Long-Term Manual Wheelchair Use: Common Health Risks and How to Prevent Them

More often than not, people who use wheelchairs develop health conditions over time from using manual wheelchairs. This could be as a result of several months or years of putting strains on your wrists, back, and even heart from consistently pushing, turning, and maneuvering. 

The discomfort is not something to be endured as it can become something riskier sooner or later. That's why you should know what you're getting yourself into if you want to use a manual wheelchair for a long period. 

Common Health Conditions From Long-Term Manual Wheelchair Use 

Listed below are some of the common health conditions that most manual wheelchair users experience after a long period of use: 

Shoulder Pain and Overuse Injuries

People who use manual wheelchairs for a long time are usually prone to pain in the shoulders considering that they push continuously over long distances. 

This might even cause inflammation or damage the tendons in the rotator cuff which in the long run, is likely to result in either tendinopathy or tears. An extensive review indicated that nearly 44% of users of manual wheelchairs suffer from shoulder pain. 

Wrist and Hand Strain

Pushing a manual wheelchair can often lead to the tendons and nerves in the wrists and hands getting strained. This increases the risk of nerve-compression diseases such as Carpal tunnel syndrome, which causes a feeling of numbness, tingling, and weakness in the hands. 

Upper Back and Neck Pain

Leaning forward for a long period to push the wheelchair not only causes poor posture but muscle strain in the upper back and neck. As a result, the muscles may over time become tight, sore, and painful if the seat is not properly adjusted. 

Pressure Sores

Staying in the same position for several hours, especially when the seat is not properly adjusted and the posture is poor, raises the pressure on the skin and tissues in some areas. 

This is a major problem for people using wheelchairs, as they are very likely to get pressure ulcers (sores), mainly in the bony or weight-bearing spots, because continuous pressure cuts-off blood supply and damages skin quality.

Fatigue and Reduced Endurance

Relying on the arms and upper body for movement instead of legs results in faster upper limbs fatigue. Continuous effort causes exhaustion and might even result in less mobility, making daily activities more exhausting. As a result, most people who use manual wheelchairs encounter tiredness and lesser stamina as the use of the chair prolongs.

Joint Stiffness and Limited Range of Motion

Pushing a manual wheelchair without regular stretching or variation can cause muscles and tendons around joints to tighten. This can further lead to reduced flexibility and limited range of motion, making it harder to perform rotations or reach movements.

Risk Factors That Make These Conditions Worse 

Here are some factors that worsen these health conditions: 

Poor wheelchair fit

According to nchpad.org, a wheelchair that doesn't fit properly may be because of the seat size, backrest, armrests, or footrests can cause uneven pressure and poor posture. This may lead to pressure sores or worse still, musculoskeletal problems due to long sitting and pushing around. 

Weak upper body muscles

An article published by PubMed explains how the upper body (shoulders, arms, back) can suffer from overuse and strain and can result in weakness relative to what is required to push a wheelchair manually over long distances. 

Uneven surfaces or long distances

With repeated long-distance pushing in uneven terrain, fatigue and pain can set in, making mobility unsustainable, reducing activities, and most importantly, the user might be forced to transition to a powered wheelchair. All these put together affect the user's overall health. 

How to Reduce These Health Risks 

It's one thing to be aware of the various conditions using a manual wheelchair for a long period poses on your health and another thing to know how you can reduce these risks. They're as follows: 

Regular stretching

Stretching maintains the flexibility of the shoulder, wrist, and arm muscles and reduces stress that accumulates and causes pain or tendon irritation. 

Research indicates that manual wheelchair users who push for around 6 months, stretch their shoulders and strengthen the muscles, resulting in about a 40% reduction in shoulder pain. This prevents stiff shoulders and reduces flare-ups after long pushes.

Proper Wheelchair Adjustments

A wheelchair that's somewhat off—either too low, too high, or with the axle shifted back—can gradually harm the body without any signs. The WHO Assistive Products Guidelines underline that a proper fit is just as important as strength or endurance.

If the chair is compatible with the user's body, then pushing requires less power and the shoulders remain within a safer range of motion. Adjusting the wheelchair helps to get rid of the hidden strain that builds up over months of use.

Using Gloves or Pushing Aids

The hands are the first to suffer the impact, and as such, there's a need to protect them. As reported by NCHPAD, the use of gloves lowers friction, absorbs pressure, and also allows firm grip under conditions like wet or rough rims. 

Pushing aids such as rubber-coated rims or ergonomic push grips offer a smoother grip and require less force from the wrist. These tools are not only effective in preventing blisters but also in reducing the risk of tearing the shoulder tendons. 

 Consider Powered Wheelchair Options

According to a study in JRRD, powered wheelchairs reduce the burden on the shoulder, mainly on slopes and on long rides. The user controls their movement properly rather than fighting every push. 

Motorized wheelchairs do not take away the user’s freedom, but rather enhance it. The shoulders, wrists, and elbows are kept functional for daily activities with decreased strain. 

If you're interested in electric wheelchairs, check out the XSTO M4 Self-Balancing Slope Climbing Wheelchair.

Wrap Up 

It's important to pay attention to your body, and if need be, adjust your equipment or better still, adopt protective habits to stop minor strain from turning into long-term injury. This way, you are not only avoiding pain but protecting your mobility, comfort, and independence.