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Maximising Comfort: A Guide to Transfers and Positioning in Manual Wheelchairs

Yes, a wheelchair empowers you with mobility, but your ability to transfer in and out of it independently is what gives you the freedom to truly enjoy your daily activities.

What a wonderful thought!

With independent wheelchair transfers, you don’t have to rely on others to complete basic tasks such as getting in and out of bed, using the bathroom, getting dinner for the cat or getting into your car for a new adventure.

As you go about your daily activities, the big question is, are you transferring to and from your wheelchair using the correct techniques, or, are uncomfortable transfers your norm?

Transferring and positioning yourself in a manual wheelchair doesn’t have to feel like mountain climbing. There’s a better way to do it to improve your level of comfort.

As we walk you through these proper techniques, you’ll also happily learn about:

  • The health issues that come with incorrect transfers
  • A simple transfer aid you can use during the process
  • The importance of positioning yourself correctly
  • How to relieve pressure while in a wheelchair

Table of Contents

A Brief Overview on Manual Wheelchair Transfers

woman in a wheelchair

When you transfer in and out of your wheelchair, your arms and shoulders experience the most strain because they’re supporting most of your body weight. It’s no wonder that up to two-thirds of wheelchair users report shoulder pain at some point.

On average, a wheelchair user makes several basic transfers per day getting in and out of bed, using the bathroom or getting into their car.

How many transfers a person makes in a day will depend on the individual. However, the more transfers you make, the higher your risk of pain.

Some painful conditions affecting wheelchair users could include:

  • Sprains and strains: Caused by falls, especially if the brakes aren’t locked and the wheelchair moves during transfer
  • Carpal tunnel syndrome: Affects the wrists when a wheelchair user supports their weight often using the palms of their hands
  • Rotator cuff tears: Occur with overuse or misuse of the shoulder muscles on a daily basis 
  • Elbow pain: Elbows become painful when you use your hands often during transfers

Despite the importance of transferring correctly to avoid such conditions, not all wheelchair users receive proper advice from health professionals. Others, perhaps even you, rely on observation, personal research or trial and error.

If you dread doing your daily transfers because of the discomfort you experience, it’s time to change things and resort to better techniques.

Keep in mind, as you apply the correct transfer techniques, you’ll minimise your risk of injury.

transfers and positioning in manual wheelchairs photo snippet

How to Make Manual Wheelchair Transfers More Comfortable

Transferring to and from your wheelchair can be done without a transfer aid, but if it’s really uncomfortable, you can use a transfer board.

A transfer board is a wooden or plastic board that bridges your wheelchair to another surface such as a bed, toilet or couch, allowing you to “cross over.”

To use a transfer board:

  1. Push your wheelchair close to the transfer surface at an angle, then lock the brakes and push back the armrest if it’s movable.
  2. Slide one end of the board under your thigh while the other end rests on the surface you’re transferring to.
  3. Support yourself with one hand on the visible end of the board and the other on the wheelchair, and make short movements across the board to the other surface.
  4. After transferring, lift your hip up and remove the board from under you. Repeat the process when moving back to your wheelchair.

Here are a few tips to ensure your transfer is as seamless as possible while maintaining maximum comfort:

  • Avoid hasty movements. Only move to another surface if you’re able to avoid falling and injuring yourself.
  • The wheelchair should be as close to your transfer surface as possible to shorten the distance you have to move and prevent straining.
  • Lock the wheelchair’s breaks so it won’t move back and forth. The foot pedals and leg rests should be out of the way to prevent tripping.
  • Don’t transfer with bare skin. Clothes will prevent the board from shearing your skin and causing sores to erupt.
  • Don’t plop down hard on the transfer board as you move across it; move slowly and  gently to avoid traumatising your buttocks.

The Correct Way to Position Yourself for Comfort

woman seated on a wheelchair

The way you position yourself in a wheelchair impacts the alignment of your spine and pelvis. It also affects your breathing and digestion.

How does this happen?

  • After years of incorrect sitting, your spine starts to shift, pulling the pelvis out of alignment.
  • Breathing can become shallow and painful because your diaphragm is constricted and therefore doesn’t allow you to take deep breaths.
  • You may also experience heartburn caused by indigestion. This happens because a pressed abdomen squirts stomach acid up the oesophagus, causing a burning sensation. 

