Exercise for People With
Spinal Cord Injuries

Published 2020/08/27

People with spinal cord injuries (SCI) need to exercise to lead a healthy life. An inactive, sedentary lifestyle may lead to a host of health problems such as heart disease, high cholesterol, diabetes, high blood pressure, depression, and anxiety.


Many people who have spinal cord injuries tend to live a sedentary lifestyle because exercising is harder or more complicated for them. However, it is still vital for them to regularly exercise to maintain physical and mental fitness.


This article will offer you some tips to jumpstart your fitness journey and list some of the common problems you might encounter while exercising with an SCI.

What to do before
you start working out?

1. Consult your doctor

 What kind of exercise you can do and what you should be aware of depends on the level and completeness of your spinal cord injury. So before you start exercising, you need to fully evaluate and understand your individual circumstance with the help of a medical professional. 


2. Consider how you want to exercise

Do you want to exercise with a physical therapist, a personal trainer, in a group, or by yourself? Do you want to exercise outdoors, in a gym, or at home? These are the things you need to consider based on your personal preference and your physical condition.


The questions you should ask yourself are: do I want or need professional guidance, do I want my workout to be a community-building experience or a solitary experience, and do I prefer competitive or non-competitive sports?


Other things you want to consider is your financial situation and accessibility to transportation. Don’t feel afraid to explore options until you find what’s ideal.


3. Set fitness goals

Know why you’re exercising. Is it to keep fit, to get a health problem under control, to improve mood, or to develop another hobby? You can also set more specific goals that you can keep track of. Write down your goals and remind yourself to keep yourself on track. Make sure your goals are realistic and don’t beat yourself up if you don’t reach them.


Now, let’s go over some common issues that may happen to people with SCI during exercise. Again, it’s best to consult your doctor on what yours are since everyone’s case is different. 

What to beware of
when exercising with an SCI

1. Blood pressure

For many people with SCI, they may get low blood pressure when they exercise. A sudden drop in blood pressure may be dangerous. So it’s important for you to ease into exercise slowly.  Some signs of low blood pressure include lightheadedness, blurred vision, inability to concentrate, fatigue, and nausea.


Avoid getting low blood pressure by taking medication (as prescribed) and giving your legs vascular support.



2. Monitor your temperature and heart rate

If you have an injury at T-6 or above, your heart rate and temperature may not increase during exercise as they normally would. You also may not sweat during intense exercise, so be aware of overheating even in cool environments.



To avoid the sudden increase in body temperature, workout in cool environments and don’t jump into intense exercise.



3. Injuries

If some parts of your body have diminished sensations due to the SCI or medication, monitor them closely for injuries. Be careful not to chafe, scratch, or burn your skin. To avoid muscle injuries, make sure you have good techniques and forms and don’t overwork muscle groups you already use daily. An example would be your arms if you push your wheelchair manually.


Anytime you feel pain, stop and consult a professional on the cause of pain and whether or not you should continue the activity.



4. Autonomic dysreflexia (AD)

For people with SCI level T6 and above, irritation and injury to the part of your body below the SCI can trigger an overactivity of your autonomic nervous system called autonomic dysreflexia, which raises blood pressure to a dangerously high level.



Some signs of AD include high blood pressure, pounding headache, sweating above the level of injury, goosebumps below the level of injury, stuffy nose, nausea, and a pulse slower than 60 beats per minute.



Make sure you know your baseline blood pressure level in order to spot signs of AD. In adults, blood pressure reading of 20mm-40mm Hg above baseline can be a sign of AD.



When AD is triggered or suspected, sit up or raise your head, lower your legs, and loosen restrictive clothing. Check for the source of irritation, it can be an issue with your bladder, bowel or skin. Remove the source of irritation if you can and seek medical help.



You can download an AD wallet card from the Reeve Foundation to give yourself more information on how to treat AD and to show your physician in emergency situations.


5. Spasticity

Spasticity can interfere with your ability to execute certain movements well. Have someone keep an eye on you to avoid accidental injuries. 

How much exercise should you get?

According to the US department of health & human services, adults should engage in 150 minutes of moderate aerobics a week or 75 minutes of vigorous aerobics. Adults should also perform muscle-strengthening activities that involve all major muscle groups for 2 days a week.


For people with SCI, stretching is also very important since they tend to have a lot of stiffness in the body. 


The Univesity of Wahington gives a lot of links and downloadable resources on SCI-specific exercises.

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