Introduction to Exercise after Spinal Cord Injury
Exercise is essential after a spinal cord injury. Lack of physical activity leads to poor fitness, weight gain, diabetes and increased risk of heart disease. On average over 60% of individuals with a spinal cord injury are obese. After sustaining a spinal cord injury, individuals are more likely to lead a sedentary lifestyle due to limited exercise options and change in mobility. Pushing a wheelchair is not enough exercise to maintain health.
Different types of exercise help focus on different areas of health. A good exercise program should have all of the following:
- Stretching – stretching of arms and legs to prevent loss of range of motion
- 1-2x/day
- Strengthening – resistive exercises to increase muscle strength
- 3 sets, 3x/wk to each muscle group
- Cardio – elevate heart rate for heart health and weight management
- 20-30 min, 3x/wk
Information for Caregivers
Learn more about how to protect yourself by using good body mechanics.
How to Use this Program
Individuals using these resources should identify their current functional abilities and choose the most appropriate categories of exercise. Exercise instructions may suggest pieces of equipment such as exercise bands, dumbbells, air splints, tables or mats. Individuals may also require physical assistance from a caregiver.
Download more information on where to buy equipment.
Learn more about how to use grasping devices:
Shepherd Center is committed to promoting lifelong wellness beyond rehabilitation. The exercise resources on this website are intended to empower individuals with spinal cord injuries to perform basic exercises to promote overall health and wellness. This content is intended for those who are currently receiving or have previously undergone training from a licensed therapist and is meant to serve only as a guide. The information provided is not meant to replace the advice or recommendations from a healthcare professional. Please be sure to consult your physician before beginning any exercise program.
Stretches should start with the shoulder blade and proceed down the arm in the order listed. Move slowly to the point of resistance and hold at least 30 seconds. Hold 60 seconds if motion is tight or limited. Stop or decrease the stretch if painful.
When strengthening, the quality of movement is more important than how much weight is being lifted. The last few repetitions of each set should be difficult to complete. Too easy? Add weight or resistance. Too difficult? Get caregiver assistance or try a different exercise. Modify or stop the exercise if it causes pain.
- Beginner Strengthening for Tetraplegia
- Advanced Strengthening for Tetraplegia
- Paraplegia Strengthening
These exercises are designed for individuals who have active hand muscles and are working on gaining or maintaining strength and range of motion. Hand stretches should not be performed if trying to maintain tenodesis.
Perform stretches on one leg in the order listed, then repeat on the other leg. Move slowly into stretches and hold at the point of resistance at least 60 seconds. Stop or decrease the stretch if painful.
When strengthening, the quality of movement is more important than how much weight is being lifted. The last few repetitions of each set should be difficult to complete. Too easy? Add weight or resistance. Too difficult? Get caregiver assistance or try a different exercise. Modify or stop the exercise if it causes pain.
Core strengthening helps with balance and stability. Move slowly and steadily through the motions and use good form. Exercises should be pain-free. Limit the range of motion or stop an exercise if painful.
Fitness and strengthening improvements only occur if the system is being challenged. When focusing on endurance, feeling slightly out of breath and heart beating faster are good indicators.
Want to see more exercise videos? Check out the Shepherd Center YouTube channel.
More information on exercise recommendations after spinal cord injury available from these references:
Cowan, R.E., Nash, M.S. Cardiovascular disease, SCI and exercise: unique risks and focused countermeasures. Disability and Rehabilitation 32(26) 2228-2236 (2010).
Jacobs, P.L., Nash, M.S., Rusinowski, J.W. Circuit training provides cardiorespiratory and strength benefits in persons with paraplegia. Medicine & Science in Sports & Exercise 33(5) 711-717 (2001).
Martin Ginis, K.A., van der Scheer, J.W., Latimer-Cheung, A.E. et al. Evidence-based scientific exercise guidelines for adults with spinal cord injury: an update and new guideline. Spinal Cord 56, 308-321 (2018).
Willig, RM (2019). Physical activity and exercise participation of adults with spinal cord injury. Influence on health-related physical fitness, functional independence and quality of life. Academic dissertation submitted with the purpose of obtaining a doctoral degree in Physical Activity and Health. Faculty of Sport, University of Porto, Portugal.
