In this episode, we’re joined by Dr. Jereme Wilroy to discuss his personal story after sustaining a spinal cord injury at a young age. In the time since his injury, Jereme has gone on to play adapted sports, built a career in exercise science research and more. Jereme is an Associate Professor with a doctorate in health education and promotion. His research centers on telehealth interventions and adaptive intervention designs to develop and evaluate exercise programs for people with disabilities. He currently leads an NIH R01 study examining the cardiometabolic impact of exercise in wheelchair users. In addition to serving as the Director of Research at Lakeshore Foundation, he is also the Program Director for the Disability Health Studies Graduate Certificate and serves as the behavioral health expert for NCHPAD.

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Episode Transcript

Quick Navigation (click the linked text below to jump to a new section)

• lntro
• Jereme’s backstory
• Jereme’s greatest challenges after injury
• Jereme explaining the role of exercise and movement in his recovery
• Jereme’s decision to pursue a career in research
• Why exercise is a critical component for people with mobility limitations
• Misconceptions people have about physical activity for people with mobility limitations
• The exercise trials he leads and what he’s learned from working with participants
• The gaps that still exist in research around adaptive exercise
• How community programs and research initiatives can work better together to make exercise more accessible
• Jereme’s advice for individuals who are newly injured and adjusting to life with a disability
• The mindset shifts that Jereme had to go through as he moved forward with life after injury
• How exercise, even in small forms, can become part of rebuilding your confidence
• Jereme’s message to his younger self
• The importance of building a future that involves people with disabilities/Conclusion

*Edited for clarity*

Host: 0:00

This is Wellness, Health, and Everything Else, a NCHPAD podcast.

Welcome to Wellness, Health and Everything Else: a NCHPAD Podcast. NCHPAD is the National Center on Health, Physical Activity and Disability – the nation’s premier center dedicated to promoting the health and wellness of everyone. In each episode, we explore topics at the intersection of health, wellness and mobility limitations. If you have an idea for a topic, would like to learn more about a topic or are interested in our free resources, programs and partnership opportunities, email us at nchpad@uab.edu, give us a call at 866-866-8896 or check out our website at nchpad.org.

Music Interlude

In this episode, we talk with Dr. Jereme Wilroy. Jereme is an Associate Professor with a doctorate in health education and promotion. His research focuses on the use of adaptive intervention and telehealth technology in the design and testing of exercise trials in populations with disability. He currently holds an NIH R01 studying the cardiometabolic effects of exercise in wheelchair users.  He is a co-director of the UAB Spinal Cord Injury Model Systems, program director for the Disability Health Studies Graduate Certificate, and serves as a behavioral health expert for NCHPAD. He is also the Director of Research at the Lakeshore Foundation, a non-profit aimed at empowering individuals with disability to live an active lifestyle.

To get the episode started, Jereme shared his personal story.

Dr. Jereme Wilroy: 1:37

My injury occurred on August 31st, 2005, and I was 16 years old at the time. And leading up to that point, I was a very active kid. I loved sports, loved getting engaged in hard work. I was a busboy at a local restaurant. And the big thing for me, though, at that point in my life, was that I really was searching for purpose and meaning. Why was I here? That kind of thing. And so, as a faith person, I began praying about that. And my church at the time was actually going through the book, The Purpose Driven Life. And that sort of prompted thinking, what’s my story? I’m just this kid that plays sports, goes to school, and nothing really has happened in my life in a significant way.

