After two decades in the military, Greg Janes says his injuries—compounded fractures, breaks and muscle tears, not to mention his osteoarthritis, stenosis, and post-traumatic stress disorder—got the better of him.
The 43-year-old says he should have given up the Forces sooner.
He isn’t confined to a wheelchair, but he says his doctors tell him he can look forward to one if he doesn’t take care of himself.
“It was just too much pounding on the body. So all my efforts now are geared towards recovery and trying to live a life of normalcy – whatever that is,” he says.
Handcycle on
Two years ago, Janes received a handcycle from Soldier On, a Canadian Forces program which uses sports and recreation to help ill and injured military members during and after their rehabilitation and recovery.
He says the three-wheeled cycle, which he tries to ride every day, turned his life around.
“With cycling, I guess you could say there’s good pain,” he says, comparing the soreness he gets after a good push on his bike to the chronic joint pain he feels from his injuries.
“That’s why I keep at it.”
Chris Bourne, a regional services co-ordinator with Spinal Cord Injury Ontario and a former medallist at the World Triathlon Championships, says handcycling can have a huge impact on the confidence and self-esteem of people with nerve and muscle problems.
“I think, in a lot of cases, being involved in handcycling or waterskiing or playing basketball or whatever allows someone with a disability to kind of beat their disability in a way,” says Bourne, who was paralyzed from the chest down when he was hit by a train in 1990.
“A handcycle or any other kind of adapted sports equipment lets people do that and it’s liberating, it provides kind of an independence.”
Linda Valent, a spinal cord researcher in the Netherlands, says she first realized the good handcycles can do for people with nerve and muscle issues while studying to become an occupational therapist in the 90s.
Valent says at the time, she used to run through Amsterdam’s Vondelpark with handcyclists from the rehab clinic where she worked.
“I saw what it did to them,” she says. “They can get around reasonably fast, they have fun, they get stronger.”
Cycling and spinal injuries
That observation helped launch over a decade of research for Valent, including a PhD thesis on the physical effects of handcycling on people with spinal cord injuries.
For the past 16 years, Valent has worked at Heliomare Rehabilitation Centre in North Holland, where she splits her time between conducting handcycling research and occupational therapy.
She and her colleagues treat between 10 and 15 patients at a time, prescribing each patient a front-wheel wheelchair attachment, which connects to their everyday chair and transforms it into an upright handcycle.
Valent says handcycling helps people with spinal cord injuries regain some of their mobility.
She says it helps them cover longer distances and build up their strength while putting less stress on their shoulders.
That’s especially important for handcyclists like Janes, who says the low-impact exercise helps him stay fit while avoiding the type of chronic muscle and joint pain that jogging or regular biking could cause him.
“With my chronic pain, if I flare my back up, you know, I’m going to suffer for days,” he says. “I’m not like that if I take my bike out today and I go for a ride. I don’t suffer the after-effects.”
Reintroducing recreation
Sue Dojeiji, the chief of physical medicine and rehabilitation at the Ottawa Hospital, says thinking about recreation often isn’t a priority for patients when they first enter her care.
“You can imagine if you’re a young man and you no longer move your legs and you’ve got a girlfriend, there’s a lot of other questions that are on your mind that are going to be filling your mind at night before exercise,” Dojeiji says. “It’s not for lack of wanting to engage in the conversation – it’s a question of timing.”
But Dojeiji, who is often the first point of contact for patients with nerve and muscle problems at the hospital, says she still encourages patients to start thinking about returning to some form of physical activity early on during their rehabilitation.
Social cycling
Dojeiji says heart-pumping activities like handcycling, in combination with strength-building exercises, are crucial for maintaining and improving physical and mental fitness after an injury or accident.
Caryn Johnston, a recreation therapist at the Ottawa Hospital Rehabilitation Centre, says her patients generally choose handcycling to keep up their conditioning, but also as a means for socialization.
“An important piece, too, is the part of socializing after you leave the rehab centre. That’s an important piece, I think, of the whole rehabilitation process is getting back to your active lifestyle that you maybe had before,” she says. “You can go cycling with your family, your friends, whatever, so cycling puts you on a very similar or the same playing field as your peers or your family members.”
For handcyclists such as Bourne, that means hitting the road with his kids in tow.
“When my kids were growing up I attached a chariot to the back of my handcycle and I’d go around pulling a couple kids in my chariot,” he says. “I’m getting a workout and they’re out having fun too.”
Johnston says her clinic doesn’t use handcycles for its inpatient rehabilitation, but she encourages handcycling to people at the rehab centre as a way to remain physically active once they leave.
Pedalling at a cost
But, unlike in the Netherlands, where wheelchair equipment is heavily subsidized, Johnston says cost can be a significant barrier for people in Ottawa who could benefit from handcycling.
The Invacare Top End Force-2 handcycle the rehab centre owns, for example, which she says is considered “affordable in the world of wheelchair equipment,” runs for $2,500 to $2,700.
Johnston says finding alternate ways to pay for handcycles can be challenging.
“What I find . . . I’ve been working [at the rehabilitation centre] for over 25 years, is it is always very difficult to get funding for a piece of recreational equipment. It’s difficult, next to impossible,” she says.
Bourne said as a triathlete, he “spent a lot of time kind of putting together a sponsorship package and beating the pavement looking for sponsors” to pay for his handcycles.
“I was a sponsored athlete so I’ve had a few handcycles purchased for me, but if you don’t have that then cost is certainly a barrier,” he says.
However, as handcycles become more popular, and established handcyclists start trading up for more expensive models, Bourne says he hopes more used handbikes will go on the market.
Johnston says sometimes community or service organizations fundraise to buy a handcycle and “the odd time” private insurance will cover part of the cost.
Accessing mobility
But she says quite often purchasing a handcycle or not comes down to a patient’s priorities.
“They need their house made accessible, they need a wheelchair, they need specialized seating, maybe a specialized van or car that’s equipped to drive – those things are funded first,” she says. “Recreation is on the tail end, unfortunately.”
Janes says Soldier On, which has purchased over 20 handcycles for Canadian Forces personnel since 2007, paid for his $3,000 handcycle in full.
Now that winter is coming on, Janes says he’s ordered rollers for his bike so he can keep cycling indoors when there is snow on the ground.
Introducing independence
He says after two years of handcycling he “fell in love” with the relief and the independence it brought him.
“I just like getting out there and getting a bit of exercise instead of sitting around on the couch in a fetal position all the time. When you’re injured, it’s very easy to fall on your injuries and to draw on them to, well, pity yourself,” he says. “Handcycling is an avenue for me to get out and especially, it lets me know that I’m not crippled, for lack of a better word. It makes me feel complete.”
