What do patients need to know about wheelchair transfers after a spinal cord injury? - Elaine Rogers, PT

The big perception is that the number-one safety thing that you should do is lock your brakes on your wheelchair. And not that locking your brakes is something you shouldn’t do, but more than that, it’s your skill and your ability in transfers are what make it safe. If I have locked brakes on my wheelchair and I accidently use my arm and push the wheelchair away from myself, it doesn’t matter if I have breaks on the chair. If I have my brakes locked and I have no tire pressure in my wheels, then my breaks don’t hold and it’s doesn’t matter that they’re locked. So what I need to focus on is becoming very skilled at transfers, and working with your therapist to maximize your skill so that you’re not creating forces that move the wheelchair while you’re trying to get into it. The other key thing really important for transfers is watching arm positions in terms of shoulder preservation, not putting your arms up on things that are going to put your arm in what’s called an “impingement position” that’s going to damage the shoulder joint or damage your wrist joint, and there’s lots of different techniques your therapist can show you for that. And then making sure that you get lift in your transfer, so your bottom is coming up off the surface so that you’re not creating shearing forces and skin issues for yourself.