And it was really just a couple of months later when all of this occurred on August 31st in 2005. And I went down to clean up debris from my grandma’s house after Hurricane Katrina had come through. She lived in Grand Bay, Alabama. And so, it was my dad, my brother and I, and we were cutting a tree down that had broken, and when I went over to help direct it’s fall, it started to fall the opposite way, and it fell back on top of me. And it compressed me to the earth. It laid across my back with my head between my knees, and it completely trapped me. And I began to reach out, hoping my dad could easily pull me out. He came over. He could barely find my hands, and he began to try to pull me out. And I didn’t budge. He pulled for over a minute. And my dad’s 5’11”, 200 pounds, solid muscle. And I didn’t budge until finally, his grip slipped. And so, at that point, I’m suffocating, and I think my life’s over and I’m going to die. But because of my faith, I believe I’d go on to heaven and all of that. However, I began to think about my dad and my brother there and got emotional about that. And it was in that moment, it really truly was a miracle that I experienced, that I heard this voice say, “You’re not going to die, but live and prosper with a message of hope and faith.” And at the same time, my dad was thinking, how should I pull him out? Should I try to cut the tree now or lift it? And he felt strongly prompted to pull one more time. So, he did, and I slipped right out from under the tree. And I knew in that moment that I would live, even though I could hardly breathe. I could tell my body was completely contorted. Couldn’t feel my legs, of course. And it turns out I had a couple of broken ribs. My spine was shattered. And one of my lungs was filling with blood. And that’s why I couldn’t really breathe or talk above a whisper.

 The other problem was that the cell towers were still down, and my dad couldn’t even call out to the area. So, he got a hold of my mom, who was 100 miles away back in our hometown, and she called 911, and they were able to redirect to get emergency services there. So, after 45 minutes of lying next to the tree, they finally got a helicopter out there. And they were able to get me taken care of and put me on the helicopter and get me taken into the hospital. And the last thing I remember, which is amazing – I was not unconscious the entire time – the last thing I remember is that they had to insert the chest tube. And so, they told me it was about to happen, and they had to drain that blood out. And that’s the last thing I remember. So, I think they gave me some medicine at that time. And that was my injury story, and sort of how all of that began. And again, because I believe it’s such a miracle that I lived, I coped well with it in the hospital, knowing I was saved for some purpose. This is some story. And I discovered over just the next few weeks and the next few months, that simply sharing my story and being able to talk about it in a positive way really brought a lot of joy, I think, for people, a lot of hope for people. And so, it was really interesting to see how I began to sort of turn this pain into purpose for my life and have my own story and be able to share my story.

Host: 6:13

Jereme shared some of his greatest challenges after his injury.

Dr. Jereme Wilroy: 6:16

The biggest challenges early on from a physical standpoint were being able to move at all, and so lying in the hospital bed for the first week made it difficult to even start to sit up. I mean, that was a challenge, and it was crazy to me to think that this was this new reality, when before, I was very athletic, I was very into working out and all of that, yet now it was difficult to sit up for 30 minutes at a time. They brought in five-pound dumbbells for me to use, which was somewhat emasculating. But, you know, it’s just sort of accepting that this is the journey. And when I went into rehab, I was still getting rolled over in bed in the middle of the night and making sure I didn’t get pressure sores.

And I remember one of my one of my parents’ friends asked if they [were] going to have to get up in the middle of the night to roll me over. And it just sort of felt, from a physical standpoint, very challenging. However, I was definitely up for the challenge. And hearing from my therapist that things would improve, it just takes time and a lot of effort, helped me through that process. So, within four weeks in rehab, I already met all of my goals. And on the weekends, I was getting on the mat and just repping out like 100 transfers, just practicing over and over again. And of course, I found that it was just like a toddler learning to walk. I mean, you really start all over, you’ve got to learn to use different muscles and how your body balances, and using your head to sort of move down. So, you put your hips up, things like that. And so, I began to progress to where I could do more and more things, whether it was transferring in and out of the chair [or] being able to push my chair. All of that began to change a lot. And from, again, the physical standpoint, a few years later, when I started playing wheelchair basketball, that was still more growth there. And that really pushed my body physically to where I could then become very independent physically and be able to do whatever I wanted to do.

