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If you have recently learned that you will need to use a manual wheelchair then this can feel quite intimidating. For most people, this is because of a lack of understanding on how to properly use the chair.
While some people may have an attendant to push them in the wheelchair, others will rely on self-propulsion. When learning how to do this, there are some important things to think about to help you move about safely and effectively.
In this guide, we’ll give you some tips on the importance of proper use of your wheelchair, as well as some handy tips on how to get the most out of it.
Why Should You Learn How to Properly Propel a Manual Wheelchair?
When you self-propel your wheelchair, you are immediately at a higher risk of injuries such as repetitive strain and back problems. However, when you use the wheelchair properly, the chances of these injuries are lessened to a degree.
As many as 50% of manual wheelchair users that self-propel experience shoulder pain. Although the chances of you developing this will depend on your age, the wheelchair and your physical condition. However, since wheelchair propulsion weakens and puts wear on the rotator cuff in the shoulder, long term users are very likely to experience pain at some point down the line.
But in order to reduce problems, it’s not only essential to learn how to correctly propel yourself but also to make sure that the wheelchair is adjusted to a way that suits you.
Moreover, when you learn how to properly propel your manual wheelchair, you’ll exert less energy. Full, smooth strokes will move you further compared to shorter strokes, so getting to grips with how to use the chair will be more energy efficient. This is essential if you’re going to be spending all or most of your time in the wheelchair.
What is the Correct Grip Placement & Posture When Propelling a Manual Wheelchair?
When gripping the hand rims on your wheelchair wheels, it’s really important to ensure that your grip is spot on. If you don’t, then there is a risk of your thumb getting caught in the spokes and this can be pretty unpleasant. Moreover, if you have to keep stopping because you’ve got caught up, this reduces efficiency and means you won’t get to where you need to be as quick.
Occupational therapists suggest gripping the hand rims so that your thumb is on the outside as opposed to the inside, where it may get jammed. What’s more, it’s inevitable that your wheels are going to pick up dirt so keeping your hands out of the way will ensure they stay clean.
It is also vital that your wheelchair is configured to offer the best support and comfort for your posture. When the wheelchair is correctly aligned, this will help to delay the onset of shoulder pain, which as we have discussed, is prevalent among manual wheelchair users. But doing this has other advantages, such as improving maneuverability and stability.
You’ll need to make sure that the horizontal wheel axle is positioned in a way that is suitable for you. This may require the help of your OT, but it’s important as when the axle is placed too far back, you’ll have to over reach when propelling.
When you sit in the wheelchair, the tip of your middle finger should be able to reach the center of the hub when the arm is relaxed. The reason that this is important is because this positioning will ensure the best weight distribution while in the chair. With this in mind, it is also essential to set up your wheelchair according to your own center of mass and anatomy as everyone is individual and will require their own minor adjustments.
How to Propel a Manual Wheelchair Tips & Advice
As with anything in life, learning to propel your manual wheelchair will take some time. Don’t kick yourself if you find it tricky in the beginning. By following the advice below, you’ll be able to get to grips with using your wheelchair, and before you know it, you’ll be freely moving around without even having to think about it.
Propelling a Wheelchair Forwards
When moving forwards in your wheelchair, you will go through a cycle that is made up of two main movements; propulsion and recovery. This also allows you to stop your wheelchair when moving forwards.
- Propulsion is the phase when the user’s hand is pushing the chair forwards.
- Recovery is when the hand has moved away and is waiting to grip the hand rim once again.
Here are some quick pointers on how to propel the wheelchair forwards.
- Start by making sure you are in the correct position. Your backside should be well back into the seat, and you should keep your weight slightly forwards. If you don’t, you may not push smoothly enough, and this could cause the wheelchair to tip backward.
- With the elbows bent to between 100º and 120º, use long, smooth movements to push the chair forwards.
- Avoid making short, sharp pushes, as this will wear you out much more quickly and put unnecessary strain on your shoulders.
- After each push, move the hands back to the starting position to make the next push.
Propelling a Wheelchair Backwards
Moving your wheelchair backward is an important skill you’ll need to learn. Fortunately, the technique isn’t all that dissimilar going forwards.
- It’s important to take your time when moving backward, especially because the small wheels at the front will need to turn.
- When maneuvering, also make sure to keep looking behind you for hazards and obstacles.
- This time, you’ll start with your hands at the front of the wheels as opposed to the back.
- As you push backward, make sure to apply gentle downward pressure on the hand rims.
- Typically speaking, you’ll only use backward propulsion over short distances.
Propelling a Wheelchair up an Incline
One of the most critical things to make sure of when moving up and incline is to make sure that your wheelchair doesn’t tip over. To ensure this, lean forwards.
- You’ll use the same forward motion as you would when moving on a flat surface. However, this can require more physical strength, so you may need to practice a little more and work out your muscles.
- It can be helpful, and much safer, to have an assistant behind you for support when you are practicing.
- Never try to go up very steep slopes without assistance.
- If you find that you are getting tired halfway up the incline, stop and take a break. Just make sure to turn the wheelchair sideways and lock the brakes so there’s no chance of rolling backward.
