Inclusion Criteria:  Age 18-65, Spinal cord injury, non-ambulatory, wheelchair user, Pain in shoulder from overuse injury, Pain interference on the WUSPI of at least 6/10 on at least 2 of the transfer items and any one of the remaining items, English-speaking, Stable spine, Full weight-bearing status in bilateral upper extremities (i.e. no orthopedic precautions on UE weight-bearing activities) Greater than 3 months post initial spinal cord injury Diagnosis of overuse syndrome of the shoulder  Exclusion Criteria:  Concomitant moderate to severe Traumatic Brain Injury Fractures in upper limbs. Concurrent diagnosis of Fibromyalgia. Cervical radiculopathy. Previous shoulder pathology Neuromuscular junction disorders (such as myasthenia gravis), Psychiatric disorder. Lack capacity to provide informed consent.