From an emotional standpoint, a mental standpoint, again, I had this mindset that this is my story. This is what it’s meant to be. And it’s really just about continuing to walk this path. And my parents began to worry about me when I was in the hospital. And they had a psychologist come and see me because they just weren’t sure I was probably in denial or something like that. And when he came to talk to me, he asked, “Have they told you that you’d be paralyzed?”  And I said, at that time, I don’t think they’ve really said it specifically, but I know that’s my current state now and how it could be the rest of my life. And I’ve accepted that. And he left to tell my parents that he believed that my head was screwed on tighter than his was and that I just sort of had the right mindset. One thing, though, that was difficult and that I’ll share is that I told my mom, lying in the hospital bed, that I accept this condition and it’ll all work out. But I’m just wondering what woman’s going to marry me in a wheelchair. I began to question relationships, which I did find was challenging when I moved back to my hometown and no one else was in a wheelchair, especially in my friend group or my high school. And so, people didn’t know how to relate to me. And so, it was just a challenge continuing to pursue relationships and being in relationships. And one neat thing actually about that story is that later I repeated that, or I think my mom repeated that, about wondering what woman would want to marry me, and it ended up in a newspaper article. And some family with their daughters had written a letter back saying [things] like, you’re a great man with faith and perseverance, and our daughters would be happy to marry a man like that.

And so, that was really nice to hear and gave some hope, sort of, to that. But it was definitely a challenge from that mental standpoint. And when I was going through rehab, it was certainly more focused on the physical. And it was about persevering and enduring through, which I was definitely good at in my life, just being a hard worker and loving sports. And at the time, though, I really believed that I wanted to get home, and things were going to be so much better. But after being in rehab for four weeks and going back home, it really was a challenge being in this new environment where I didn’t have therapists. I didn’t have a nurse with me. I wasn’t surrounded by other people in similar conditions. And so that was really challenging. And I believe that to get through it at that time, I sort of shut that off. I did not think much about the fact that I’m the only one in a wheelchair or something. I just kind of kept pushing through and still putting myself out there. I went back to school the next month, or really in a few weeks, and had a huge amount of support from the school. And I really just embraced it. I actually rode up the first day, and I had fire trucks and everybody standing outside with balloons. It was quite the spectacle, but I really just embraced it and took it in stride. And so that helped me to continue to push forward into this new journey. And one thing I will say in case I forget, probably the most powerful thing someone told me within those first few months was to just give it a year. Give it a year and know that things will be better when you look up a year from now. And they were about a year out, actually, from their injury. And I found that to be true. And I really found that the year after that, things continued to progress. And it’s so easy to just get focused on the here and now, thinking this is how it will always be. So that was just a powerful thing that helped get me through that time.

Host: 12:30

Here’s Jereme explaining the role of exercise and movement in his recovery.

Dr. Jereme Wilroy: 12:35

Exercise was instrumental to me getting back to being confident, living independently, just being able to do everything I wanted to do on my own. And I was able to do an all-sports camp [during] the last week at rehab. And that really opened the door to me and introduced me to the world of adaptive sports, and being able to see so many adaptive athletes and what sort of level that they were at was very inspiring and filled me with a lot of hope for what I could do. And so, when I got back home, I had so much support. I had a great vocational rehab counselor, and they got me this Bowflex cross trainer, and I was able to get that in and just start working out and doing different things to exercise my body. I got a hand bike as well and was doing that. And I got another arm bike where I could also put my legs in it. That was like a stationary thing. And so I started really doing anything that I could to help me physically, and not even really realizing at the time that this was not just improving my condition but really helping my mobility, helping me be more independent. Even though I wasn’t regaining more function in my core muscles or my hips or my legs, I was still able to get more balance and just able to make bigger transfers, and things became easier.  And so, it really was a powerful way to regain independence and engage more with life and just participate more in life. And it really started to increase as I got into adaptive sports.

So, I started playing wheelchair basketball when I was still in high school. And then that’s when I learned about the University of Alabama. And then I did their sports camp there. And it was definitely a grueling camp. I remember dragging myself into the van afterwards. After a couple of days, I could barely pull myself back in the van. And I was just so spent. But after that, the recovery, I came back. And then all of a sudden I could push so much easier, make lifts so much better, transfers and things like that. And so, I really found exercise was instrumental. And as I went into college, I really got into it. I, at one point, was the strength and conditioning coach for the team because I just loved to work out as well as doing all the training we were doing for wheelchair basketball. And so, exercise has been very instrumental in recovery for me. It’s also been a great outlet for me mentally as well. I found that it really helped release a lot of frustration or any sort of built-up emotion and kept me [in] the right mindset. And I would actually find later in life, when I had some back injuries and stuff and I wasn’t able to exercise, how really detrimental it was to my mental health and stress and all of that. So, exercise was a key to my mental health and stress as well.

