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Hand Exercises for Spinal Cord Injury: How to Improve Fine Motor Skills

survivor sitting down on a mat practicing hand exercises for spinal cord injury

After spinal cord injury, survivors may struggle with hand movement, coordination, or other effects. Fortunately there are hand exercises for spinal cord injury that help improve hand function and promote recovery.

This article will explore some of the most popular and effective hand exercises for spinal cord injury that help rebuild strength and flexibility. Be sure to check with your therapist before adding any new exercises to your regimen to make sure they’re safe for you.

Benefits of Therapy Exercises After Spinal Cord Injury

The level of spinal cord injury is an important factor to consider when creating a rehabilitation exercise program because it determines which functions are affected. For example, high level injuries, such as cervical spinal cord injury (which affects the neck area), can result in weakness or paralysis in both the arms and legs (quadriplegia).

Movement is only affected from the point of spinal cord injury down. Meaning, lower level spinal cord injuries may leave arm function unaffected. Thus individuals looking for hand exercises after spinal cord injury have likely sustained high-level SCIs.

Fortunately, through rehabilitation many survivors can improve function. Therapeutic exercises after spinal cord injury help stimulate neuroplasticity, the central nervous system’s ability to rewire itself. 

Neuroplasticity is essential to restore function after neurological injury, and is best activated through high-repetition of exercises, or massed practice. The more a skill is practiced, the more the nervous system will learn to recognize its importance and strengthen that skill.

Thus, spinal cord injury survivors must engage in massed practice in order to improve movement, coordination, and overall hand function so long as the injury is incomplete (partial damage) and not complete (meaning the spinal cord is completely severed).

There are many benefits of rehab exercises after spinal cord injury. Passive exercise in particular is beneficial for individuals with quadriplegia that struggle with hand movement.

How to Adapt Hand Exercises for Individuals with Quadriplegia

Passive exercise involves assisting your affected limb through a movement. Even though passive exercise does not involve direct effort, it helps stimulate neuroplasticity. If the spinal cord injury is incomplete, individuals with quadriplegia can use passive exercise to capitalize on neuroplasticity to regain as much movement as possible.

In spinal cord injury rehabilitation, passive exercises are often used to improve mobility and range of motion in people with quadriplegia. Passive range of motion exercises can also help improve blood flow, flexibility, and overall function.

You can either practice yourself, or your therapist or caregiver can assist you when performing quadriplegic exercises to facilitate the movements. With consistent practice, this may help reintroduce movement into your hand.

Hand Exercises for Spinal Cord Injury: Getting Started

Engaging in high-repetition exercise is essential to improve fine motor skills. Start with simple hand exercises for spinal cord injury and work your way to more challenging movements, depending on your ability level. You can turn any of the hand exercises below into passive exercises by asking a caregiver to help move your hand through the movements.

Be sure to consult with your therapist before attempting new exercises that may not be safe. Your therapist can provide guidance and a tailored rehabilitation plan suitable for your ability level.

Here are some great beginner hand exercises for spinal cord injury:

1. Palm Up, Palm Down

For this exercise, take your hand and place it on the table with your palm facing upwards. Then use your other hand to flip the palm down. Repeating this exercise can help improve hand and wrist mobility.

2. Wrist Bend Movement

Place your arm on a table to provide support and gently bend your wrist upward and downward. This exercise helps improve wrist flexibility, which is necessary to increase hand movement and range of motion.

3. Grip and Release

Place a small item, such as a pen, on the table. Grab the item and practice gripping on it with your affected hand. Move it across the table, release, and then bring it back to the other side of the table.

4. Finger Curls

For this exercise you can either use one or both hands at the same time. You are going to practice “making o’s” by alternating tapping the tips of each finger to your thumb. This can be a difficult exercise, so if you can’t touch your fingertips precisely at first, keep trying. You will improve through consistency and practice.

5. Therapy Putty

Therapy putty is a simple, affordable physical therapy tool that helps individuals improve hand dexterity. It can also help rebuild hand strength and restore mobility. With therapy putty you can practice exercises such as pinching, gripping, and extension.

Occupational Therapy Hand Exercises for Spinal Cord Injury

Practicing hand exercises that mimic daily activities such as opening and closing doors, turning the lights on or off, and eating. Here are a few examples of occupational hand exercises you can try:

6. Turning Door Knobs

Opening and closing doors is a part of our daily routine therefore turning door knobs are a great occupational exercise to practice. This also helps you twist and strengthen your wrist. Even when you are opening a door during your daily routine, pay extra attention to the movement to turn it into therapy. When attention is paid to a movement, it helps stimulate the nervous system. All movement is beneficial. 

7. Flipping Light switches

Turning the light on and off is another way to practice daily routine activities. Flip the light switch using your affected hand and alternating each finger. This helps develop motor control and build strength in your hand.

8. Holding Utensils

Utensils are often essential for eating, an extremely important daily activity. Therefore, hand exercises for spinal cord injury that target this skill are beneficial. You can practice by grabbing a utensil like a spoon to practice grasp and release movements.

You can also lift the spoon up and down to add arm movement too. As you practice your hand and arm movements over time, you can improve control and feel more comfortable using a utensil.

9. Pouring Water Into a Cup

Staying hydrated and drinking water is crucial for spinal cord injury recovery and overall health. While there are various ways to drink water, such as from a bottle or a straw, it helps to practice the skill of holding and using a cup. You can practice this by pouring water into a cup but try not to make it too heavy. The weight of the water will help add resistance as you practice holding the cup by gripping your fingers.

