The First Big Step

Well it has begun. Officially. This past Saturday, April 6th, I began my pre-treatment physical therapy and fitness training at the Push To Walk fitness center in Riverdale, NJ. It was an eye-opening and exciting experience. I have spoken a bit in past postings about these types of programs, but I am going to get into more detail in this week's edition. First the description from the Push To Walk website...
Push to Walk is a non-profit gym offering a specialized exercise program for people with spinal cord injuries, paralysis, and other neurological conditions including, but not limited to Multiple Sclerosis, traumatic brain injuries and stroke. Push to Walk offers very specific trainer aided exercises and activities, which has been termed “Activity Based Training.” Workouts help our clients get physically and emotionally healthy, so if and when a cure or treatment is found they are in the best condition.
Each client receives an assessment of personal and individual abilities, strengths, and goals by a qualified professional. Exercise programs are individually designed and continually updated and improved to stay progressively challenging. Focusing not only on what an individual can do, but also on what they wish to do. Through consistent weight bearing exercise routines and electric stimulus aided activities, a person with SCI and neurological conditions spends fewer days in the hospital, has a stronger cardiovascular system, and is actually developing increased motor functions. Functions they were not expected to regain after traditional therapy was completed.

Push to Walk’s trainers work very hard to promote confidence and inner strength in each client. They encourage everyone to identify and embrace a good work ethic so they may see improvements in their daily lives. By redefining what is possible, Push to Walk’s goal is to help and ultimately improve the lives of those living with a spinal cord injury and paralysis. 
Using movement and a whole body approach to achieve health, wellness and fitness, Push to Walk is committed to helping all clients reach a higher quality of life. Research shows the many benefits of exercise for everyone, including people with physical disabilities. This forms the basis for why Push to Walk strives to help people:
  • Maximize their physical health and well-being
  • Work toward and achieve optimal function and independence
  • Live life as fully and productively as possible
 The process of getting into one of these types of programs began back in November. As I have shared before, all physical therapy programs are not created equal and when it comes to spinal cord injury not just any program will do. The forward-thinking type of therapy embraced by these training facilities was virtually non-existent when I was injured and they are currently in such high demand most of the centers around the country are booked solid. People come from far and wide, even by airplane just to get what they need. It took me over a month and a half to get an open slot for an evaluation.

The first step in the process was to obtain a referral from my Doctor to a Neurologist. The Neurologist performed a thorough exam since I had not seen one in some time, then prescribed a bone density scan of my lumbar spine, my pelvic and hip bones, and my femurs. This entire process took two months because Medicaid has to say it's "Ok" for me to have a bone density scan done. So... once I met with their infallible approval I was off to the radiology clinic for a small dose of radioactive ions and T-Scores showing the health of my bones. Add on another week for results, wait... my personal Doctor must give me the results, not the Neurologist... allow several more days for transferal and scheduling and we're already into late-February. Finally I got my date for April 6th at 11:30AM.

I have been thrilled and terrified for over a month. I have spoken to others in a program like this, but nothing compares to experience. Would I fall on the floor? Would they drop me? What if I break a bone or worse? What if the external catheter comes off? On and on and on. The mind may be a terrible thing to waste, but it's a hell of a thing to shut up.

So I awoke bright and early Saturday morning, put on my only pair of sweat pants, my Duluth Trading Co. base layer, my fleece vest, my trusty Vans sneakers and my fingerless weightlifting gloves and piled into my Honda Element with my mother and brother for a 70 mile drive to New Jersey. No breakfast. I was too nervous to eat.

Now 70 miles may not sound like a big deal, but driving through New York City, more specifically the Bronx, is like the urban version of the Baja 1,000. Remember my earlier analogy of having a high-level spinal cord injury is like perpetually balancing on a pilates ball? Try that, in a car, speeding up, slowing down, hitting the brakes, swerving, turning and my personal favorite, the pothole. That shit, HURTS.

We uncharacteristically made it through the city in record time and arrived at Push To Walk 45 minutes early. The whole facility resides in a quiet industrial park about 20 minutes outside New York City. It takes up all of 3,500 square feet of the downstairs of a large office building. There is one sign on the door and that's it. First impression, I like it. No muss, no fuss, no doctor's offices, no ambulances in and out, none of that "welcome to the place where sick people go so we plant flowers to make it look cheery". All about the work. Once inside you're greeted by smiles and handshakes. Being a Saturday morning there was only one trainer and an assistant working with one client. What's this? Attention? They are actually working with this person! What really threw me for a loop is that the trainer looked up from the exercise mat, smiled and said, "You must be Caleb!" Now I'm hearing the theme song from Cheers and half-expecting Woody Harrelson to step out from behind a door with a freshly poured pint. Thanks Woody, it's still early for me, but do you have any orange juice, maybe with a splash of vodka?

It looks more like your local fitness center than a medical therapy facility. There are the essentials needed for intense physical therapy, mats, parallel bars, a standing bike and various adapted pieces. Then there are weight machines, a PowerPlate, Total Gym, a power rack, treadmills and an elliptical. The trainers are dressed like trainers and they come ready to work. I'm starting to relax by now and feel the excitement as I read the big chalk board on the wall highlighting the achievements of various clients for that month, "So-and-so walked 400ft unassisted with the walker" and "Congratulations to '?' for her 20 miles on the exercise bike". Wait, what's this? Hhh-Hope? Encour-aAAgement?! Don't they know they could fail? They could get sued!

Mike was my trainer. Assisted by Christie. For the first 45 minutes I answered the usual questions. Where do you have pain? What type of sensation? Can you feel this or that? All of the answers and notes go into the proverbial file on yours truly. A quick tour of the facility and description of each piece of equipment, then before I know it I'm air-borne in Mike and Christie's arms and planted safely on the mat. Breathe. BREATHE. So far so good. I find myself seated on the edge of the mat with both feet flat on the floor. They lean me back against a large wedge-shaped pad and proceed to vigorously stretch and move my legs. The pain of arthritis begins to give way to improved circulation, loosened ligaments and tendons and stimulated neural activity. Then Mike says, "Can you feel that stretching?" Uhm... yup. "Contract that muscle." Right, what part of spinal cord injury did he not get? "Come again?" "Contract that muscle."

Then I got it.

The basis of the success of these programs is predicated on the concept of muscle memory and that basic movement memory is also stored in the nervous system, not just the brain. By consciously imagining that movement the brain is still trying to "get through", by timing that signal with the sensation of the movement, theoretically a new neural pathway can be opened. Mike was making my brain focus intently on specific joints and muscle groups as he provided the assisted movement. Now I know the traditional therapists are stamping their feet and huffing, but this method is getting results. I experienced it personally after a two-hour workout. Did I walk out the front door? No, but I felt more nerve activity in that short time than I have in 15 years. Placebo? Maybe, but I was pain free for 48 hours and still feel pretty good.

From the moment I understood the modus operandi we were off and running. They stretched and worked my neck, shoulders, arms, core, hips, gluts, quads, knees, calves and ankles. They placed my feet on a PowerPlate. This divine device was invented by the Russians to restore bone density and muscle mass to cosmonauts returning from space. It resembles a Segway scooter without wheels and it vibrates on an X/Y/Z axis. You sit, stand or rest your feet on it while doing exercises. After 15 minutes on this thing you feel as if you've been run out like a rag, but the leftover nerve stimulation and pain relief is astounding. I bounced all the way home back through New York City with total comfort and slept most of the way home.

In summary? Awesome. Excited. Results. I'm already booked for my second session set for this Monday. I can't wait. If you're out there reading this and you have a spinal cord injury. Do yourself a huge favor. Get into one of these programs. Research. Find what's in your area and what isn't. Find out about fundraising. Don't wait and don't take no for an answer. Is it a cure? No, but it's a damn good workout and the mental, emotional and physical benefits could save your life, it'll definitely improve it.

Thanks for reading.


  1. This is so great! I'm glad to see the ball get rolling. Incidentally, you were in my dreams last night. I don't remember the details but I know that positive things were happening. Must have been a good omen!

  2. I know a program down in South Florida that my husband attended last year with his spinal cord injury. It is called the Center for Neuro Recovery. I cannot tell you how much of an amazing place it is to watch my husband after it traumatic spinal cord injury be able to regain strength, function and control. It's centers like these around the United States that make all the difference in the world when one suffers a neurological injury. I wish everyone the best and I'm so happy to see these companies flourish.

    Karen B.


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