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INTRODUCTION: Spinal cord injuries (SCIs), while relatively rare, profoundly alter the lives of those affected. Among the diverse causes of SCI, traumatic sporting injuries represent 8.7% of newly reported cases. Despite the life-altering consequences of SCI, physical activity (PA) can mitigate some of these impacts.PATIENT PRESENTATION: This case study highlights the long-term benefits of sustained PA and its crucial role in fostering a cascade of positive outcomes post-SCI. We present the case of an elite South African athlete, 'Jim', who sustained a complete SCI at the C6 level at the age of 16 in 2012 following a fall during dismount in a gymnastics competition. Jim's rehabilitation journey began shortly after the injury, encompassing formal inpatient care, alternative therapies and ultimately a return to competitive sports. By 2015, Jim resumed athletic activities, beginning with shot put and discus before transitioning to wheelchair racing, which became a pivotal aspect of his recovery.MANAGEMENT AND OUTCOME: The case emphasises how sustained PA led to Jim's significant physical and mental improvements, such as weight loss, enhanced self-esteem, increased mobility and greater independence in daily living. Moreover, sport provided Jim with a renewed sense of purpose and direction.CONCLUSION: This case underscores the importance of creating ongoing opportunities for individuals with SCI to continue their recovery long after discharge from inpatient rehabilitation.CONTRIBUTION: This case study illustrates how sustained PA contributed to a cascade of positive outcomes in Jim's recovery following SCI, offering valuable insights from his lived experience.