Intermediate, Fun Hand Exercises for Spinal Cord Injury

More advanced hand exercises can be fun but also more difficult. When choosing hand exercises to add to your regimen, be sure to choose movements that make you feel challenged but not frustrated. If you give these a try be sure to take breaks in between and not overwork or overwhelm yourself. 

Some advanced hand exercises for spinal cord injury can include:

10. Playing Card Games

Card games can help individuals with quadriplegia improve fine motor skills while playing a fun game. You can shuffle a card deck, pick a single card out of the pile, practice holding it and placing it down. There are also card holders that can help make things easier as you work your way up to playing without assistance.

11. Popping Bubble Wrap

The squeezing motion needed to pop the bubbles adds resistance, which helps build strength in your fingers. With this exercise you can practice a tripod grip (using your thumb, index, and middle finger) which is the motion most often used to pick up an item.

12. Painting

Painting is a great hand exercise for spinal cord injury recovery because of the dynamic movements it requires. You can practice hand control with long, fluid strokes and repetitive short strokes. It also gives you creative freedom to use all kinds of shapes and colors, making it a fun hand exercise.

13. Tracing

Take an image of something you like, place a piece of paper over it, and try your best to trace it. Tracing requires meditative focus, which helps improve the mind and body connection. For this exercise, you can practice tracing from the outside in and then trace it again from the inside out.

14. Braiding

Braiding hair is an intricate process that requires control over your fingers. The repetitive motions of folding each strand over while holding others in place help build endurance as well as in-hand manipulation skills.

15. Playing Jenga

Jenga is a game that can be played with multiple people to make it more fun. It requires extra attention and focus which helps stimulate neuroplasticity. Pushing the blocks and carefully removing them with your fingers also helps develop stability and fine motor control.

How to Motivate Yourself to Be Consistent with Your Hand Exercise Regimen

Practicing the same exercises over and over again can get redundant and at times, boring. To help you stay engaged and motivated you can use gamified neurorehabilitation devices such as MusicGlove

This is a fun, interactive hand therapy device that contains lots of hand exercises you can practice from the comfort of your own home. MusicGlove is especially popular because it combines music and hand exercises into a therapeutic game and can be adapted to your ability level. User’s can choose to focus on just one finger at first, and work their way up to targeting all fingers for an intensive workout.

MusicGlove keeps track of your progress and motivates you to achieve the high repetition of exercises necessary to spark neuroplasticity. On average, users are motivated to accomplish hundreds of repetitions per half hour session. This is one reason why MusicGlove has been clinically proven to improve overall hand function in just 2 weeks.

Here’s a story of a spinal cord injury survivor that has been using MusicGlove for just one week:

My 17 year old daughter had a SCI and suffered 2 strokes. She has minimal function on her right hand and no function on her left. She’s been using the Music Glove for a week now and her pinch grip on her right hand has gotten stronger. I’m excited about the possibilities Music Gloves gives her to regain more mobility and usage of that hand. Definitely worth the investment.


When time with a therapist is limited or grows too expensive, at-home therapy devices like MusicGlove help bridge the gap. They inspire motivation to exercise on a consistent basis, which is the key to recovery after spinal cord injury.

Using Hand Exercises for Spinal Cord Injury Recovery

While every spinal cord injury is different, many survivors with high-level SCI often have difficulty with hand dexterity. Thus, hand exercises for spinal cord injury are beneficial to improve hand function and promote/maximize recovery.

Exercise stimulates neuroplasticity which is vital for the central nervous system to repair itself. Neuroplasticity is best activated through massed practice, therefore survivors must engage in high repetition exercises.

Remember to work with your therapist to find the most effective hand exercises for your ability level. Lastly, remember to practice hand therapy exercises you enjoy to keep yourself motivated. We hope this article has helped you explore various hand exercises for spinal cord injury and encouraged you to practice as much as possible.

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Do you want to improve mobility after a spinal cord injury?

Depending on the severity of your spinal cord injury, there may be hope for improved mobility. Consistent at-home therapy is key to making this happen.

That’s why Flint Rehab created FitMi, a motion-sensing, gamified home recovery tool designed for neurological injury like SCI.

Here’s what others have said about it:

Say bye-bye to your Physiotherapist

“I purchased this wonderful equipment for the use of spasticity for my right hand. Initially I wasn’t sure if it would work because of the various treatments I tried and also many physiotherapists who tried their level best, but didn’t achieve any positive results.

However after trying FitMi, I could feel that slowly and steadily I am improving. It’s really a great device that minutely takes care of each and every muscle of your affected body part. The biggest plus point is, you can use this device anywhere, anytime with precise exercises that you need and also saves your money and time spent on your physiotherapist.

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It’s all about high repetition of therapeutic exercises

FitMi works by encouraging you to practice rehab exercises with high repetition. On average, survivors complete hundreds of repetitions per half hour session.

“Massed practice” like this helps stimulate and rewire the nervous system. While you can achieve massed practice with a written sheet of exercises, it can be tough to stick with it consistently — and consistency is key to recovery.

FitMi helps transform rehab exercises into an engaging, interactive experience. The yellow and blue “pucks” track your movement and provide feedback. All of this comes together for a motivating home therapy program.

A survivor named Tom put it perfectly:

“I believe this device will help me concentrate on making the repetitive actions needed to obtain further movement range in my wrist and hand and arm and therefore rating it with five stars. My occupational therapist recommended to give this a try. I have been using FitMi for just a few weeks. I feel more at ease in flexing.”

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