18 replies to this topic

[ETW Grumpy]

I'm a C8/T1 incomplete, so I have no stomach muscle or lower back muscle control and I'm trying to figure out how I can sit up straighter. Currently I keep all my weight on my elbows against the armrests because I hold myself upright that way. When I relax, I look all "slumpy" and I'm not really comfortable. I'd like to do away with the armrests but I need them to stay straight. Also, I have some spinal curvature from years of bad posture, so sitting properly on my bottom doesn't work because I fall forward out of the chair. I hope this all makes sense.

[Scribbler]

ETW Grumpy, on Sep 23 2009, 01:52 PM, said:

I'm a C8/T1 incomplete, so I have no stomach muscle or lower back muscle control and I'm trying to figure out how I can sit up straighter. Currently I keep all my weight on my elbows against the armrests because I hold myself upright that way. When I relax, I look all "slumpy" and I'm not really comfortable. I'd like to do away with the armrests but I need them to stay straight. Also, I have some spinal curvature from years of bad posture, so sitting properly on my bottom doesn't work because I fall forward out of the chair. I hope this all makes sense.

You don't say how long you've been injured, which makes a big difference.
There used to be, and still maybe a thing where people didn't want arm rests, but I've always kept mine.
I find them ideal for leaning forward to take pressure off my bum, but I understand about feeling 'slumpy'.
I was fine when I was young, but now I'm much older I find my shoulders getting rounded plus its harder to lift my arms as high as i could.
In my home i had the room thermostat placed low so I could switch the heating on and off as i wished.
I'm now finding it harder to reach it.
Over the years I've developed a bit of a curved spine, but a lot of its down to old age. It certainly makes me lean to one side.
To try and correct this, I switch on my webcan when I'm at my computer and this shows how bad I'm sitting, so I try and correct it.
I don't give advice as we're all different, I'm just telling you of my experiences and maybe it will help.
Good luck
Mike

[Wynne]

I'm much the same as you two. Been in a chair just over 20 years now and I tend to lean to my left side, with my gut more pronounced on the right side. Given up worrying about my posture now, as long as I feel comfortable in the chair, that's all that matters. And yes, I do use arm-rests now after years without them and I find they help a lot, though they do restrict me a little when pushing. Swings and roundabouts...

[gordonr]

Grumpy,

I also have a high lesion.

The first thing to keep you straight is to avoid gravity bringing you forward. The whole chair has to be slanted backwards just enough to keep your body naturally leaning against the backrest when your arms are hanging free at your side and your head is up straight.

Obviously, when you extend one hand in front to touch something, you will be pulled forward and must work sith the other arm against that pull. But when you are at rest you should be straight and still against the chair back.

The basic angle of the chair is adjusted by moving the big wheels up and down on the frame.

As for arm rests. Note that your neutral position is with arms swinging free at your sides. Therefore, as soon as you put your arms on the rests, you are being pulled forward. Arm rests are the enemy of posture.

I used rests for about a year, and thought I could not survive without them. Then an airline lost one of my rests. I took off the other to make my position symetrical. After a week I was used to it, and I have never looked back. Absolutely outstanding improvement to posture and freedom of movement.

Lastly, along with the chair angle, you might want a little cushion to push out your lumbar region. This will also lean you up against the chair back better.

Good luck,

Gordon

[ETW Grumpy]

Thanks for the input all. I've been injured 2 years yesterday.

I've got a new chair coming soon, a Quickie GT, so I'm hoping I can work with the PT to get it set up right. The chair I'm in has never been comfortable. When I told the V A doc about the posture problem, she said, "Find a way to get comfortable." and walked off. Wish I'd have had something heavy in hand.

I'll keep your suggestions in mind when I go to get fitted for the new chair.

[nomis]

Keep working with and hassling, if necessary. your wheelchair therapist. There's lots that can be done with different cushions, wedge-inserts and the same goes for the backrest. It's not right till you're comfortable and that can take a lot of trial and error and patience. You've got many fruitful years ahead so it's worth sorting any possible postural problems now.

[gordonr]

Grumpy,

I disagree somewhat from the nomis opinion. Wheelchair therapists are like all therapists. Aside from the true rare pearl, they will never get you set up right.

Take the time to inform yourself on the theory and practice of wheelchair adjustment. Only the broad strokes are neccesary.

If you ask specific questions here on this forum, you will get much better responses than at the hopsital/rehab/chair-dispensary.

Best Regards,

Gordon

[wheeliebear75]

I had arm rests on my 1st 2 chairs, none on my 3rd & 4th, & I have removable swing aways on my newest chair & I LOVE them. I can pick & choose when I want them or don't. I have a much lower injury than you but like scribbs said "we're all different". One other thing to look at would be the fitting of the chair itself; they can do some adjustments as to your posture by making the seat lean back or sit more forward......just depends (you didn't say if this was a manual or an electric chair).

