Purpose The purpose of this study was to determine the extent to which EMG biofeedback training plus exercise program are associated with a reduction in the shoulder pain and the muscle tone of upper trapezius in manual wheelchair users with spinal cord injury. Methods Exercise group (N=12) was instructed to do stretching and strengthening exercise to alleviateshoulder pain for 8-week, 50 minutes/day, 5 days/week. EMG biofeedback training group (N=12) was assigned to do the same program plus EMG biofeedback training to induce muscle relaxation. The level of pain was measured by WUSPI, and Myoton®PRO was utilized to measure the changes in tone, stiffness and elasticity of the upper trapezius. Results Both of experimental and control groups were effective for shoulder pain and muscle tone. However, in comparison between groups, EMG biofeedback training group showed a statistically significant difference in reduction of the shoulder pain and in muscle stiffness as compared with exercise group (p<.05). Conclusions EMG biofeedback training when combined with exercise program appear to show positive effects in the shoulder pain reduction.