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Spinal cord injury (SCI) is a result of disease or injury that results in the loss of sensory, motor, and autonomic function, or a combination of these functions below the level of injury. Research suggests that, along with medical treatment, exercise may aid in the maintaining of cardiovascular, muscular, and osteogenic health in individuals with an SCI. Practices, contraindications, special considerations, and general recommendations for whole-body cardiorespiratory and resistance exercise programming and progression for individuals with an SCI are discussed throughout.

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Eccentric resistance training has been shown to elicit beneficial effects on performance and injury prevention in sports because of its specific muscular and neural adaptations. Within the different methods used to generate eccentric overload, flywheel eccentric training has gained interest in recent years because of its advantages over other methods such as its portability, the ample exercise variety it allows and its accommodated resistance. Only a limited number of studies that use flywheel devices provide enough evidence to support the presence of eccentric overload. There is limited guidance on the practical implementation of flywheel eccentric training in the current literature. In this article, we provide literature to support the use of flywheel eccentric training and present practical guidelines to develop exercises that allow eccentric overload.