Bedsores most often develop on the bony parts of the body that have little padding of muscle and fat — the spine, tailbone, buttocks, shoulder blades, hips, heels and elbows. Any part of the body that rests against the wheelchair or presses against the surface of a firm mattress for a prolonged period of time is in danger of developing a bedsore.

Here’s why: the prolonged pressure temporarily cuts off blood supply to the skin, which causes damage to the cells. Surprisingly, the pressure doesn’t even have to be intense. Normally, our skin is protected from injury because we move frequently—mostly unconsciously–even while we sleep. People with SCI don’t move automatically, so they train themselves to do “pressure releases,” which reposition their bodies, as part of their everyday lives. These, too, can become almost automatic over time.

These drawings illustrate the parts of the body that are likely to develop bedsores:

Spinal cord injury expert, Mary Zeigler, explains how to position your body in bed to avoid bedsores: