Spinal Cord Injury
- Physical Therapy International Service
- Oct 16
- 3 min read
Authors: Anna Norton and Ella Bonner
The spinal cord runs from your brain all the way to your lower back. It carries signals to help you move your body, feel sensations, and keep your body functioning. There are three different sections of the spinal cord, similar to the sections of the back: cervical, thoracic, and lumbar, and they contain many different nerve pairs. The spinal cord is also made of multiple layers for protection, as the spinal cord is extremely important for function. Despite the protective layers, it is our job to avoid harmful situations that could put our spinal cord at risk for injury.
A spinal cord injury is a basic term for any injury impacting the spinal cord. Spinal cord injuries can affect our body’s function, such as strength, movement, feeling, or can even present as mental side effects. Some common causes of spinal cord injuries include car crashes, falls, violent injuries such as a shooting or knife stabbing, or injuries from sports.
Spinal cord injuries are ranked based on the placement of the spinal cord and the severity of the damage. To begin, there are either incomplete or complete spinal cord injuries. An incomplete injury means that there is still some function at the lower end of the spinal cord, and the patient can still use the musculature connected to that level of the spinal cord. A complete injury is when the spinal cord is damaged enough that there is no voluntary movement, strength, or sensation in the anal region of the patient.
When describing the injury on a neurological level, we use different letters and numbers that help indicate the location and severity of the injury. Based on the three sections of the spinal cord, the first letter (either C, T, or L) describes which section the injury is part of. From there, the next number indicates which part of that section the injury is in, such as C1, meaning it is in the first part of the cervical section of the spinal cord. The last letter will indicate the severity of the injury in that location, such as A, B, C, etc. The letter scale is based on the ASIA scale, with A being a complete injury and E being a normal spinal cord. So, for example, a C1A injury is a spinal cord injury in the upper part of the cervical region that has extreme or complete impairment.
The muscles affected by a spinal cord injury depend on where the injury happens along the spine. Higher injuries, like in the neck (cervical spine), can affect both the arms and legs. For example, someone with a C5 injury might be able to move their elbows but not their hands. While someone with a lower cervical injury may regain more fine hand control. These types of injuries are often called tetraplegia.
Injuries lower down in the thoracic spine usually leave arm movement intact but affect the trunk and legs. People may struggle with sitting, balance, or standing. Injuries in the lumbar or sacral spine may allow for some leg movement, but walking is still difficult and often requires assistive devices. Over time, muscles below the injury weaken, shrink, and fatigue more easily. Even when some function returns, strength and endurance are often reduced. This affects everything from mobility to daily tasks like transferring, dressing, or pushing a wheelchair.
Spinal cord injury rehab is a team effort. Doctors, nurses, occupational therapists, psychologists, and social workers all work together to support recovery. Each professional plays a unique role; from managing medications and skin care to helping with daily tasks or emotional adjustment.
Physical therapists are key members of this team. They focus on restoring movement, strength, and mobility. This could include stretching, resistance exercises, walking training, or teaching wheelchair skills. PTs also work on balance, transfers, and preventing complications like joint stiffness or pressure injuries. Most importantly, they help patients find safe and effective ways to move again, whether it is walking or using a wheelchair. Research shows PT interventions can improve strength, sitting balance, and independence in daily life.
A spinal cord injury can drastically change how the body works, depending on where the injury happens. Muscles below the injured area may weaken or stop working, which affects everything from walking to basic self-care. Thankfully, rehab teams, especially physical therapists, help people rebuild strength, regain mobility, and return to meaningful activities. While full recovery may not always be possible. The right therapy can make a big difference in quality of life.
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Stanford Health Care. (n.d.). Spinal cord injury rehab team. https://stanfordhealthcare.org
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