The modern world isn’t as accommodating to those in wheelchairs as it should be. Not only do they face accessibility restrictions, but emotional and social complications are often overlooked. Several medical concerns also plague wheelchair users, including pain, strains, skin damage, and pressure sores.
Whether your wheelchair is a permanent addition or a temporary mobility device, physical therapy may be helpful. The program builds strength and coordination, improving wheelchair navigation and maneuvering. Your therapist will also address any challenges and make adjustments as needed to ensure you’re adapting well.
Your doctor can also assist with any concerns, including the following common issues.
Wheelchair Users – Most Common Concerns
Many healthcare providers work hard to support their patients, but wheelchair users often face unique challenges that may go unspoken or unnoticed, even by the most caring professionals.
A common complaint among wheelchair users is that their struggles are hard to explain, and they often feel misunderstood especially when it comes to how difficult day-to-day mobility really is.
They also experience discrimination, lack of emotional support, and travel complications, including limited wheelchair parking or spaces on public transit. Of course, Another major concern is the physical strain caused by prolonged wheelchair use which we’ll cover in the following sections.
Proper evaluation for a wheelchair: fit and comfort issues
Backrests are designed to support the spine and pelvis, but recent studies state they often fail at their task. When these pieces aren’t positioned well, proper posture support isn’t provided, risking deformities such as scoliosis, lordosis, or kyphosis.
Wheelchair users also face other comfort concerns. For instance, footplate height could increase pressure on the hip bones or thighs. A seat that’s too deep results in sliding forward, while a wide one causes shifting that decreases spinal health. Incorrect armrest height often results in neck or shoulder strain.
Pain and repetitive strain injuries (RSI)
The hands, wrists, and shoulders work hard to move and maneuver manual wheelchairs. Though muscle strength builds over time, the risk of pain and injury in these areas concerns wheelchair users.
In fact, experts state that repetitive strain injuries, including rotator cuff damage, are common in the upper extremities. The threat of pain and RSI increases with higher levels of rolling resistance and propulsion force. Frequent use also contributes, especially in wheelchair athletes, resulting from improper positioning, muscle imbalance, fatigue, and other factors.
Skin health and pressure sores
Limited mobility or paralysis causes more damage to the skin than most people realize. Collagen loss reduces elasticity, allowing the skin to scrape or tear more easily. Muscle atrophy also decreases padding, causing further skin breakdown.
The loss of sensation also prevents you from moving or shifting, increasing pressure on a single spot. Pressure sores develop, particularly beneath bony areas, requiring treatment or surgery to repair. Other concerns for wheelchair users include skin thickening, dryness, or fungal infections from moist conditions.
Understanding & emotional health issues
Medical professionals often focus on a wheelchair user’s physical health concerns. Unfortunately, their emotional health may be overlooked, even by their close friends and family. Many places have limited or no access for mobility devices, restricting the activities of wheelchair users. Such issues increase isolation and loneliness.
Wheelchair users may also experience a loss of employment, recreational activities, and community. These factors, combined with a higher risk of physical complications, often result in depression or other mental health concerns.
The more openly these concerns are shared, the better equipped doctors, therapists, and caregivers will be to support people who rely on wheelchairs — with empathy and insight.
Resources:
- PubMed Central, May 26, 2021, Comfort and stability of wheelchair backrests according to the TAWC
https://pmc.ncbi.nlm.nih.gov/articles/PMC8152044/ - Clinics Can Help, 4 Steps to Prevent Sliding Forward From In A Wheelchair
https://www.clinicscanhelp.org/news/4-steps-to-prevent-sliding-forward-from-in-a-wheelchair/ - PubMed Central, July 1, 2023, A High Prevalence of manual Wheelchair Rear-wheel Misalignment Could Be Leading to Increases Risk of Repetitive Strain Injuries
https://pmc.ncbi.nlm.nih.gov/articles/PMC8435044/ - PubMed, The impact of seating and positioning on the development of repetitive strain injuries of the upper extremity in wheelchair athletes
https://pubmed.ncbi.nlm.nih.gov/12441510/ - SRNA, Jan. 2011, Skin Health: Prevention and Treatment of Skin Breakdown
https://wearesrna.org/resources/skin-health-prevention-and-treatment-of-skin-breakdown/ - Mental Health Connecticut, Surprising Ways Poor Accessibility Affects Mental Health
https://www.mhconn.org/2019/02/22/surprising-ways-poor-accessibility-affects-mental-health/
This content comprises informative and educational resources only and can not be considered as a substitute for professional health or medical guidance. Reliance on any information provided in this article is solely at your own risk. If you have any inquiries or apprehensions about your medical condition or health goals, talk with a licensed physician or healthcare provider.
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