Inclusion Criteria:  cervical level injury (C5 to C7) at least 1 year post-injury  Exclusion Criteria:  individuals with damage to the nervous system other than to the spinal cord pregnant women (effects of stimulation on the fetus are unknown).  Transcranial magnetic stimulation-specific exclusion criteria:  participants with active or inactive implants including cardiac pacemakers, implantable defibrillators, ocular implants, deep brain stimulators, vagus nerve stimulator, and implanted medication pumps participants with conductive, ferromagnetic or other magnetic-sensitive metals implanted in their head participants with a history of seizures or epilepsy participants taking any medication which may reduce seizure threshold