Host: 15:46

We asked Jereme how his personal experiences influenced his decision to pursue a career in research.

Dr. Jereme Wilroy: 15:52

When I began the journey of looking at what my career could be, and that started really going into college, I first started out going into engineering, because that’s what my dad did. I loved math and science. I really enjoyed that. So, I thought maybe that’s what I would do. And it wasn’t until a few years in when I discovered the degree of exercise science. And I thought that was just so neat. I enjoyed exercise. I was passionate about it. And I discovered more [about] how not normal that was, how most people did not like exercise. So, it was a pretty unique thing for me. And so, I switched majors and did that. And I also got into doing some personal training. I really enjoyed helping design programs for people and helping them improve their health and wellness. And I did my internship at Lakeshore Foundation. And that was in 2011. And I was, I think, a junior that year. And so, it was across that summer. And when I went to Lakeshore, not only now had I seen that exercise and health promotion was an opportunity for me for a career, but to actually now see how I could give back for other people with disabilities and helping them to improve their lifestyle and improve their quality of life was just so impactful for me and for the future. And not only that but being able to see how passionate everyone was at Lakeshore for contributing to people’s lives and activity, and all of that was very powerful. And I really enjoyed it. I enjoyed working in the fitness facility. I also got to do some recreation camps and work with kids, do some kids camps, and that was really awesome to see.

And it was the last week I was there, the director of fitness at the time, she took me up to the meeting with all the directors. And that was the most powerful experience that I had there because I saw how passionate everyone was about their different area, whether it was fitness, aquatics, injured military, or rec and athletics. Like everyone was so passionate about how they could grow their program and impact more people, and get more people involved, telling personal stories about an interaction they had with someone, and how some camp or some event had really seemed to change their life in a powerful way. So, I knew that’s definitely what I wanted to do, and the next summer I got to come back as a rec assistant and work all the camps, and I really enjoyed that. That really sort of set me on the path for having a career in this area. At one point, though, I had the opportunity to come on to Lakeshore and be an exercise specialist. At that time, though, I began looking at graduate school, and I had to make the decision [whether] I wanted to come to Lakeshore to do that or if I wanted to go to grad school, where my aspirations were to make a bigger impact than the sort of one-to-one or group coaching. I wanted to be able to create more opportunities and design programs and really be on the cutting edge of impacting the field for rehabilitation and health promotion for this population. And ultimately, it was a hard decision, but that’s what I decided to do. And so that’s why I moved forward with going to graduate school and getting a PhD and doing a postdoc and all that.

Host: 19:27

Jereme explained why exercise is a critical component for people with mobility limitations.

Dr. Jereme Wilroy: 19:32

Yeah, I think that exercise is such a critical piece for people in general. I mean, for the entire population, because I love the phrase that the fitter you are, the easier it is to manage your life. And that’s so true, I think, for people with disabilities, because there’s so much more life that they’re having to manage and deal with, especially from a physical sense. Again, if I’m having to use just my upper body to push around and make transfers and all of that, it’s important that I maintain a certain weight, that I maintain strength and everything. And so, of course, the way to do that is through exercise. As I mentioned before, it also helps bring a lot of mental clarity and emotional regulation, and I’m sure a lot of people have heard the statement before that if exercise were a pill, they would sell out every single day like there would not be enough of it to go around for people wanting these benefits that it provides. The trade-off, of course, is that the person has to get uncomfortable. You know, it feels a little uncomfortable. And for some people, they experience it differently. For some people, it can get more enjoyable. For some people, it’s never enjoyable. It’s really just an act of discomfort in order to get the benefits that come along with it. From a physical standpoint, from a mental health standpoint, there has been research showing how it does improve confidence for someone, whether it is helping to improve their appearance or it’s simply helping to improve their conditioning. It helps kind of grow that confidence. It’s also so foundational to independence. And so, all of these are interrelated. A person who is more in shape and has the strength and the range of motion that they need can do more things for themselves, which in turn brings more confidence, which helps their mental state. It helps people to be able to participate in life. And so, we like to say we focus on increasing the function for the purpose of increasing participation, whether it’s returning to work, going back to school or raising a family and just being able to participate more in life, because that’s where quality of life comes in. Quality of life is not about obtaining things or working more to earn more money, but it’s really about participating more in relationships and contributing back, and all of that. And that’s where I really see the foundation of exercise and how critical it is, especially for people with disabilities.

