How to Exercise with Spinal Cord Injury

November 29,2021 |
Two women exercising on a sunny day.

Spinal cord injuries are injuries that inflict damage to any part of the spinal cord or any of the associated nerve cells. They are fairly rare and affect under 13,000 people each year, but spinal cord injuries lead to serious life changes in individuals. They often result in a loss of movement and mobility, changes to bodily functions, and completely uproot how individuals navigate through their lives. While the severity of a spinal cord injury depends on certain factors, getting an adequate amount of exercise is still important for healthy cellular function and muscular strength. While you should always consult with your doctor or physical therapist regarding changes to your routine, here is some basic information on how to exercise with a spinal cord injury.

What is a Spinal Cord Injury?

Our bodies function due to millions of interconnected nerves, cells, organs, muscles, bones, and tissues. Through communication with the brain, we can voluntarily and involuntarily perform thousands of day-to-day functions without much effort. This is thanks to the spinal cord. Our spinal cord is made up of millions of cells that connect your brain to different parts of the body. Signals are sent and received along neural pathways and tell your brain or your body what to do. Unfortunately, the spinal cord and all of the interconnected nerves are a delicate system. If damaged or injured, the message is interrupted and causes a lack of response within your cells. Spinal cord injuries can occur to the vertebra, ligaments, or discs present in your spine that help absorb shock and improve mobility. Spinal cord injuries can occur from any type of trauma to the area, but most commonly include motor vehicle accidents, falls, slips, gunshot or knife wounds, sports injuries, and disease.

Life After a Spinal Cord Injury

After suffering from a spinal cord injury, you will work with your doctor to determine the degree and severity of the injury. There are several different classifications of spinal cord injuries ranging from incomplete to complete. Incomplete injuries often result in only a partial loss of movement while complete injuries lead to a full loss of movement. Most complete injuries are severe enough that a full recovery is unlikely. However, there are possibilities for improvements in minor mobility issues depending on where the injury occurred along the spine. Incomplete injuries have higher instances of recovery and with hard work, individuals can drastically improve mobility. In either situation, physical therapy is essential to recovery.

Spinal cord injuries can result in varying degrees of paralysis, such as in the case of quadriplegia or paraplegia. Physical therapy is still worthwhile in these instances to continue to strengthen the remaining mobility you have. For more information on your specific circumstances, talk to your doctor about your treatment plan and prognosis. Spinal cord injuries can also result in neurogenic bladder, incontinence, urinary tract infections, kidney disease, and kidney stones.

Exercising with a Spinal Cord Injury

People with spinal cord injuries are more likely to have health related problems that are associated with weight gain, high blood sugar, changes in cholesterol, and heart disease. One of the biggest reasons for this is that spinal cord injuries create primarily sedentary lifestyles, which can have a huge impact on your overall health. While it’s unlikely that physical therapy is going to allow you to regain full mobility after a spinal cord injury, incorporating different exercises into your routine will help you stay healthy and combat some of these risk factors. To help you get the most of your efforts, here are some tips on exercising with a spinal cord injury.

Find a Professional

First and foremost, never begin a new exercise regimen without first discussing it with a professional. This is especially important for individuals living with spinal cord injuries. You’ll need to fully understand the different health precautions associated with new exercises, how to properly perform them to reduce injury, and how often you should be doing each exercise. Over time, you’ll learn how to incorporate safe routines into your daily schedule without supervision.

Assess Your Strengths

Next, you should assess your current stage of physical fitness. This will give you a baseline for starting so that you don’t over-do it and you can keep track of your progress over time. Ways to assess your strength may include lifting dumbbells of varying sizes, flexibility assessments, and an overall assessment of your cardiovascular health.

Create Goals

After determining your baseline, create goals for where you want to improve. Make sure that your goals are actually attainable and include how you’re going to measure your progress along the way. Keep them small to start and once you achieve the first round of goals, you can begin increasing the difficulty to keep you motivated and moving forward. Some examples of good goals include improving heart health, becoming physically fit, losing weight, relying less on medications, being active, spending more time outdoors, or even just making a new friend at the gym.

Incorporate Plenty of Stretching

Stretching is essential to avoiding injury and improving overall mobility in your joints and ligaments. Before performing any type of exercise, go through a variety of different stretches to help prepare your muscles for work. The more thoroughly you stretch, the less likely you are to pull a muscle and hinder your progress. For the best results, consider stretching immediately after waking up and beginning your workout routine afterwards. This can help you set a positive mood for the day and make sure that you get your workout done before other things take precedence.

Aerobic Exercise

While undergoing aerobic exercise with a spinal cord injury may be difficult, it’s not always impossible. The degree to which you can perform aerobic exercise will depend on the classification and severity of your injury but working with a professional will help you learn about activities that you can do. The goal is to elevate your heart rate and exercise at a moderate or vigorous intensity for about 20 to 30 minutes. Some aerobic exercises that can be performed by individuals with a spinal cord injury include hand cycling, rowing, circuit training, wheelchair sports, swimming, or even pushing your wheelchair briskly.

Strength Training

When strength training, you’ll likely want to break up your workouts so that each day you target different muscle groups. This will help you improve your muscle mass and strength without over-working any specific area. If you’re new to strength training, make sure you start small and don’t push yourself too hard. You want to avoid burnout by making small changes that are easier to commit to. Schedule rest days in between workouts and talk to your doctor if you have any questions or concerns. Aim to work muscle groups that you can control until it’s difficult for you to do another rep without assistance.

The Benefits of Exercising with a Spinal Cord Injury

As we mentioned, full recovery after a spinal cord injury is rare, but not completely unheard of. While you should work with determination and a positive attitude, the benefits of exercising with a spinal cord injury go much further than regaining a full range of movement. Research has shown that exercising after a spinal cord injury has the following benefits:


  • Better cardiovascular health
  • Fewer injuries
  • Reduced spasticity
  • Stronger range of motion
  • Ability to perform daily tasks easier
  • Increased neuroplasticity
  • Improved mobility


While the benefits of exercising with a spinal cord injury can be vast, it’s important to remember that complete injuries often will not result in neuroplasticity or mobility recovery. Unfortunately, due to the nature of the injury, you will need to adapt and learn new skills to help you navigate your daily tasks. A professional can help you with this and if you need additional support, consider joining a support group where you can connect with other individuals suffering from complete spinal cord injuries.

Risks of Exercising with a Spinal Cord Injury

There are some risks of exercising with a spinal cord injury, which is why working with a professional is absolutely essential. You may incur skin problems from friction or pressure that you aren’t able to feel, thus creating opportunities for infection. Autonomic dysreflexia (AD) is also a common occurrence in those suffering from spinal cord injuries along with spasticity and overuse injuries. Always discuss any potential risks with your health care professional and make sure you’re performing exercises with the proper form to avoid painful situations.

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