Whether you use a manual or a powered chair, your shoulders and upper body do a lot of work every day. Transferring in and out, reaching for things, steering and, for some people, pushing all rely on your arms and shoulders. Looking after them now can help keep them comfortable and working well for years to come.

Why shoulders work so hard

Shoulders are built for a huge range of movement, but they are not naturally built to bear weight in the way legs are. For wheelchair users, the shoulders often take on jobs the legs would usually do, like lifting your body weight during transfers, reaching from a seated position and moving your chair.

Shoulder pain is common in wheelchair users. The good news is that how you transfer, how you reach and how strong your shoulders are can all make a real difference, whatever type of chair you use.

Transfers

Transfers put a lot of load through your shoulders, especially when you push your body weight up. Some things that can help:

• Try to transfer between surfaces of a similar height where you can.
• Alternate which arm leads, rather than always using the same one.
• Keep your hands close to your body and avoid reaching far to the side.
• Use a transfer board or other equipment if it suits you, especially for larger gaps or height differences.
• Try to limit the number of transfers you do in a day where possible, by planning ahead.

Reaching and everyday tasks

Reaching overhead, forward or far to the side from a seated position can add strain. Some ideas:

• Keep things you use often within easy reach, between waist and shoulder height.
• Use a reaching aid for high shelves.
• Move your chair closer to what you need, rather than stretching.
• At a desk, pull in close so your forearms can rest and your shoulders can relax.

If you use a powered chair

Steering a powered chair is much lighter work than pushing, but holding your arm in one position for long periods can still leave your shoulder and neck feeling tired. Some things that can help:

• Make sure your forearm is well supported on the armrest while you use the controls.
• Check the controls are positioned so you can use them without reaching forward or lifting your shoulder.
• Let your hand relax on the controls, rather than gripping firmly.
• Take short breaks to let go, move your shoulders and change position.

If the controls or armrests do not feel right, your wheelchair team or occupational therapist can help adjust them.

Building shoulder strength

Strengthening the muscles at the back of your shoulders and around your shoulder blades helps balance out the muscles at the front, which tend to do more of the work. Research in wheelchair users has found that a home exercise programme focused on shoulder strength and stretching reduced shoulder pain.

Something to try two or three times a week, adapted to what feels comfortable for you:

• Shoulder squeezes. Sit tall, draw your shoulder blades back and down, hold for five seconds, then relax.
• Rows. Pull a resistance band towards you, squeezing your shoulder blades together.
• Outward turns. With your elbow tucked into your side and bent, hold a resistance band and slowly turn your forearm outwards, then back.
• Lowering your shoulders. Sitting tall, gently draw your shoulders down away from your ears, hold, then relax.

If you would like to follow along, VIDA has short videos of shoulder squeezes you can use at your own pace. Start with light resistance and build up gradually.

Stretching the front of your shoulders

The muscles at the front of your chest and shoulders can become tight from time spent sitting, reaching and pushing. Something to try once or twice a day:

• Sitting tall, clasp your hands behind your head and gently draw your elbows back.
• Place your forearm on a door frame at shoulder height and gently turn your chair or body away.

Reading how your shoulders respond

A mild ache after exercise that settles by the next day is usually fine. If your shoulder is sorer the following morning, ease back a little. Building up gradually helps your shoulders adapt without adding to their daily load.

When to get it checked

If shoulder pain is starting to make transfers or everyday tasks difficult, it is worth speaking to your GP, physiotherapist or wheelchair team.

Your VIDA pain check-in can help you notice how your shoulders change over time.

What to take away

• Your shoulders do a lot of extra work as a wheelchair user, whatever type of chair you use.
• Transfer between similar heights and alternate your leading arm.
• Keep your forearm supported and your hand relaxed on powered chair controls.
• If you push your own chair, use long, smooth strokes.
• Strengthen the back of your shoulders and stretch the front regularly.

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