Host: 22:08

Here are some of the biggest misconceptions people have about physical activity for people with mobility limitations or individuals who use a wheelchair.

Dr. Jereme Wilroy: 22:16

I think that one of the biggest misconceptions is that people have to lay off doing intense exercise when they have some sort of disability or chronic condition because they don’t want to…there’s this fear of over-straining their self. And even where people don’t even call it exercise. They’ll call it therapy. They just say that you just need to keep up with their therapy instead of saying that this is exercise or physical activity. And I even had a situation early on where the doctor felt that I needed to make sure to restrain myself and not cause any sort of injury or something because of my condition. And that is seen a lot with various conditions, whether it is a physical mobility issue or it’s a neurological issue, where they believe that exercise is going to place too much stress on the body and cause some symptoms of increased fatigue or temperature regulation issues.

However, I think that people sort of having these misconceptions or fears or worries about that doesn’t mean that they need to stop completely from doing any sort of exercise. I think it’s very important for people to find out what level of intensity and what sort of progress they should make on increasing that intensity for exercise. I think it’s also true that only doing intense workouts is not all that matters. I think there’s a lot of benefit from just daily activity or reducing sedentary time. We’re finding so much in research about how important these things are for people. And it also varies from person to person, what intensity is when it comes to exercise.

So, everyone can move in some way, and it’s important for people to do the most that they can. In our current exercise trials, we have people follow along to an exercise program that’s tailored to them, the exercise, the movement patterns and stuff. And then they repeat that recording. However, we tell people to just do the best they can because it’s really just about pushing their body just a little bit more, because that’s what we’re trying to do. We’re trying to increase the conditioning. We’re trying to increase the range of motion and those things. So, it’s about just steady increases over time. And we see that even at the elite level. If we see powerlifters, the biggest mistake people can make in the gym is going to failure too much, too often and training too much. It’s really about that steady progress that’s going to benefit people more in the long term. And that’s, again, I think that’s what really can help people overcome this misconception that exercise isn’t for people with disability. The other big thing for that is knowing that there are a lot of adaptations people can make. There are a lot of assistive devices out there, ways that people can do that differently. Or again, especially early on for people with newly acquired disability, it takes some time for the body to adapt. The arm muscles aren’t used to going that long and pedaling a bike or pushing a chair, but eventually they will be. And it won’t be about muscular fatigue anymore. It’ll be about cardiorespiratory fatigue once the muscles kind of build up that type of endurance. So, the body is just really powerful in the way that it can adapt over time.

Host: 25:45

Jereme discussed the exercise trials he leads and what he’s learned from working with participants.