Propelling a Wheelchair Downhill
When you are moving down an incline, it’s essential to maintain good friction on the hand rims so that you have better control over the speed.
- Take hold of the hand rims and, rather than letting go, allow the rims to slide through your hands.
- Make sure to keep your weight towards the back of the chair.
- Once you have a good level of experience, you may perform a wheelie when going down ramps as this is much more efficient.
One-Handed Wheelchair Propelling
For amputees or people who only have the use of one hand, learning how to move the wheelchair one-handed is essential. This also applies if you have to carry something while moving and can only use one hand to control the chair.
- If possible, you can use one hand normally and use your elbow or forearm to control the other wheel. This is usually done for those who do have the use of both hands but are carrying something while moving.
- It’s also possible to use alternating hands if you are carrying an item. You’ll need to push one wheel with the corresponding hand before swapping the item over and then pushing the other wheel with the other hand. Keep repeating this until you get to where you want to be.
- A great technique for people who only have the use of one hand is the seatbelt method. To do this, you propel one wheel forward and then reach over your body to grab the other wheel, propelling that with the same hand. Keep switching from side to side.
- You might also use the banana technique. This involves using one hand to propel the wheelchair with two propulsions. The chair will start to veer to one side so at this point, you’ll brake slightly to bring it back on course and then repeat.
Opening a Door While Propelling a Wheelchair
There may not always be an automatic door or someone to hold a door open for you. For these reasons, it’s important that you learn how to move through doors in your wheelchair.
- Approach the door at an angle so you are easily able to reach the handle.
- To keep yourself balanced and stable, make sure to keep one hand on a hand rim while the other reaches forward for the handle and pulls to open the door. Note that if it is a very heavy door, you may need to stabilize yourself by placing one hand on the frame as opposed to the hand rim.
- Use your hand or elbow to hold the door open as you push your wheelchair through it.
- For push doors, take hold of the handle and push forward at the same time as propelling the wheelchair with your free hand.
Turning a Wheelchair
You will need to learn how to turn your wheelchair to either move around corners or obstacles and to change direction. When turning in tight spaces, things can be difficult depending on the dimension of the wheelchair. Choosing a wheelchair with a more compact turning radius is important if you’re going to be using it indoors.
- To turn when stationary, place one hand on the front of a hand rim and the other on the back of the other hand rim.
- Move the front hand backward and the backhand forwards simultaneously to turn.
- If you are turning whilst on the go, then you will need to take a firm grip on the left-hand rim.
- Using the right hand, propel the right wheel to turn left.
- Reverse this to turn right.
Useful Propulsion Aids for Manual Wheelchairs
Learning the right techniques is a great way to make propelling your manual wheelchair much easier. But there are also aids you can purchase to make life even less complicated.
Push Rim Covers
Push rim covers, as the name suggests, are fitted over the hand rims of your wheelchair. The idea is that they aid in propulsion, making it more comfortable and less tiring.
These aids can be custom-made to fit your wheelchair, or you can purchase generic ones. The main benefits include a much better grip on the rim, saving you from having to wear gloves.
What’s more, the push rim covers are ideal for people with limited dexterity as grip will be easier, allowing them greater control.
Everything feels much more comfortable and as a direct result of this, you’ll experience less fatigue from propelling your wheelchair.
If you have trouble propelling your wheelchair using the hand rims then propulsion levers might benefit you. The innovative NuDrive propulsion levers have been praised for their effectiveness. Instead of taking hold of the hand rims, you use the levers to propel which is less tiring and much easier.
One of the best things about these levers is that they will reduce strain on your shoulders, so degradation will be delayed. Moreover, the levers can be fitted to most manual wheelchairs and are secure enough that they’ll remain in position.
There is also evidence to show that using propulsion levers improves your posture. This means less pain and discomfort, plus other benefits such as easier breathing.
Using propulsion levers is also much more hygienic as your hands won’t be coming into contact with the wheels. You’ll also notice that you have much greater control over the movement of the wheels even when conditions are less than ideal such as when moving on a wet floor.
When manually propelling your wheelchair, it is possible to catch your fingers in the spokes, which can cause injuries. To reduce the chances of this, you could use spoke guards. These are simply shields that fit over the spokes so you won’t come into contact with them. Not only will they offer protection, but they’ll also make you feel less anxious when moving around.
If you find that you struggle when moving up ramps and inclines, then a grade aid can be a useful addition to your wheelchair. These aids will prevent your wheelchair from rolling back and aid in propelling you forward, which means you have to do less work.
Grade aids are ideal for people with upper limb weakness, and even when the hands are not on the rims, the wheelchair will not roll back. They’ll reduce the risk of injury and help to make you feel more confident.
Wheelchair gloves are simple aids that can make a huge difference to your quality of life and how easy it is to use your wheelchair.
These padded gloves are designed to make propelling your wheelchair more comfortable and reduce the risk of things like calluses. Much more than this, the gloves are designed to stabilize and support the hands so you will have less joint and nerve pain owing to reduced pressure.
Wheelchair gloves have improved grip, so you’ll find it a lot easier to grip your hand rims and this will give you better control over your wheelchair.