Sunday was a "non-location" day and I had planned to walk in Sussex, however, my right knee went into "spasticity" from the moment I woke up to the time I went to bed. Good that it happened yesterday as I would have struggled to walk if I was at a specific location.
Perhaps I should explain a bit more about spasticity. I don't have too many occasions when this happens, but when it does, it stops me from doing quite a bit.
Background to Spasticity
Following a spinal cord injury the nerve cells below the level of injury become disconnected from the brain at the level of injury. This is due to scar tissue which forms in the structure of the damaged area of the spinal cord, blocking messages from below the level of injury reaching the brain.
Spasticity does not occur immediately following a spinal cord injury. When an injury occurs to the spinal cord the body goes into spinal shock, which may last several weeks. During this time changes take place to the nerve cells which control muscle activity.
Once spinal shock wears off, the natural reflex which is present in everyone reappears. Spasticity is an exaggeration of the normal reflexes that occur when the body is stimulated in certain ways.
In an able-bodied person, a stimulus to the skin is sensed, and a sensory signal is sent to the reflex arch where it travels to the brain via the spinal cord. The brain then assesses the stimulant, and if the stimulant is thought not to be dangerous, an inhibitory signal is sent down the spinal cord, and cancels the reflex from moving the muscle.
In a person with a spinal cord injury this inhibitory signal is blocked by the structural damage in the cord, and the natural reflex is allowed to continue resulting in a contraction of the muscle.
Muscle spasms can occur in a person with a spinal cord injury any time the body is stimulated below the level of injury. This is usually noticeable when a muscle is stretched, or there is a painful stimulant below the level of injury. Because of the injury to the spinal cord, these sensations can trigger the reflex resulting in the muscle to contract or spasm.Almost anything can trigger spasticity. Some things, however, can make spasticity more of a problem. A bladder or kidney infection will often cause spasticity to increase a great deal. A skin breakdown will also increase spasms. In a person who does not perform regular range of motion exercises, muscles and joints become less flexible and almost any minor stimulation can cause severe spasticity.
So there you go! I'm not sure what causes this in my body, but it can and does stop me from doing things. I spent most of Sunday laying down and waiting for each spasm to pass. This was one of the worst episodes in the last four years and I had a spasm every five minutes or so for about nine hours.
I have a T12/L1 Spinal Cord injury so if you check out the diagram below, you'll see that my leg muscles, bladder, bowel and sexual function are all affected by my injury; I'll talk about all of these in more detail throughout the year.
For now, I'm just glad that the spasticity has passed for this time!
Phil