Dr. Jereme Wilroy: 25:50

The exercise trials that we lead are really focused on real-world outcomes. So, how can we get people to exercise more? Whether that’s making that more convenient for them, such as doing our home-based exercise trials where they receive a tablet and exercise videos or they do it live through telehealth. These are ways that we’re trying to really impact the field. We’re also looking at how exercise improves certain measures, whether it’s cardiometabolic health, respiratory health or strength. But our real big focus is how do we increase participation in exercise and helping people reach the goals that they have, whether, again, it is getting back to work or being able to manage their day-to-day easier, being able to even increase their mobility in some way because they’re just in a better range of motion or increased conditioning. And our aim then is to address the barriers that are often seen with exercise, and that includes access, making sure that people have access to some sort of fitness facility or video resources or something like that. It’s about increasing motivation for people. A lot of times, that comes with coaching, having some sort of coach that helps them set goals, create habits [and] talk about outcome expectations for their exercise. That also comes in the form of community. It’s so important that people do it alongside others, whether they’re actively exercising with people or whether they’re exercising on their own, but they’re part of a bigger community that they know is exercising. And that’s where sport comes into play a lot. Sport is exercise, but it’s in the form of a community and it’s in the form of a game that you’re playing. And so, it sort of takes your mind off that discomfort exercise component. And that’s why I’ve been honored to be at Lakeshore Foundation as their director of research, helping to increase opportunities for athletes. And that has come in the form of research for sports science and performance, but really it is about increasing opportunities for athletes and how they can get more athletes involved in that higher level of sport. And the other thing that I would say a lot in our research is that participants really are the experts. We want to make sure that we’re creating these programs that have what they want and have the benefits that they want. It’s designed the way they want. So, we get a lot of feedback. We’re always doing interviews to find out what people found was important or easy to do, or what they found was a challenge to do, or a barrier. And we take that into consideration. And we even try to design our studies where it isn’t just a simple clinical trial that’s very controlled but trying to create study designs that allow us to tailor the exercise programming, again, to help increase participation. And so that’s a lot for what we’re really focused on with our exercise research.

Host: 29:10

There are gaps that still exist in research around adaptive exercise. Here are Jereme’s thoughts on what needs to happen to fill them.

Dr. Jereme Wilroy: 29:18

For the gaps with research and exercise, there’s still a lack of inclusive programs and a lack of availability for some people in rural communities. So, making sure to continue to get access to more people. There’s still a lack when it comes to handing off exercise programs to people as soon as they’re done with their rehabilitation. Again, people are really still focused on their therapy and that sort of being the mindset. And then once the rehabilitation center sends them home and insurance says that they’ve met their goals, there’s such a missed opportunity where people are not getting enrolled into an exercise program. And there are a lot of communities out here, of course, that are trying to get people involved, but we really need the medical community to really bridge that gap between the medical facility and the institution and the community. So that trade-off is that the people respect the authority of the medical institution, saying, “This is how you need to recover and go through rehabilitation.” We need that to extend with the whole exercise, sport and physical activity, and that just being such a critical piece, which we’re so blessed to be here on Lakeshore Foundation’s campus, where that’s a big part of it. And that’s where all of this began. Right now, we’re sitting in Wallace Gym. That’s what it was about. People kept getting readmitted to the hospital because their condition would worsen once they went home. But once they started engaging in an adapted sport, they didn’t have that issue. And so, we want to continue to extend that. And then, of course, with NCHPAD, wanting to do that nationwide and get people the resources that they need to engage in exercise, whether it’s after a newly acquired condition or disability, or whether it’s a person who’s had a disability for a long time. So, there’s still a gap there and much work that needs to be done.

Host: 31:18

Here’s how community programs and research initiatives can work better together to make exercise more accessible and sustainable for people with disabilities.

Dr. Jereme Wilroy: 31:26

A big shift in the research to really bridge the gap between research and community is the co-design with users. A lot of funding institutions now are requiring that people with lived experience serve on consumer boards or as advocates, even part of the research team, where they really are sort of a co-designer of the research and certainly of the actual intervention. There are a lot of research projects out there, where the goal is to work along with the participants, individuals with disabilities who are participating in the study, to help design their own sort of program, as well as working with medical providers and getting their input as well. And the other thing is going to be to translate findings into action. So, a lot of research, of course, takes years for it to become where it’s being implemented, especially in the medical setting. And we always hear about the 17-18 years it takes to translate research. And that was actually in cancer research. And so, it can definitely fall through the cracks when it comes to rehabilitation, exercise and health promotion. And fortunately, where we are here at UAB, there are just so many resources, and with NCHPAD as a national center, we can really scale a lot of our projects quickly through that. So, once we find something that works through research and something that’s valuable, we can implement that at a national scale. And so, we’re really fortunate to be on the leading edge when it comes to bridging research and community, but there’s still a lot of work to be done.