Once you’re settled in your wheelchair, be mindful as to how you sit in order to decrease the risk of health issues, discomfort and fatigue.

So how do you position every part of your body to maximise comfort and minimise the risk of health issues?

Your Arms

Your arms do most of the work while transferring. To maintain the correct position and keep them comfortable, adjust the armrests to a level where your shoulders are neither slumped nor shrugged. That midpoint will be the correct level for your arms to rest comfortably.

Your Back

Sit upright against the backrest without leaning to one side. Your back and head are connected, so to prevent your back from leaning to one side, hold your head in a straight position and your back will follow suit.

Your Pelvis

Your buttocks should gently touch the backrest, which is only possible if your wheelchair is the right width. If the seat is too wide, your pelvis will slide from side to side, and if it’s too narrow, your pelvis may twist over time due to the pressure.

Adding a cushion to your seat provides a soft base for your buttocks and helps relieve pressure from your skin. Mobility Shop Direct has a wide range of pressure relief cushions to minimise the likelihood of pressure ulcers.

Your Feet

If your feet are too far in front, you will slouch, and if they’re too far back, your backbone will be overly straight and make you feel uncomfortable. 

To ensure the right balance, adjust your foot plates so that your knees and hips are at a right angle.

How to Reposition Yourself to Ease Pressure

When you sit for too long in a wheelchair, pressure accumulates and prevents proper blood circulation. You need to reposition to offload that pressure.

This pressure, if not released, can lead to pressure sores. These occur when your skin remains in one position for too long.

To relieve this pressure, there are a few exercises you can do independently:

  • Push ups: Hold your wheelchair’s armrests and lift yourself up so that your bottom lifts off the chair. Hold for as long as you can, then sit back down. Repeat three times.
  • Side to side lean: Lean toward one side of the wheelchair until one hip is lifted off the seat; hold for 30 seconds and repeat on the other side.
  • Forward lean: Bend forward and slide your hands under your bottom. Hold for 30 seconds and repeat every 30 minutes until you find relief from the pressure.

Another way to reposition yourself is by using a reclining or tilt-in-space wheelchair. It’s adjustable backwards so as to distribute pressure evenly across your body.

A tilt-in-space wheelchair and a reclining wheelchair are both useful to help relieve pressure, but they’re not the same. The table below showcases their differences.

Reclining Wheelchair Tilt-In-Space Wheelchair
Repositions your body’s posture due to its ability to recline all the way back and lay flat Only the seat tilts back. Your hip angle doesn’t change, so your posture remains the same
Can be used independently Requires assistance
Travel-friendly since it’s not very bulky Bulkier than a reclining wheelchair and therefore not travel-friendly
Risk of sliding and shearing your skin when the wheelchair is reclined No risk of sliding since your hip angle remains the same even when the chair tilts
Less expensive than tilt-in-space wheelchairs More costly due to its complex design

Since each chair has its pros and cons, the best repositioning chair is a combination of both. You can find them at Mobility Shop Direct.

Check out our Tilt Recline Adjustable Wheelchairs.

tilt recline wheelchair

DRIVE ID SOFT Tilt and Recline Wheelchair Multi Adjustable

tilt recline wheelchair

DAYS Tilt and Recline Adjustable Wheelchair

These adjustable tilt and recline wheelchairs are designed to relieve pressure, promote blood flow, help manage spasticity and improve sitting tolerance.

You can make adjustments to the wheelchairs, such as:

  • Seat depth
  • Knee angle
  • Seat width
  • Seat back height
  • Seat back angle
  • Lower length

With such a wide range of adjustability, these chairs can be perfectly fitted to each individual.

“Our son has used it for over a week and absolutely loves how comfortable this tilt and recline chair is.”
Joanne V 

The best thing is that our tilt and recline wheelchairs are foldable for easy transportation so you won’t miss out on any fun while travelling. 

Maximise Comfort With Correct Transfer and Positioning Techniques

When you transfer and position yourself correctly, you minimise the risk of health issues associated with everyday wheelchair use.

Likewise, learning how to reposition yourself ensures you release any accumulated pressure from the skin, preventing pressure sores from developing.

Only a well-designed wheelchair allows you to position your body comfortably for long periods. From foldable tilt and recline models to self-propelled wheelchairs, Mobility Shop Direct has comfort, mobility, and independence at your disposal.

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