Common Injuries Sustained by Wheelchair Users and How to Prevent Them

Wheelchair users face unique challenges that can lead to various injuries, often due to the repetitive nature of wheelchair use and environmental factors. 

In this article, we list some of the most common injuries that arise from wheelchair use and some guidance on how to minimise the risk of them.

Common Injuries Among Wheelchair Users

1. Shoulder Injuries

Wheelchair users often rely heavily on the shoulders for propulsion and transfers. The repetitive stress of pushing a wheelchair can lead to overuse injuries such as rotator cuff tears, impingement syndrome, and bursitis.

Prevention of Shoulder Injuries

  • Strengthening and stabilising exercises. Engage in exercises to strengthen the shoulder muscles, such as resistance band workouts focusing on the rotator cuff and scapular stabilisers.
  • Proper technique. Learn and practise proper wheelchair propulsion techniques to minimise strain. A physiotherapist or occupational therapist can help teach safe form and posture to minimise the risk of injury. 
  • Regular breaks. Incorporate regular breaks into daily routines to give the shoulders time to rest and recover.
A person on a wheelchair exercising

A physiotherapist or occupational therapist can guide a wheelchair user on exercises that strengthen and stabilise the shoulders. 

2. Pressure Sores

Prolonged pressure on the skin – such as the case of those using their wheelchair for long periods – can restrict blood flow and lead to pressure sores. The most commonly affected areas are the buttocks, tailbone, and heels. 

If left unresolved, pressure sores can lead to painful infections of the skin and soft tissue (cellulitis) and even joint and bone infections.  

Prevention of Pressure Sores:

  • Cushioning. Use high-quality, pressure-relieving cushions on wheelchairs to distribute weight evenly and reduce pressure on vulnerable areas. For those with complex postural needs, there are companies that provide custom seating solutions to give the user optimal support. 
  • Frequent position changes. Shift weight frequently by performing wheelchair push-ups whenever possible. If the user is not capable of shifting position independently, the caregiver must take care to assist them in doing so with enough frequency. Alternatively, a tilt-in-space wheelchair can also make position changes easier on the user. 
  • Skin checks. Conduct daily skin inspections to identify early signs of pressure sores, such as redness or discoloration, and address them promptly.

3. Carpal Tunnel Syndrome

Carpal tunnel syndrome is a hand and wrist condition caused by compression of the median nerve in the wrist. Repetitive motion and pressure on the wrist can cause this. 

Symptoms include numbness, tingling, pain and weakness in the hand and fingers.

A diagram of a wrist affected by Carpal Tunnel Syndrome

Image credit: Wikimedia Commons

Preventing Carpal Tunnel Syndrome 

  • Wrist supports. Use wrist supports or gloves with built-in wrist rests to maintain a neutral wrist position while propelling the wheelchair.
  • Ergonomic modifications. Consider ergonomic adaptations to the wheelchair, such as handrim covers or pushrim-propelled power assist devices, to reduce wrist strain.
  • Stretching and strengthening. Incorporate wrist stretching and strengthening exercises into daily routines to maintain flexibility and strength and ease pressure on the joint. 

4. Repetitive Strain Injuries

Aside from the shoulders and wrists, other body parts such as the elbows, hands, and cervical spine can also suffer from repetitive strain or overuse

Preventing Repetitive Strain Injuries

  • Ergonomic positioning. A poorly fitted or aligned wheelchair can exacerbate strain. An occupational therapist can help find a wheelchair and seating solution that is optimal for the user’s needs. 
  • Rest and recovery. Allow adequate time for rest and recovery, particularly after activities that require prolonged wheelchair use.
  • Myofascial release therapy. Fascia are connective tissues surrounding our muscles and organs. These can become tight due to repetitive movement, potentially causing pain and discomfort, and poor mobility. Your physiotherapist or occupational therapist may recommend and perform myofascial release therapy, which is a manual technique used to release tension in the fascia.

5. Falls and Related Injuries

Wheelchair users may experience falls during transfers, navigating uneven surfaces, or when the wheelchair tips over. Falls can result in fractures, sprains, or head injuries.

Preventing injuries from falls

  • Transfer training. The user as well as their caregivers should be trained in safe  transfer techniques, including the use of assistive devices like transfer boards or lifts when necessary.
  • Environmental modifications. Ensure home and public spaces are wheelchair-accessible, with ramps, grab bars, and non-slip flooring to reduce the risk of falls.
  • Wheelchair maintenance. Regularly inspect and maintain the wheelchair to ensure it is in good working condition, with properly inflated tires and functional brakes.
An elderly woman being assisted into a wheelchair

Training on the safe transfer in and out of a wheelchair is important for wheelchair users and caregivers alike. 

Additional Preventive Strategies

Apart from the specific issues and preventive measures listed above, here are some more ways wheelchair users can mitigate the risk of injuries in general:

Assistive Technology

Assistive technology can make a big difference in the quality of life of wheelchair users, especially those with limited upper body strength. Power wheelchairs can eliminate the need for manual propulsion. There are also power assist devices available that can be attached to a manual wheelchair. 

Education and Training

It’s always worthwhile for wheelchair users and caregivers alike to participate in education programs that provide information on injury prevention, proper wheelchair use, and health maintenance. Connect with peer support groups or organisations for individuals with disabilities to share experiences and learn from others.

Support from medical professionals

Physiotherapists and occupational therapists can help wheelchair users in a variety of ways, from developing a safe exercise program specifically tailored to their needs, rehabbing injuries, as well as recommending home modifications to make wheelchair use safer. 

Physiotherapists and occupational therapists are also skilled in assessing a patient’s needs and prescribing wheelchairs and seating solutions that are tailored to each individual. 

Need help with wheelchair use safety? 

If you’re struggling with injuries and other problems from wheelchair use – or have just started to require a wheelchair and wish to prevent them – our team of highly qualified physiotherapists and occupational therapists are here to help. 

We can assist you in finding a wheelchair that suits your needs, and train you and your caregiver on the proper techniques for safe wheelchair use. 

Our team can also help in the prevention or rehabilitation of injuries, through various therapy modalities including exercise therapy, soft tissue mobilisation, heat and cold therapy and myofascial release. 

And we can bring these services right to your location, whether it’s your home, workplace, or community setting. 

Get in touch with us today by filling out this form or calling us at 02 8808 4000. We’ll be happy to chat and answer your questions!