Host: 33:09

Jereme has advice for individuals who are newly injured and adjusting to life with a disability.

Dr. Jereme Wilroy: 33:14

I think my advice to someone who has been recently injured would be a few things. I would say to them that their life still has meaning. I would tell them that they’re not alone in this journey, that they have so many people that have gone before them that will come behind them, of course, but they have so many people that are right there with them that want to give them the support that they need to be advocates for them and to be able to help encourage them on their most discouraging days. And so, simply what they need to do is to reach out and to receive some of that support that’s being given. And it’s important for people to, of course, grieve the loss that has occurred because a lot of times, when we see patients there in the rehabilitation facility, and my own experience was wondering, well, how am I going to do this now? And how am I going to get back to that? How can the plans I had still work out for me? And the reality is that it’s about focusing forward. What’s possible now? And what can I do now? And how can I do this differently? How can I get back involved in sports? I was really involved in sports before, and it was just having an open mind to see how I could be involved in sports now, and finding out, well, there’s this wheelchair basketball team, and there’s wheelchair tennis. And I was able to even play wheelchair tennis with my friends, get a hand bike and be able to be active again. There are so many opportunities and so much potential, whether it comes with just rehabilitation and helping to improve the functioning of the body, or if it’s all the technology and assistive devices that we have, people can get back engaged. And so, I think it’s important to communicate to people who have a new injury that there’s much hope that they’re going to have a great life. It will look different. It will look different, but it could be even better than they thought. Because I don’t think I would have played college sports if I weren’t playing wheelchair basketball. And that was an amazing opportunity for me. I wouldn’t be in the career field I am in if I had not gone through my injury. And I love what I’m doing. I’m very passionate because of the experience that I had with acquiring a spinal cord injury.

Host: 35:52

Here are some of the mindset shifts that Jereme had to go through as he moved forward with life after injury.

Dr. Jereme Wilroy: 35:08

I think for me, the mindset shift was knowing the value or really experiencing the value of having a story. And as I mentioned before, my injury, I was really questioning what my purpose was and what my story was. And that was also because a lot of people began sharing their stories, their sort of testimonies about how their life had changed through some experience. And I thought that was so powerful. And so, for me, it was realizing like, this is my story, and I can start sharing it now, even though I’m still living through it. Early on, even within the first year, I was able to be in a few newspaper articles. I went to some speaking engagements and stuff like that. But my story now has changed drastically. Before, it was just simply trying to rehabilitate and get back into school and all of that. But now it’s being able to have a career in rehabilitation science and disability. It’s being married now, having five kids and learning how to parent and all of that. And now being able to tell people more of my story is definitely a powerful opportunity. I think another mindset shift that a lot of people face is thinking, “Why me?” Why did this happen?” And I think it really needs to change to focusing on “what now?” And as they get through that process of grieving and going through sort of this anger or denial or sadness, it’s making that shift to what now? You know, what can I do now? Where can I start now? Who do I need to know that can really help encourage me and get me through this process? And one other thing that I would say is also sort of this identity shift beyond physical abilities. That was definitely a challenge for me because I was a very hard worker. I, for some reason, loved hard work. I loved to cut grass in the summers and work as a busboy at a restaurant and all of that. And I was, again, really into sports and everything. But now being in a wheelchair and then being around other teenage guys, we had some event through our church, and guys were doing sleepovers, people brought out the boxing gloves, and people were boxing and everything like that. There’s so much, especially as a teenage boy, that things are physical and it’s about being in a fight and being in a battle and all of that. But understanding that there’s a battle and it’s not physical. There’s so much out there when it comes to having the endurance to get through things from a mental standpoint and even a spiritual standpoint. And that’s a much more powerful battle to face than the physical.

Host: 39:02

Jereme discussed how exercise, even in small forms, can become part of rebuilding your confidence, resilience and physical self.

