This chapter will address common questions and concerns related to changes in relationships after spinal cord injury. This can include role changes, managing conflict, communication and coping with life changing events. Suggestions for enhancing relationships in the face of these challenges will be discussed.


What Is It?

Relationships are defined as the connection between people. In this section we will be focusing on intimate relationships. Intimacy can be physical, emotional or both. Physical expressions of intimacy can be sexual intercourse, holding hands, kissing or cuddling. Emotional expressions of intimacy can be talking about dreams, goals, future plans, fears and insecurities. Intimate relationships are usually supportive, affectionate and loving.

What’s Different Now?

Most people say that everything is different after a spinal cord injury, but what does that really mean?

Role Changes
Who you are and what you are capable of doing at certain stages of the rehab process can change your previous roles. This can be things like: finances, household chores, employment, driving, initiating intimacy, parenting roles etc.
Physical Changes
What you are able to do and how you are able to do them can change after SCI. Tasks like grooming (shaving, washing your hair, brushing your teeth), feeding, showering and dressing yourself can take longer or you may need assistance to do them. How you express physical affection can also change (hugs, kisses, hand holding, cuddling, dancing etc.)
Emotional Changes
Living and adapting to a spinal cord injury can certainly have its ups and downs. Changes to mood (depression), confidence, anger, fear, guilt, and feeling like a burden are all common emotions when trying to cope with a significant change. However, if your mood is mostly low, seeking emotional support from a professional may be necessary. Don’t be afraid to ask for help when you need it.
How you interact with your surroundings can be altered following SCI. This might be a new living situation (new home or major renovations) or a need for equipment (transfer lifts, sliding boards, grabbers, universal cuff, wheelchairs etc). Your sleeping arrangements might change (separate rooms, hospital beds) and you may require care workers to come into your home. Because your independence may be affected, it is especially important to create your own space in your environment.
The way you are used to presenting yourself to the world can change after SCI. You may not be able to carry out your regular grooming routines (hair, makeup, shaving, showering) the way you like and have to rely on others to help you. You may have to choose different clothing from what you would typically wear for better function and comfort. You may also notice changes to your body shape, which can be common after SCI.
Hobbies and Socializing
After SCI, where you go for fun, the activities you enjoy, and where you can enjoy them may be different. Where and how you see your friends or family may also differ and change your relationship dynamics.
Time Apart and Together
Whether it’s your partner, mom, brother or friend that’s helping you after an SCI, you may be together a lot more than you used to be. Although you may feel like you can’t be left alone at times, it is important to create your own space and have some time for yourself. Sometimes your loved ones may feel worry and guilt for leaving you at home alone but time apart is just as important as time together to maintain a healthy relationship.
Relearning tasks and going through the rehab process can be exhausting and can often lead to fatigue. For partners, balancing life while trying to maintain the relationship and support you can sometimes lead to burnout. During these times, staying positive can seem tiresome as well and may put strain on your relationship.


Now that I have an SCI, my marriage will fall apart.


Marriage is hard work for everyone—an SCI does not mean it will automatically fail!

If you are in a relationship:

All of these changes can add up and before you realize it your relationship is different. All the changes and stress can lead to tension and frustration that can make communication challenging. However, this is a time where communication is even more important because an SCI is a major life event. Communication is the main highway that keeps people connected and working through your thoughts, feelings and emotions. That’s easy to say, but it’s a lot tougher to put into practice. With all that’s on your plate, often the last thing you think about is intimacy but it’s probably the time you need it the most.

It’s important to note: All relationships can be difficult to maintain. The state of your relationship before your injury will have an impact on your success. If there were issues before the injury, these difficulties can become bigger after your injury. Alternatively, if you and your partner have been through difficult circumstances before the injury, this may build some resilience for managing through this situation.

If you are not in a relationship:

You may require support with all of these changes from your family and friends but asking for help can be tough. Depending on what stage you are in your life (eg. teenager, older adult, college student, young professional, couch surfer) this can feel like an invasion of your privacy and put tension on your relationships. Communication and being able to express your needs becomes very important to help maintain your boundaries with the people trying to help you.

Through your rehab process you will likely have thought about dating. You may have wondered, “how will I meet someone?”, “who will want to date me?”, “will I ever have sex again?” or “what will dating be like now?”. The biggest step towards feeling ready to date is building your self-confidence. For more detailed information on this process visit the Sexual Self-Image page.

Once you are ready to date you may want to consider how and when you talk about your disability. For example, if you create an online dating profile, what picture do you choose of yourself? Do you talk about your SCI in your bio? When you go out on a date, be aware that people may have a lot of questions about your SCI so try to prepare yourself, Being aware of what you’re willing to tell someone can be helpful.


10 Tips for Partner Caregivers

What Can I Do About It?

Read Peer stories to learn more about dating with an SCI. These Spin articles feature Peer Stories about online dating. Click the pages below to view in full screen.

What Do I Need to Know?

Whether you are in a relationship or not, the things that you need to do will be similar. A good place to start is to build a foundation based on understanding key parts about yourself. This involves trying to gain a better understanding of who you are, how you deal with different situations and how you relate to people.

If you are in a relationship, it is important to make space and time for your partner while also allowing them to have space and time for themselves. Often when something life changing happens, the person closest to you becomes the outlet for your frustration and anger. Recognize that although you have been injured, this injury happened to both of you and your partner is going through their own losses and changes too.

Building trust and intimacy with your loved ones is a good way to strengthen your relationships.

My Role

Starting and/or maintaining a relationship might seem low on the priority list when there are so many other things going on in life after an injury. But your role here is to recognize that all relationships need to be nurtured. Whether it’s with your partner (if you have one), friends or family, support from others is a key element to success in adapting to the changes you will have to face through your life with a spinal cord injury.


Maintaining or initiating a relationship can seem difficult. However, spinal cord injury does not limit your ability to be a partner. Despite your physical changes, it’s important to remember sexuality comes from within. The process of starting and keeping a relationship can often take time and can involve taking some risks and pushing yourself outside your comfort zone. You may experience ups and downs along the way but keep trying. Approaching relationships with kindness and patience can make this process smoother; try to bring people closer rather than push people away.

Relationships Resources


Dating and Relationships - Blog post, Easter Seals.

Keeping a Marriage Strong After a SCI - Interview with Peer Codi Darnell, SpinalCord.

Love Online - Johanna Johnson, The Spin.

Online Dating Stories - Peer stories, The Spin.

Sex on Wheels: Relearning Intimacy - Interview with Peers Teri Thorson and Cory Parsons, Vancouver Sun.

Top 10 Tips for Partner Caregivers - Peer blog post, SCI BC.

To Post? Or Not to Post? The Weird World of Online Dating - Alexandra Stoffel, Push Living.


Dating after SCI - A page of resources by United Spinal Association.

Relationships module - Living With SCI website, G.F. Strong and SCI BC.

Wheel Love - YouTube documentary about marriage and SCI.


Hold Me Tight: Seven Conversations for a Lifetime of Love - Sue Johnson

In Sickness and in Health: Love, Disability, and a Quest to Understand the Perils and Pleasures of Interabled Romance - Ben Mattlin

Regain That Feeling: Secrets to Sexual Self-Discovery - Dr. Mitchell S. Tepper

The Seven Principles for Making Marriage Work - John M. Gottman


Communication - Sexuality After SCI

Dating After SCI - Sexuality After SCI

Check out our Video Playlist for this chapter!


Check out the video playlist for this chapter!