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Pressure relief techniques for wheelchair users

Gentleman in a wheelchair being assisted by his wife

Pressure sores, also known as pressure ulcers or bedsores, are a very common injury. The NHS estimates that almost 500,000 people in the UK will develop at least one pressure sore in any given year.

A common belief is that only people who are bedbound develop pressure sores. That’s why they get called bedsores, right? But really, anyone can develop pressure sores and there are other factors that put people at greater risk.

Wheelchair users are among those that are more likely to develop pressure sores. Individuals who are confined to their wheelchair for most of the day are at particularly high risk. So, if you, a relative, or a patient regularly uses a wheelchair, read on for our top three pressure relief techniques for wheelchair users.

What is a pressure sore?

A pressure sore is an injury that develops when an area of skin is put under pressure for a prolonged period. The severity can differ, ranging from skin discoloration and itchiness in the affected area through to deep open wounds which are extremely painful.

Regularly relieving pressure is the most effective way to prevent pressure sores. Let’s look at the different pressure relief techniques and tools that are suitable for wheelchair users.

1)    Perform Pressure Relief Exercises

One of the best pressure relief techniques for wheelchair users is to regularly carry out specific pressure relieving movements. Here are some popular exercises to try:

Please remember to check that your wheels are locked, and any belts are undone before attempting any exercises.

  • The push-up – Use the wheelchair armrests (or wheels if you don’t have any) to push up out of the seat with your arms. You should straighten your arms fully so that your elbows are locked. Then ensure that the buttocks and lower back are fully out of the seat.
  • The forward lean – Lean forward as far as you can – imagine that you are trying to rest your chest on your knees! This movement is particularly good for relieving pressure on the coccyx.
  • Leaning side-to-side – Whilst seated, shift your body weight onto your left side to lift your right side out of your seat. Then repeat on the other side. Like the push-up, this movement relieves pressure from the buttocks and the lower back. However, because this is a more subtle movement it’s great to perform whilst you’re out and about!

The purpose of these exercises is to shift your body weight around in the wheelchair, relieving pressure from the areas where it is most commonly felt.

General advice suggests performing each movement for 15 seconds for every 15 minutes of wheelchair use. So, if you had been sat in your wheelchair for 30 minutes, you would exercise for 30 seconds. But we always recommend speaking to your doctor or physio first to find out what is best for you.

Any of the three movements mentioned above can be performed independently, or with assistance, depending on individual mobility levels.

Pros and Cons

ProsCons
No specialist equipment requiredRequires some degree of mobility, or someone who is available to assist the user frequently
Only a short period of time is required to complete the exercisesWheelchair users may feel uncomfortable performing the exercises in public
Encourages regular movement in those using a wheelchair as part of a recovery programmeRequires the cognitive abilities to remember to perform the movements at regular intervals

 

2)    Use pressure relief aids

Unfortunately, not all wheelchair users are able to perform pressure-relieving exercises. That’s one of the reasons why pressure relief aids like wheelchair cushions and heel pads are another great option.

What is a pressure cushion?

A pressure relief cushion is one of those items that really does ‘do what it says on the tin’. They provide a layer of cushioning – made from foam, gel or air – which acts as a barrier between the user and their wheelchair, relieving pressure from the areas of the body that typically come into the most contact with the chair.

Pressure Relief Cushion

This pressure relief cushion has a moulded shape to help it contour the body

Choosing a pressure relief cushion

An important factor when choosing a pressure cushion for wheelchair users is ensuring there is a close contour against the user’s body. This maximises surface area to help reduce pressure.

Another thing to note is that cushions can also be categorised into three risk bands – low risk, medium risk, and high risk. A higher risk band means that the cushion is designed for a wheelchair user who is more likely to develop a pressure sore.

Gel, foam and air pressure relief cushions can all be categorised as either low, medium or high risk cushions. It is not the material that determines the risk band, how effectively they relieve pressure is the key.