[ETW Grumpy]

The new chair is a manual, as is the one I'm in now. If I could find a chair that the backrest would lean back more than the stock settings, it would solve the problem. I've researched all the chair manufacturers, and the backrests only go back past vertical a couple of degrees, if at all. The other solution that is usually recommended is to add more dump. That creates the side effect of making transfers more difficult. If a chair back could be made to "recline" relative to the seat several more degrees, the problem would be solved. I'm actually thinking about contracting a fabrication shop to do that very thing. Is there anything else I can do to rectify the problem before I go to the (considerable) expense of having this done?

Also the new chair will have swing away armrests, so it's good to know they come off pretty easily. Thanks wheeliebear.

[Avocado Baby]

Hi there,

I have exactly the same problem. I'm 28 and been in a wheelchair all my life. I have Spina Bifida and have developed quite severe scoliosis and now kyphosis. I've just had a postural support put on my chair which helps but they tried giving me a bucketed cushion (J2) and I was quite alot of pain and discomfort with it so I'm not sure about the 'tipping' back idea, although I understand the idea.

Sorry...I didn't mean to hijack your thread. What I was going to suggest was, can you sit with your hands under your thighs, just past your knees? I used to do that all the time to push myself up and it was really comfortable.

Good luck. I'd be intersted to hear how you get on and if you have any good ideas.

[ETW Grumpy]

Avacado Baby, I usually sit with my elbows on the arm rests to push myself upright, but that has pinched a nerve in my forearm causing continual pain in that arm. The new chair is supposed to have some lumbar support, so I hope I can get it all rigged up right. Thanks for all the input folks. I'll post again when I get the new chair.

[gordonr]

ETW Grumpy, on Sep 24 2009, 03:49 PM, said:

The new chair is a manual, as is the one I'm in now. If I could find a chair that the backrest would lean back more than the stock settings, it would solve the problem. I've researched all the chair manufacturers, and the backrests only go back past vertical a couple of degrees, if at all. The other solution that is usually recommended is to add more dump. That creates the side effect of making transfers more difficult. If a chair back could be made to "recline" relative to the seat several more degrees, the problem would be solved. I'm actually thinking about contracting a fabrication shop to do that very thing. Is there anything else I can do to rectify the problem before I go to the (considerable) expense of having this done?

Also the new chair will have swing away armrests, so it's good to know they come off pretty easily. Thanks wheeliebear.

Grumpy,

What is "dump" ?

Best,

Gordon

[Ches]

Everything to know about dump http://www.spinlife....Angle/a/321/c/3

[gordonr]

Ches, on Oct 2 2009, 03:46 AM, said:

Everything to know about dump http://www.spinlife....Angle/a/321/c/3

Ches,

Thanks,

This is what I was talking about in an earlier post in this thread. But there some new twists I was unaware of.

Increasing dump while maintaining the chair uprigtht tightens the angle between the thighs and abdomen. I imagine this is an issue with fixed folding back chairs, of which I have no experience.

In the old style "x" form folding chair dump is achieved by moving the wheel axles higher on the frame. In this case, the angle of body/legs stays the same, because it is the whole chair which is tilted back, not just the seat. This is what I have, and I think it is good.

However, if the dump is making transfers difficult, It would be possible to put a spacer under the back edge of the cushion, using a rigid support like a sheet of plywood under the cushion. In this case, if the whole chair is tilted back, the back is tilted back, and if the back edge of the cushion is moved up, then the seat is flat for transfers. This would be the same effect as a reclining back, but simpler, as there is no reclining mechanism.

Best Regards,

Gordon

[Johnny V]

ETW Grumpy, on Sep 23 2009, 01:52 PM, said:

I'm a C8/T1 incomplete, so I have no stomach muscle or lower back muscle control and I'm trying to figure out how I can sit up straighter. Currently I keep all my weight on my elbows against the armrests because I hold myself upright that way. When I relax, I look all "slumpy" and I'm not really comfortable. I'd like to do away with the armrests but I need them to stay straight. Also, I have some spinal curvature from years of bad posture, so sitting properly on my bottom doesn't work because I fall forward out of the chair. I hope this all makes sense.

Do you have any burning type sensation in your torso anywhere?

[StillFingers]

ETW Grumpy, on Sep 23 2009, 05:52 AM, said:

I'm a C8/T1 incomplete, so I have no stomach muscle or lower back muscle control and I'm trying to figure out how I can sit up straighter. Currently I keep all my weight on my elbows against the armrests because I hold myself upright that way. When I relax, I look all "slumpy" and I'm not really comfortable. I'd like to do away with the armrests but I need them to stay straight. Also, I have some spinal curvature from years of bad posture, so sitting properly on my bottom doesn't work because I fall forward out of the chair. I hope this all makes sense.