Dr. Jereme Wilroy: 39:09

Yeah, I’ve always thought that exercise was a powerful metaphor for how we grow in life. The exercise is about having small wins over time. It’s about small changes and adaptations of the body through exercise. Because what happens is you break down the muscle and then it has this recovery process, and it builds back stronger. And it’s just doing that over and over and over again. And then one day you look up and whether it’s a person that’s doing bodybuilding, powerlifting or some elite-level sport, they’ve sort of made it there. It wasn’t some one major workout or something like that that had that breakthrough. It’s just, it’s really about the consistency, and those changes happen. That happens from a mental standpoint. It happens from this internal integrity standpoint. That’s so important. Exercise helps to build autonomy; it helps to build hope for people. Because a lot of times, people do put a lot of stock in the physical aspects of things and being able to do things physically. But that true strength, resilience, really is about that deep within hope and joy and faith and strength within that helps to drive a person over time. And that’s really critical. And I think that’s what I’ve learned a lot in exercise. Even simply what they’re learning a lot in neuroscience about exercise. When we choose to do things that are hard, it lights up a different part of our brain. And it’s different than even if we do those hard things, but we’re not choosing to do them. The brain doesn’t light up in the same way. And so, when we choose to do hard things like exercise, it translates to a lot of different areas of our lives as well. And I’ll also say one thing too about just adaptation and how that movement, adapting the way that we move and being able to figure things out, again, especially from a person with a disability, can translate a lot into other areas of life.

Host: 41:23

Here’s Jereme’s message to his younger self in the first year after his injury

Dr. Jereme Wilroy: 41:26

What I would say if I went back to my first year of injury, it really would be to continue to remind [myself] about patience and just being patient with the process, to really take time to reflect and enjoy the journey. I think one way to do that is simply to journal. Look back over the last month or two months or see where you were six months ago. Because it’s so easy for us to get caught up and feel like everything’s so hard, but if we look back a year ago, we’re way further along than we’ve been. Whether it’s increasing our capacity to endure things or the knowledge that we have to solve problems that we don’t have anymore, because we’ve solved those problems. I think the other thing is not to rush healing because it is an emotional journey, a mental journey. And that’s one thing that we see now with the length of stay being so short for rehabilitation. People may be able to physically get to the level they need to be to meet their goals, but they don’t have much resilience when it comes to getting back home and continuing to work [toward] those goals. Like I said, it’s years. It takes years to get to the level of where I am today [in terms] of independence, the way I can move around, transfer and do everything that I need to do with ease. It takes years. And so, I think for people to not rush the healing process. And then the last thing I would say is, I definitely leaned into the faith component of things, but leaning into relationships. As I mentioned before, it’s a challenge because as a person with disability, you feel different from everybody else around you, and it’s really easy to take the road of avoiding it, but I would push myself to really share more in relationships and try to connect more with people because they want to connect with others. Everybody wants to be connected. Everyone has their own story. Whether they have some physical condition or not, there’s something that they’ve gone through that may be just as traumatic or intense as an experience. And so, I would go back and encourage myself to be more relational.

Host: 43:59

Finally, we wanted to know what message Jereme has about the importance of building a future that involves people with disabilities in health, sports and leadership.

Dr. Jereme Wilroy: 44:08

I would say that it’s important to simply acknowledge that people with disabilities are already in a lot of leadership roles. And I think for a long time, people felt like they needed to hide that or not speak up or mention that because they don’t want people to see them a certain way or have a certain lens about it. But I think if people could recognize how many people have some sort of disability and yet here they are leading their life in such a powerful way, and it’s because of the resilience that they have gained over the course of managing whatever condition they may have, that people would begin to change the view that they have on someone that has a disability. That disability doesn’t mean weakness. It really means strength that has overcome difficulty. And so, I think that’s an important part of when we talk about inclusion, knowing that people are already included, but they don’t need to hide anymore. And I think that it’s important to know that disability must be central when it comes to health and inclusion efforts, because that is, as I mentioned before, how exercise is critical for everybody. It’s very important that everyone engage in exercise if they want increased quality of life and longevity. But for people with disabilities, it’s so much more important and valuable. And that’s why I really like studying or having this population as part of research, because we learn so much more about the human body and how we can make improvements and stuff like that when we’re working with a population of people with disabilities.

Host: 45:54

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