Knoxville Man with Spinal Cord Injury Benefits from Specialized Therapies, Driver Training

Delaney Estes of Knoxville was 30 years old when he suffered a tragic accident that caused a T10 and T11 complete spinal cord injury. Paralyzed “from the belly button down,” as he describes it, he now uses a wheelchair. But after surgery and rehabilitation at Covenant Health Therapy Centers, Estes has come a long way and has a new outlook on life.

Occupational Therapy at Covenant Health Therapy Centers

Estes had an initial surgery that placed two rods in his back in September 2022. He waited a year for a second surgery to correct a bone growth in his hip that caused him immense pain and left him bedridden. He says he went through “a dark time” and was glad for the second surgery in October 2023 to help relieve some of his pain. He spent almost two months total in skilled rehab facilities while healing from both surgeries. He also underwent occupational therapy and physical therapy at Covenant Health Therapy Center – West. He worked with Bethany Edmond, occupational therapist, and Madison Ledbetter, physical therapist.

“Madison and Bethany have been amazing,” he says. “They really helped me get to a place in my rehab that I didn’t think I could get to as quickly as I did. Working with them has helped me understand and be interested in what’s going on with my body.”

Edmond says, “After his accident, Delaney had to learn how to maneuver his body to get in and out of bed, dress, and bathe himself. Occupational therapy encompasses a lot of mental health as well as physical rehabilitation, so meeting him ‘where he was’ mentally in each session was important. We wanted him to feel supported and encouraged that he could live a very functional life again without the use of his legs.”

OT focuses on patient goals as they relate to daily roles and activities, or “occupations.” Through task analysis, OTs break down the subcomponents of tasks. Then they match compensatory/adaptive strategies and/or equipment to promote independence so patients can cognitively, emotionally or physically complete their tasks and goals.

Physical Therapy at Covenant Health Therapy Centers

Because Estes cannot feel or voluntarily move his lower body, he had to learn adaptive techniques to perform everyday activities. He admits wheelchair life has its challenges. “There were days I didn’t want to talk to people, especially during the time when I couldn’t get out of bed,” he recalls. Estes says getting to “a better mental place” required hard work and a lot of prayers. “I’m thankful I had my family and friends around me to help support me. I wouldn’t have made it through without them.”

After a lot of hard work in therapy, he gained flexibility and strength. He can now transfer in and out of his chair without assistance, as well as get up into his chair from the floor – two key milestones in gaining independence.

“Now I can work on wheelchair skills and get reassurance that I can get up if I fall. I can go about my day without feeling as helpless as I did before,” he says.

Ledbetter says, “Physical therapy can completely alter someone’s functional potential and feelings of self-efficacy after an event such as this. Delaney’s attitude and goals really facilitated his rehab. He demonstrated such great motivation and positivity. It was amazing to see him change in many ways. He continuously challenged me and always made therapy fun!”

Ledbetter explains that many of the exercises she used with Estes were function-based. Therapist and patient worked on activities that helped his range of motion, aerobic activities for endurance, and upper body strengthening exercises. Other activities were related to his ability to transfer onto and off a variety of surfaces, manage his wheelchair, and perform skills such as controlled falling and “righting” while using the chair.

Therapies Help Patients Meet Goals for Independence and Personal Interests

“What I learned at outpatient therapy has been essential,” he says. “In therapy, I had to learn the skills to live life as normally as I possibly could. They can teach you skills you can use for the rest of your life. All the therapists at Covenant Health want to help make your life better. They are such positive individuals, and they are so willing to help you.”

He still attends physical therapy every other week and does his daily exercises and stretches at home. He hopes to join a wheelchair basketball league and adaptively learn to snowboard and water ski.

Edmond says, “We worked on his ability to bounce and throw weighted balls for wheelchair basketball. He used to coach basketball and kids’ soccer teams, so this was a big goal for him. Another goal for him was to be able to transfer onto a regular toilet in a public restroom when traveling. He was able to meet this goal through OT problem-solving and practice.

“Delaney was such an inspiration to me because he never said ‘no’ in trying new ways and setting lofty goals – and he paired it with a strong motivation to reach those goals,” Edmond says.

Getting “Back on the Road” With Comprehensive Driving Program

Another opportunity on the horizon is returning to driving. Estes has enrolled in Patricia Neal Outpatient Center’s Comprehensive Driving Program, an outpatient service of Fort Sanders Regional Medical Center.

The Patricia Neal Comprehensive Driving Program evaluates stroke, TBI, and spinal cord injury patients who are looking to return to driving after their injuries. The driver rehab specialist evaluates cognitive, visual, and physical abilities of each patient to determine if they are ready to drive again and what modifications may be needed. Examples of modified equipment include hand controls, extra mirrors (rear and side), steering knobs or a left-foot accelerator.

Nicole White, OTR/L, CDRS, occupational therapist and certified driving rehab specialist, says driving is often a big milestone for patients rehabilitating from a stroke or spinal cord injury. “Returning to driving will be one of the last hurdles that Delaney has to cross to meet his goal of getting his independence back. I’m happy to play a role in helping him meet this goal,” she says.

During his sessions with White, Estes is learning to use hand controls to operate gas and brake pedals. After completing the program, he plans to obtain his own modified vehicle with equipment that he can use on his own.

“Being able to drive will open up more options for me and give me some independence back,” he says. “I can work, and I don’t have to rely on my family to get me places. It’s huge.

“Working with OT, PT and the driving program has completely changed the game for me,” Estes says. “Before, I was mentally there, but so physically limited. The mobility was not there. Now, I can get myself in and out of bed, do my stretches and exercises, and I’m becoming more independent every day.”

“The Sky’s the Limit”

Estes expects to perform all activities of daily living at an independent level with modifications and compensations as needed. “If there is something I wanted to achieve, like a goal of transferring myself, the therapists worked with me to help get me there. They saw my potential – and I told them the sky’s the limit for me.” Learn more about Covenant Health Therapy Centers and the Patricia Neal Comprehensive Driving Program.

About the Author

Covenant Health

Headquartered in Knoxville, Tennessee, Covenant Health is a community-owned, healthcare enterprise committed to providing the right care at the right time and place. Covenant Health is the area’s largest employer and has more than 11,000 compassionate caregivers, expert clinicians, and dedicated employees and volunteers.