Grumpy,

Have you ever tried an abdominal support binder, see link below. I have worn one since my injury, back in '78. It helps with my balance and as you put it, it helps with not looking slumpy. I use mine when driving, when out shooting pictures and when working out, going out. Being a c5/6 with a few years in chair and little to no abdominal/back muscles, I find the extra support a huge benefit.

My better half sews and she adds several pieces of semi-rigid boning to the binder to give me more vertical support. This boning is semi-flexible so as not to restrict movement to much, while still adding additional support. Another word for this type of binder is corset. The binder below is made of a soft elastic material, is constructed of two pieces and has a wide piece of velcro, from top to bottom, that allows for easy adjustment/closure. I use this binder as a starting point, adding the boning as needed.

If you think this might help, send me a message. You can also contact your local orthotics department, physical or occupational therapy departments for info.

Surgical Binder & Abdominal Support
http://www.futuro-us...tail.aspx?id=35

Regards,

Jerry

Edited by StillFingers, 04 October 2009 - 11:13 PM.

[NorCalQuad]

gordonr, on Sep 23 2009, 07:56 AM, said:

Grumpy,

I also have a high lesion.

The first thing to keep you straight is to avoid gravity bringing you forward. The whole chair has to be slanted backwards just enough to keep your body naturally leaning against the backrest when your arms are hanging free at your side and your head is up straight.

Obviously, when you extend one hand in front to touch something, you will be pulled forward and must work sith the other arm against that pull. But when you are at rest you should be straight and still against the chair back.

The basic angle of the chair is adjusted by moving the big wheels up and down on the frame.

As for arm rests. Note that your neutral position is with arms swinging free at your sides. Therefore, as soon as you put your arms on the rests, you are being pulled forward. Arm rests are the enemy of posture.

I used rests for about a year, and thought I could not survive without them. Then an airline lost one of my rests. I took off the other to make my position symetrical. After a week I was used to it, and I have never looked back. Absolutely outstanding improvement to posture and freedom of movement.

Lastly, along with the chair angle, you might want a little cushion to push out your lumbar region. This will also lean you up against the chair back better.

Good luck,

Gordon

Great insight. im c5-6 incomplete quad that is 2 1/2 years post.

i, myself do not have my arm rest on my manual chair but, i do occasionally use my power chair(im a bit self-concious when im in my power chair) for comfort. back to the subject at hand, i was wondering what kind of chair do u use? the reason i ask is because im having the same problem as our friend.

[nikki buckley]

ETW Grumpy, on Sep 23 2009, 12:52 PM, said:

I'm a C8/T1 incomplete, so I have no stomach muscle or lower back muscle control and I'm trying to figure out how I can sit up straighter. Currently I keep all my weight on my elbows against the armrests because I hold myself upright that way. When I relax, I look all "slumpy" and I'm not really comfortable. I'd like to do away with the armrests but I need them to stay straight. Also, I have some spinal curvature from years of bad posture, so sitting properly on my bottom doesn't work because I fall forward out of the chair. I hope this all makes sense.

hi im a c4/c5 incomplete and have the same problem i fall to the right side and forwards, i have curvature of the spine caused through my spasms. seven years ive been injured and with having physio twice a week my spine is alot straighter. When im in my chair i have latteral supports
but i still need my arm rests. also iv made
a belt to go around my waist and back rest to keep me in.

[russ1]

ETW Grumpy, on Sep 24 2009, 03:49 PM, said:

The new chair is a manual, as is the one I'm in now. If I could find a chair that the backrest would lean back more than the stock settings, it would solve the problem. I've researched all the chair manufacturers, and the backrests only go back past vertical a couple of degrees, if at all. The other solution that is usually recommended is to add more dump. That creates the side effect of making transfers more difficult. If a chair back could be made to "recline" relative to the seat several more degrees, the problem would be solved. I'm actually thinking about contracting a fabrication shop to do that very thing. Is there anything else I can do to rectify the problem before I go to the (considerable) expense of having this done?

Also the new chair will have swing away armrests, so it's good to know they come off pretty easily. Thanks wheeliebear.

I'm virtually the same level as you for all intents and purpose and 6 yrs post - I was having the exact same issues as you before I got my new chair - that i was sitting slumped and becoming hunched and uncomfortable and have solved it by going the opposite way to you - by making the backrest MORE upright. If you want to sit up straight I can't see how leaning back more is going to help you. I had my back as far forward as it would go and couldn't get upright (I run about 2.5 inches of dump). Since getting a new chair (same dump) I'm now much more upright by having the backrest more upright (and have a lower backrest - about 6 inches lower than my injury level). I now sit a lot taller in my chair and don't curve my shoulder anywhere near as much as I used to. I think you're moving in the wrong direction.

I've also adjusted my seat slings to give me an ergo seat effect (rear half of seat is flat, front half creates the dump) which helps too.

With transfers just move to the front of the seat before transferring - it's by far the best way as solves the issue with the dump and gets you in front of the wheels so you don't have to lift over them. Dump is your friend for stability, especially when you don't have core muscles.