Living with a spinal cord injury (SCI) comes with unique challenges, from maintaining muscle strength and joint health to pain management and daily function. While structured movement is essential for overall well-being, exercise prescription must be tailored to the individual’s injury level, functional capacity, and goals.
This is where an Accredited Exercise Physiologist (AEP) plays a crucial role. Unlike generic exercise programs, an AEP customises exercise prescription, ensuring safety, effectiveness, and long-term benefits for people with SCI.
This article references information from the Health Maintenance Tool for Spinal Cord Injury, developed by icare NSW and Royal Rehab, which provides evidence-based recommendations for maintaining health and function following an SCI.
Why Exercise is Important for People with Spinal Cord Injury
Regular physical activity has a huge impact on overall health and independence for people with SCI. It can:
- Improve strength and endurance – Essential for transfers, wheelchair propulsion, and daily tasks
- Enhance circulation and reduce secondary complications – Reducing the risk of pressure sores and blood pooling in the legs
- Support bowel and bladder function – Movement increases abdominal pressure, aiding digestion and continence
- Manage pain – Exercise triggers the release of endorphins, the body’s natural painkillers
- Improve cardiovascular health – Reducing the risk of heart disease and metabolic conditions
- Enhance mental well-being – Helping to reduce stress, anxiety, and depression
According to the Health Maintenance Tool for Spinal Cord Injury, engaging in just 3–10 minutes of moderate to high-intensity exercise can lead to the release of endorphins, which improve pain management and overall well-being.
How Exercise is Tailored for SCI
A one-size-fits-all approach doesn’t work for SCI. Every person has different needs depending on injury level, mobility, and health conditions. An Exercise Physiologist will assess factors like:
- Level of injury – Complete vs incomplete injuries require different movement strategies
- Current function and movement capacity – How much voluntary movement exists in the upper and lower body
- Pain levels and spasticity – Ensuring exercises reduce, rather than trigger discomfort
- Fatigue management – SCI-related fatigue is real, so pacing and progression are key
- Goals – Whether it’s improving independence, sport participation, or reducing pain, the program is built around the participant’s lifestyle and aspirations
Exercise Strategies for People with SCI
Exercise can take many forms, and the right mix depends on the participant’s abilities and goals. Below are some SCI-specific approaches, as supported by the Health Maintenance Tool for Spinal Cord Injury:
- Strength and Mobility Training
Building upper body strength is crucial for those who rely on their arms for mobility. Resistance training using therabands, dumbbells, or body weight can enhance:
– Shoulder and arm function for wheelchair propulsion and transfers
– Core stability for posture and balance
– Grip strength for self-care tasks and independence - Pain Management Through Movement
Neuropathic and musculoskeletal pain are common in SCI, but exercise can help by:
– Releasing endorphins, which act as natural painkillers
– Improving joint support and posture, reducing stress on the body
– Encouraging gentle mobility and stretching to relieve muscle tension
The Health Maintenance Tool for SCI highlights that exercise can significantly reduce pain by increasing endorphin release and supporting musculoskeletal function. - Fatigue Management and Energy Pacing
Many people with SCI experience chronic fatigue, making exercise feel overwhelming. The key is pacing and gradual progression:
– Short, structured sessions that build endurance over time
– Hydrotherapy or seated exercise options to reduce strain
– Focus on low-impact, energy-efficient movement patterns - Cardiovascular Exercise for Heart Health
People with SCI have a higher risk of heart disease and metabolic conditions due to reduced activity levels. Safe options include:
– Arm ergometers (hand cycles)
– Seated rowing exercises
– Hydrotherapy for full-body movement in a reduced-weight environment - Hydrotherapy – Movement in Water
Water-based exercise is one of the best options for people with SCI, as it:
– Reduces joint and muscle strain
– Improves circulation, pain management, and mobility
– Allows for greater movement freedom than land-based exercise
With an Exercise Physiologist’s guidance, hydrotherapy can be adapted to any level of ability, whether it’s gentle stretching, resistance exercises, or functional movement training.
Making Exercise a Sustainable Part of Life
One of the biggest barriers to exercise after an SCI is accessibility—finding the right support, facilities, and motivation. This is why having a mobile Exercise Physiology service is so valuable, as it brings individualised support directly to the participant, whether at home, in the community, or at a local hydrotherapy pool.
With expert guidance, a structured plan, and a participant-centred approach, exercise can become an empowering tool for managing health, improving independence, and enhancing overall quality of life.
If you or someone you support has an SCI and would like to explore individualised exercise options, get in touch—we’re here to help.
0493 133 667 | :e-mail: admin@focusonfunction.com.au
References:
Middleton, J. W., et al. (2020). How to Stay Healthy and Well with Spinal Cord Injury: A Tool for Consumers, icare NSW & Royal Rehab.
