• Increased sensation
• Increased control of your life

A side affect of Phase III is an increase in occupational abilities.  Each client comes to us with a goal of walking, but amazing things  happen along the way in the form of occupational milestones. In phase  III, most clients are now driving, can transfer using their legs for  support, can stand without a standing frame, and all have gained back  their independence.

Since your body has changed, its time to change your workout prescription.

Now that we’ve given you our training guidelines, it is important to note that we realise every client is an individual with individual needs and goals. To keep up with each client’s evolution through improvement, we re-evaluate workout prescriptions on a monthly basis and may change the training guidelines based on their improvement process.

Training Guidelines

During this phase workout days and hours are determined by the clients  tone and spasms, with the majority of our clients’ working three days a  week. An exception to the rule would be someone that is over one year  post injury whose nervous system is out of control, meaning, they have  tremendous tone and are controlled by their spasms. We would see this  person everyday because we need to continuously break down their  nervous system. We have found our clients with these characteristics  feel better on Saturday after a hard week than they do with a rest day.  One thing that we have learned is that every nervous system is  different and we have to be able to adapt to the continual changes. As  your body changes, we will adapt to it and determine how long your  sessions should be.

Phase III workouts are about creating contractions. The SCI Specialist  you are working with should not be doing all the movements, just  helping you to create movement.

Most clients will spend the majority of their time one-on-one with a  Specialist working the nervous system to create muscles contractions.  Nothing in the world can react to your nervous system or be as  beneficial to you as a certified SCI Specialist. Your workouts will  involve a Specialist creating contractions and having your muscles  resist.

• Positional Movement
  This is where we start. It is simple; we move your leg around looking  for your nervous system. As we elicit a response, we put your leg in a  position that enables you to perform a muscle contraction. Repetition  after repetition will be performed to increase strength and endurance  while creating voluntary contractions. Weights will be added and you  will perform movement in all planes of motion to recruit more muscles  to respond and contract.

The goal of positional movement is to get all of the muscles that move  a particular joint involved in eccentric contractions. As you now know,  this will not happen all at once. Some muscles will receive nervous  signals while others will respond more slowly. Our goal is to continue  to promote nerve activation in all the muscles and not ignore those  that are slower to respond.

• Developmental Movement Patterns
  Developmental movement patterns are how we learn general movement  pattern skills which eventually become specific skills. When training  for any sport you practice skills over and over until you don’t need to  think about it, it just comes naturally. At Standing Start  developmental movement patterns are practiced from day one up until you  leave. Your improved function allows us to do more advanced movements  necessary to increase the stimulation to your developing nervous  system. Because you now have joint stability we can create demand on  your joints by performing load bearing exercises. We have developed  specialised sequences using weight equipment, combined with floor and  table work that excites your nervous system in all planes of motion.  This stimulation affects all of the postural skeletal muscles forcing  your nervous system to respond. Being sedentary does not allow for any  improvements.

• Load Bearing Exercises with Movement
  The human nervous system needs to load bear to improve; a standing  frame is great for a passive workout and teaching your body the proper  resting length of your muscles, but standing while being supported is  passive. We need action! During this phase you will start to  eccentrically load your muscles. Achieving this milestone is one of the  biggest changes in your body since your injury.

• Controlled Positional Movement
  We move your legs into a position and you control the desired movement.  Some might say you are controlling a spasm; but what is a spasm—it’s an  uncontrolled muscle contraction. So, if you are controlling an  uncontrolled muscle contraction…get the point? Through positional  stimulation and repetition we create controlled contractions, and in  time, as the nervous system matures, movement increases.

• Cheating to Create Movement
  This is where the client creates the movement by cheating. An example  would be a client who has learned that if they arch their back, they  can control a movement in their legs. Eventually, through repetitions,  the client can perform the desired movement without cheating. This is  called coordination.

Symptoms of Phase III

• Plateaus
  As you continue to heal and gain function, you will hit a plateau. A  plateau is where you heal internally, where your nervous system is  adapting to the new stresses that your increased function places on it.  Once your nervous system has caught up to the stresses, your body moves  forward. This cycle happens over and over throughout the course of  improvement. This training cycle is no different for someone without  SCI. As the body adapts to the training stimulation you hit a wall—it’s  only when you challenge the body with something new again does it  adapt. Then you see a gain in fitness or skills. The only difference  with SCI is the time frame of the gains.

• Night time
  You will find that your night time symptoms may become extreme! The  movements that you are working on and creating during the day will come  back and haunt you at night. If we are working your hip flexors during  the day, you might be doing hip flexor lifts all night long. This is  because we are stimulating your nervous system and pushing it to its  limits. At night it is healing, and because you are dealing with an  electric system, as it heals, it causes movement. Our clients tolerate  these night movements and the lack of sleep because their peers that  have already been through it explain how it is part of the healing and  improvement process. And, like most symptoms associated with SCI, as  you improve, the night time symptoms slowly start to disappear. You  will find that the more you move your legs during the day, the less  they move at night.

• Crazy Legs
  At one time or another, all of our long-term clients have had ‘crazy  legs’. We love ‘crazy legs’ because it shows us that our clients are  recovering. Training ‘crazy legs’ is easy, but very hard on the  individual Specialist. Through The Dardzinski Method we have learned  with practice to create controlled movement out of ‘crazy legs’. It is  determined in this stage of healing whether you will go on to walk or  just get tighter. We are the best at this stage. Those who rely on  Botox and anti-spasm medication don’t under stand how a person with SCI  recovers. You can mix and match recovery training with occupational  medication but you should check out the research on the medications  that you have been prescribed.

Additional Modalities

• Standing Frame
  At one time or another, all of our long-term clients have had ‘crazy  legs’. We love ‘crazy legs’ because it shows us that our clients are  recovering. Training ‘crazy legs’ is easy, but very hard on the  individual Specialist. Through The Dardzinski Method we have learned  with practice to create controlled movement out of ‘crazy legs’. It is  determined in this stage of healing whether you will go on to walk or  just get tighter. We are the best at this stage. Those who rely on  Botox and anti-spasm medication don’t under stand how a person with SCI  recovers. You can mix and match recovery training with occupational  medication but you should check out the research on the medications  that you have been prescribed.

• External Electric Stimulation
  FES bikes or any other type of external electric stimulation should not  be used during this stage of development. You don’t need it, your body  is producing its own internal electric stimulation. Adding an external  source will only confuse your nervous system.

• Pool Therapy
  We still do not recommend pool therapy for your legs. Your nervous  system is developing and needs a closed chain connection. Only when you  can move your legs controlling the muscles should you hit the pool.

  Pool therapy is only recommended for C level injuries to work only on developmental movement patterns of their upper extremities.

• Cardiovascular Conditioning
  We recommend cardiovascular training in this stage of recovery. One of the best ways to do this is by swimming laps. You can use a pull buoy  to support your legs and some clients have used a snorkelling mask and  tube for breathing. Other good cardiovascular tools are a hand cycle  (sitting tall, not in your wheelchair), versa climber, or a hand cycle  on the road.

• Real World Outside Activities
  We encourage all of our clients to get outside and participate in life. Many go to school or work. Our clients go horse riding, scuba diving,  skiing, and kayaking.

Graduation from Phase III

You can now move your legs and have controlled movement but you are not very coordinated; you may even be able to stand on your own. What you are lacking now is coordination of the nervous system consistently in all planes of movement. In Phase IV, Function and Coordination, your workouts will become more dynamic and we will teach you how to control all of this new movement in all planes of motion.