Your spinal cord injury can change many functions of your body’s systems. It can also lead to other problems or complications called “secondary complications.” These are complications that are related to or secondary to the SCI. To anticipate and manage these changes successfully, you must first understand how your body and abilities have changed. Below is an overview of physical changes you may experience. Paralysis—the inability to move parts of the body—is the most familiar and visible effect of SCI. As described above, the muscles in the body communicate with the brain through nerve connections in the spinal cord. Without those connections, the muscles are unable to receive the input they need to work. Depending on the level of injury, this condition may lead to an inability to walk, sit at the edge of the bed, write, or even breathe without assistance. Some, but not all, spinal cord injuries result in total paralysis below the level of injury. If some strength remains in the affected area, then medical rehabilitation can help rebuild those muscles that are still functioning and help you relearn how to use them. If no movement remains below the level of the injury, then the goals of rehabilitation are to strengthen intact muscles above the injury level and to find ways to compensate for those that are unable to move. For example, if you have no movement in your legs, you may work on strengthening your arms and upper body in order to learn to use a wheelchair instead of walking. In many cases, rehabilitation will include some strengthening and retraining of muscles that have become weaker because of the SCI and finding new ways to use the muscles that are working normally above the level of the SCI. When we move, our bodies normally send sensory information to the brain to help create smooth, coordinated movement. If that sensory feedback is lost after SCI, then your muscles are unable to perform as they did previously. Sensation changes might include a change in the ability to: ·         Feel objects ·         Feel pain Sense where your body parts are in space Loss of the ability to feel an object or to feel pain can put you at risk for injury. Think about stepping on a sharp object in bare feet or sitting in one position for too long. Under normal circumstances, messages would be sent to your brain through the nerves in your spinal cord, signaling pain and causing you to move away from the sharp object. Following SCI, those messages may not reach the brain and the sensation of pain may not be perceived. Feeling where your body parts are in space, or “proprioception,” is another type of sensation that may change after an SCI. This loss may make it difficult to understand where your leg is when you try to walk or to know where your arm is when you try to dress. You may need to watch your leg while walking or watch your arm while dressing to understand where they are in space.