Spinal Cord Injury

This resource includes spinal cord impairment (SCI) specific topics, advice and adaptations so that all the information you need is in one place.

The main goals of Fit for Life are to improve function for daily living and to stop the onset of a variety of problems associated with inactivity. Your individual goals may be large or small and may include walking to the shops without getting out of breath, the ability to play football with your kids or maybe even to take up a new exercise class. Whatever you wish to achieve, getting to grips with the basics is a great place to start.

Andy Barrow

Portrait image of male wheelchair rugby player for Great Britain.
GB Wheelchair rugby player and 3-time Paralympian, Andy Barrow.

ParalympicsGB Wheelchair Rugby Athlete 
3 x Paralympian 
3 x European gold medallist 

Having played Wheelchair Rugby for many years I understand the importance of training, nutrition and psychology for the elite athlete. However, overcoming barriers to physical activity and exercise and eating well have become even more important now that I have retired. I may not be an elite athlete anymore, but I still want to maintain my health and fitness.

Safety Considerations

  1. Consult your doctor if you are considering starting an exercise programme for the very first time or if you experience any adverse consequences.
  2. If possible consult a registered exercise professional or an accredited physiologist with good knowledge of your impairment and the exercise implications (e.g. regulating your body temperature or the effects of your medication on blood pressure).
  3. If you have a mark, sore or cut on a pressure bearing area, do not do any exercise which will aggravate it.
  4. Always stabilise your chair prior to performing resistance/theraband type exercises.
  5. Make sure you are highly visible when out on public roads and pathways.
  6. Stop exercising if you experience pain, discomfort, nausea, dizziness, light-headedness, chest pain and/or shortness of breath.
  7. Remember to empty your bladder and bowel prior to exercise.
  8. Seek professional advice if you are unsure of the correct technique for any exercise or stretch.
Group of impaired individuals in community shoot for para sport.

What type of exercise can you do?

© Paralympics GB
Collection of food and drink for consumption during exercise.

Weight Management for SCI

Exercise Considerations

If your level of weight-bearing activity is low, you may be susceptible to osteoporosis. The bones of your legs may therefore become weak leaving you more likely to get a fracture if you fall. Hence, your safety and stability during any exercise is of utmost importance.

Pressure-bearing areas may be prone to ulceration. To help prevent sores developing you will need to periodically relieve these areas during daily activities and exercise.

Make sure that your bladder routine can integrate with your chosen exercise programme. In particular, make sure that the bladder is empty prior to exercising.

It is also important to tell your coach if you are on medication to help regulate blood pressure or reduce pain and spasms such as Tramadol or Tizanidine.

  • Aerobic capacity (the ability of your body to transport and use oxygen) is lower in individuals with tetraplegia compared to non-disabled individuals and those with paraplegia. However, it can be improved by participating in endurance-based activities/sports.
  • Exercise also involves training your respiratory muscles, including the diaphragm, which can become fatigued during exercise. If you have high tetraplegia (above C6) it is therefore often suggested that you fix your trunk using a trunk belt or abdominal binder to prevent your diaphragm from this stress.
  • Experiment with different types and positioning of strapping to help improve your trunk stability. Non-elastic and elastic straps and binders can help maintain trunk balance during wheelchair exercise.

You may experience some problems regulating your body temperature due to your impairment, which may put you at greater risk of overheating during exercise. The magnitude of this effect is dependent on the level and completeness of your SCI. This is mostly due to a reduction in your ability to sweat and a reduced blood flow to the skin, both of which help to remove heat from the body. Here are some tips to help prevent overheating:

  • For those who do sweat it is important that you drink enough fluid during exercise, especially in hot conditions, to help prevent you from dehydration and consequent over-heating.
  • Avoid training in very hot conditions. If you are training/ competing abroad, try to train in the cooler parts of the day (morning and evening) or in an air-conditioned facility.
  • Wear lightweight, loose clothing.
  • Use passive cooling strategies such as cooling vests, fans or water sprays to reduce your temperature.
  • On the flip side, use hot drinks and layers of clothing in the winter months to stay warm.
  • If you have a shunt or have had scoliosis surgery you should discuss exercise with your doctor and always avoid excessive trauma to the shunt and tubing.
  • If foot or leg swelling occurs during exercise elevate your legs. If swelling persists discuss this with your doctor and consider using compression stockings to help keep the swelling down. Monitor skin closely for breakdown in areas of swelling.
  • If you have a latex allergy always check beforehand to make sure that the exercise equipment you plan to use is not made of latex. Many equipment manufacturers offer latex-free versions of their products.

AD is a condition that can occur in anyone who has a spinal cord injury at or above the T6 level. It is a sudden and exaggerated autonomic (involuntary) nervous system response to stimuli below the lesion level such as constipation, a blocked catheter, pressure sores or an overstretched bladder. It causes your blood pressure to rise to potentially dangerous levels. You must learn the early signs of this condition developing such as a slow pulse, goose pimples, headache, hypertension, sweating above your lesion level and cold, clammy skin. For more information please consult your GP.

When propelling a wheelchair, your wheels, and therefore hands, encounter any number of things that may have been on the floor. Please be careful to sanitise your hands prior to eating, or touching your eyes, nose or mouth to help prevent the spread of germs. Small bottles of hand sanitiser or wet wipes are easy to carry in your pocket or bag and are useful for this purpose.