However, alternating air cushions are typically considered the ultimate high-risk cushion. This is because they actually change pressure over time. Air is moved from cell to cell inside the cushion, so pressure to builds up in one area before moving onto another area. Unfortunately, users often find them less comfortable than standard air, gel or foam pressure cushions. So, it is best to only use them when it is really necessary.

If you need help understanding the risk bands, or finding the right pressure relief cushion for you, please give us a call or visit us in the showroom. Someone from the Yorkshire Care team will always be happy to help!

What is a heel pad?

A heel pad is a specially designed piece of material that is strapped around the foot to protect against pressure sores. For wheelchair users, they are useful for protecting the lower part of the leg which comes into contact with the wheelchair frame.

Shear Heel Pads

These heel pads are multi-purpose, they can also be used to protect the elbows, arms, and palms

They are also sometimes referred to as heel cushions, as they are often used together with a pressure relief cushion. It is important to remember that the lower back and buttocks aren’t the only areas at risk of pressure sores in wheelchair users and therefore aren’t the only areas that need protection.

Pros and Cons

ProsCons
Relatively affordable and widely available online and in shopsPressure cushions can cause a pressure ulcer if not used correctly
A wide range of aids are available to suit different wheelchair users needsThey can reduce some users’ ability to move around independently using their wheelchair.
They offer pain relief as well as being a preventative measure

3)     Get a Modified Wheelchair

If you have tried pressure relief exercises and aids but are still experiencing pressure ulcers, it may be that your wheelchair does not have the correct seat dimensions for you.

When we put together our specialist seating assessment guide, we found that if a care chair has a seat depth that is too high, then the user’s feet won’t be properly supported and 94% of their body weight will be going through their buttocks and thighs! That seriously increases the pressure levels in those areas.

These principles also apply to wheelchairs, so getting the seat properly sized is crucial for pressure relief and avoiding ulcers.

Tips for seat sizing

The key measurements to take are:

  • Seat Height
  • Seat Depth
  • Seat Width
  • Armrest Height
  • Back Height

Do you remember that we said incorrectly using a pressure relief cushion can cause pressure sores? Well, that usually occurs due to using a pressure cushion in an incorrectly sized wheelchair.

Tape Measure

A tape measure should be used to take the required measurements

Getting your seat sizing measurements correct is key. If the measurements are inaccurate then the user is at an increased risk of pressure sores, as well as poor posture and other issues. Plus, because pressure sores can start developing in just a few hours it is important that sizing is correct from day one.

To get peace of mind, you’re always welcome to visit the Yorkshire Care Equipment showroom. Our team are pros with a tape measure and have been creating custom-built wheelchairs for decades!

We can offer advice on whether your existing wheelchair is the right fit for you or take measurements to help you choose your new wheelchair.

Tilt-in-Space Wheelchairs

As well as modifying your wheelchair so that the dimensions are just right, you can get specially designed wheelchairs with built-in features for positioning, posture support, and pressure relief.

They are called tilt-in-space wheelchairs. What makes these wheelchairs perfect for pressure relief is their ability to tilt the whole chair whilst maintaining correct body positioning with hip and knee angles at 90 degrees. This tilting allows the user to reposition their body weight to stop pressure building up in one area, without compromising proper posture.

Different wheelchair models have different ranges of tilt. For example, the Ibis allows a 30-degree tilt adjustment which can be easily operated by both the user or their carer.

Ibis Wheelchair in a tiled back position

Here’s what the Ibis wheelchair looks like when tilted back

Summary

Pressure relief exercises, pressure relief aids and having a bespoke wheelchair that suits your needs are all excellent pressure relief techniques for wheelchair users. Where possible, using a combination of all three is an effective way to reduce the risk of pressure sores. However, not everyone can perform exercises and pressure relief aids cause discomfort for some. Therefore, our number one tip is to make sure your wheelchair has the correct sizing dimensions for you.

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Leanne Godfrey

Leanne is our Marketing Executive, meaning she coordinates and writes some of our blogs, magazine articles, and brochures amongst many other resources. She also takes care of all our social media profiles, so feel free to send her any blog ideas you have!

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