Sex Part Four: Answers to the Questions I Had When I Was Newly Injured

A question mark made from a lighted sign.
Feb 16, 2023 | by Kayley Lawrenz

Welcome back to this series on sex after spinal cord injury (SCI). I am pleased to have you join me again for part four of this series. As I mentioned in the first part of this series, I will now discuss information that those who have sustained an SCI often want to know about spasticity and sexual positions.


Experiencing spasticity to some degree is incredibly common after sustaining an SCI. Research finds that 65-78% of people with a chronic SCI have spasticity. Spasticity often happens when you have not moved for a while, when you stretch, during certain forms of stimulation to body parts below your injury level, and when you change your posture or position.

Many sexual positions that involve bending your legs upward and spreading your legs may cause spasms. Genital stimulation may cause you to spasm, often in the leg area or in the wrists and hands. Spasms may also happen if your partner lies on top of you.

In my experience, partners often enjoy it when you spasm a little bit, as long as you and your partner are not in pain. My partners often smile or take my spasm as them pleasuring me in a good way. Sometimes I giggle and explain to them, again, that spasms are a normal part of having an SCI. Other times, I let them think the spasm is a reaction to them being successful in pleasuring me. We can keep how humorous that thought is a secret from my partner and past partner(s), right?

Anyway, I have learned a few things about decreasing spasms and handling them during sexual intimacy. These include:

  • The spasm may surprise your partner. I find that playfully shrugging it off and explaining why I spasm to my partner makes any future spasms a non-issue.
  • If you are in pain when you are spasming, inform your partner right away that you need to stop for a moment or switch positions and explain why.
  • Teaching your partner how to stop your spasms by gently stretching the muscle or placing pressure on the body part may be helpful. You can also ask your physiotherapist to help show your partner these things.
  • Placing a pillow or wedge under your pelvis and legs may reduce your spasticity and allow you to get positioned comfortably.
  • If you have less spasticity when you are seated, engaging in sexual activity while sitting in a chair or the wheelchair you use may help reduce your spasticity during sexual intimacy with your partner.
  • If you are having a lot of difficulty with spasms during sexual intimacy, you may want to talk with your doctor about changing your spasticity medications or providing you with spasticity medication to use in moments of sexual intimacy.


There are tons of different sexual positions out there, and I recommend trying a variety of positions with your partner. Just be safe when you are doing so! Some positions are easier than others, depending on your level of SCI and upper body balance and strength.

For those with limited upper body strength and balance, positions where you are on your side or back will work well without too much difficulty. These positions also leave your hands free to touch and play with your partner.

Additionally, if you have a ceiling track lift, you may teach your partner how to put you into it safely, and you may use this device to your advantage. It may help you get into certain positions where you are on top or up against the wall. It does kind of look like a sex swing. However, if you try using your ceiling tract lift, make sure you and your partner are safe, that neither of you is under the influence of any intoxicating substances, and that the lights are on.

For those of us with limited hand function, you may use sex toys and vibrators to pleasure yourself or your partner during foreplay and intercourse. Many assistive devices, such as those sold by Active Hands, may help you hold onto different toys. You may ask your occupational therapist about assistive devices to help you grip and hold things, such as sex toys. If you choose to use a strap-on dildo or similar sex toys, make sure you check that your skin is not being damaged or broken down when using these devices.

You may also use your mouth. When it comes to oral sex, I find that having my partner straddle my upper body while I am on my back works best when I am pleasuring them. If you are sitting in the wheelchair you use, you may also have your partner sit on something you can wheel under. Your partner can rest their legs on the large wheels or armrests of your wheelchair. This position is my favourite when I want to give my partner oral stimulation, but it is also probably a good position to use your hands and toys to pleasure your partner.

Regardless of the positions you try, it is essential to guide your partner in how to best move you if you need assistance. Experiment with what works and feels best for both of you.


I hope that I provided you with information about SCI and spasticity during sex, as well as information on sexual positions. I am optimistic that I provided some advice and answered any questions you had on these topics.