Many people think about a wheelchair in the context of getting from point A to point B. That’s fair, it’s the purpose of a wheelchair, after all. But what so many fail to realize—and what many fail to acknowledge until it becomes a problem after months of use—is how your wheelchair impacts your wellness.
The wheelchair becomes a part of your support structure, like an extension of your body. If you choose the wrong one, you can suffer from consequences that may take months or years to appear. But if you choose the right one, you find yourself avoiding complications that many other wheelchair users suffer from in the first place.
The Issue of Pressure Sores
The first problem is one that seems innocuous but is anything but: pressure sores. Pressure sores occur when you’re sitting too long in one position and the blood flow to the skin (and tissue below) stops. They can occur relatively quickly, sometimes in a matter of just a few hours.
Once you develop a pressure sore, however, it’s weeks—sometimes months—of healing without proper sitting (thus mobility) before you’re back to normal. In addition, severe pressure sores require surgical intervention.
A good chair prevents this through cushioning and being able to shift your weight over time. Some offer tilt or recline abilities that make it so you don’t have to get out of the chair to readjust position. This is not just a luxury; it is preventative medical care.
Support for Your Spine
When you sit with poor posture in a wheelchair, you might look slumped. However, you’re also putting pressure on your spine in ways that only get compounded over time. You may not even have sensation in certain areas to feel the strain building or maybe you do but have developed a level of tolerance for discomfort that you’ve learned over time is just how life goes.
Regardless, slumping for years leads to real, structural issues. Your spine becomes crooked where it shouldn’t be. Your musculature compensates in places it shouldn’t be—which leads to pain in unrelated areas. Organs even become compressed leading to digestive problems or restricted airways.
Back support is so important. It needs to maintain the natural shape of your spine without compromising comfort. Height matters. Angle matters. Firmness matters. Those with lightweight electric wheelchairs often find that these options offer greater versatility in avoiding these problems through active adjustment throughout the day when seated—the longer your spine supports the wrong position, the more permanent the changes become.
Circulation Issues
Sitting all day is bad for circulation, and honestly, it doesn’t matter if you’re in a wheelchair or an office chair. However, additional issues arise when it comes to a wheelchair user because the position of one’s legs and areas of pressure on the body vary.
Poor circulation results in swollen feet and ankles. It prevents proper extremity temperatures—it’s why some people get cold all the time while others find their feet puffy and irritated. Excessive pressure per one area keeps them there not only from annoying blood clots (in severe cases) but they reduce healing time for cuts or sores—and this only adds exhaustion and fatigue into the fatigue because it feels as if you’re working ten times harder than everyone else for no reason.
Footrests impact this more than you’d think. If they’re at the incorrect height or angle, you’re going to be unable to shift your legs into a position optimal for circulation back up to your heart and further into your bloodstream. If the seat depth is wrong, there’s additional pressure behind your knees preventing return circulation efforts as well.
Shoulder and Arm Stress
Are you in a manual wheelchair? Then you’re performing repetitive stress motions all day long. That takes a toll on your shoulder, elbows, and wrists. Rotator cuff problems emerge frequently and carpal tunnel syndrome shows up often enough. Arthritis can also develop.
Even if they are powered wheelchairs, if the controls are too far away or their accessibility isn’t easy enough without using much strength, the same problems occur over time.
The weight of the chair matters as does accessibility not just for your ease but for your long-term health outcomes—what’s easier for maneuvering is easier for you if it’s lightweight as well. Therefore health needs are not solely focused on maneuverability but also weight considerations as well.
The Fatigue Factor
Wheelchairs can be tiring in ways that we don’t even realize until we’ve used other options. Maybe the seating is uncomfortable so we’re constantly shifting in it utilizing muscle strength that we could be using to do other things just trying to find a comfortable position. Maybe it’s too heavy so each rock forward requires more energy than should be exerted.
All of this adds up to drain your energy bank. Furthermore, when people are constantly fatigued from excess strain, other health factors decline as well. People don’t want to engage with opportunities that would otherwise be good for them; some people fall into depressions and find their immune systems lack external strength to operate appropriately in public forums with others.
A chair that’s appropriate for your body and lifestyle shouldn’t render you exhausted at the end of every single day. If it does, it’s worth investigating.
Skin Complications
Lastly, beyond pressure sores comes skin health. Even if you never develop an overt pressure sore, poor fitting wheelchairs can impact your skin in dramatic ways–friction creates exposure irritations; moisture gets trapped if there’s no airflow; seams or hard parts may rub against your skin for hours.
These seem like small nuisances until they aren’t. Skin break down happens quickly and once it occurs it’s difficult to heal while seated in that same chair with minimal resources implementing change. The materials matter here; airflow accessibility matters; seat and back shape matters.
What Makes a Wheelchair Appropriate
So what should you look for? It’s less about cost or excess value or bells and whistles than it is about using a common and appropriate sense to match your body with its needs.
This means proper fitting means that seat widths should accommodate each hip with about an inch of space per side; seat depths should accommodate thighs without nicking behind knees; back heights should support spines based upon trunk control observation; footrests should accommodate feet so that thighs are relative to parallel positioning as feasible.
Beyond this basic fit consideration, it comes down to how you generally use the chair. Do you transfer in and out often? Are you frequently outdoors? Are you going to need to transfer often? These considerations give potential suggestions that matter versus those that add weight without function.
Therefore all assessments matter—get assessed by an occupational therapist or seating specialist—it’s worth time taken—with someone who can spot things go unnoticed by clients but can assess reasonable concern down the line when complications might emerge.
The Takeaway
A wheelchair isn’t just a mean of mobility; it operates as preventative medical care that engages with daily access challenges and if you’re not careful it can jeopardize your health by rendering negative outcomes far more complicating than preventative measures would suggest during a timely matter up front.
The right wheelchair protects skin health, spinal accommodations, circulation and energy conservation where the wrong wheelchair puts challenges at risk that could have been avoided entirely—with minimal effort if you’ve got an appropriate fit with considerations made both medically and personally through assessments needed potentially by professionals who know best how they operate over time up front.