Wheelchair Mobility
Book Excerpt – Wheeling
The most important thing to learn or teach in wheelchair mobility is how to wheel properly. This is the foundation upon which all other skills will be built. If you don't wheel properly, your body and hands will be in the wrong positions to do the necessary maneuvers, such as jumping a curb. So please, learn to wheel properly and the rest will be simple.
When wheeling, several things occur at the same time. Let's start with the hands and add the head and body later.
The Hands
To begin, place your hands on the wheels at about 10:00.
Now, without moving the chair, just slide your hands up past 12:00 and down to 3:00.
At this point, you simply let go of the rims and let your arms fall
while bringing them back to 10:00 to start again. Do not lift your hands back over the handrims (3:00-12:00-10:00).
We are looking for a smooth circular motion of your arms which should look like an old steam locomotive.
This technique requires the least amount of effort to accomplish a complete stroke.
Bringing your hands back over the top of the wheel is by far the worst and most common mistake people in wheelchairs make.
Avoid this bad habit at all costs. (Click the photos for a larger image.)
Let's try gently moving the chair forward just to get the feel of the hand motion. Reach back and start at a comfortable spot. Don't try to take too big of a push. Keep your hand motion smooth and notice how easy it is to get your hands back to 10:00.
The Head
Now that your hands know what to do, let's get your head and body into the act.
Your head is always the first part of your body to move in the direction you want to go.
Since we want to move forward, simply tilt your head forward and use its momentum to get the rest of your upper body moving.
You will actually be losing your balance momentarily to do this.
Before we start moving, I want to illustrate the importance of using the head and trunk with the following illustration.
Sit up straight and place one of your hands at the end of its stroke (2:00).
Now lean forward and let your hand slide along the handrim.
Notice that you are gaining about four or five inches in your stroke by leaning forward.
This represents about a 30% to 40% increase in your stroke,
but actually you will get at least 100% to 200% more distance with each push
because this is the "Golden Area" of your stroke. (This applies to all wheelchair users.)
As your body is moving forward, begin pushing forward with your hands to maintain your balance.
As the chair glides ahead and your hands approach 3:00,
arch your back and bring your head and torso back to its starting position.
This should occur just as your hands are finishing their stroke and are returning to the 10:00 position.
Your body should be sitting fully upright just before your hands return to their 10:00 placement.
The Shoulders and Arms
Great. One more step and you will be ready for some serious cruising. All we have to do is add the final ingredient, a little kick that will help you to fly. This kick comes from depressing your shoulders and straightening your arms simultaneously, right at the end of your stroke in the "Golden Area". Let's break this final step into two pieces. First, the downward push of your shoulders. Your shoulders are your strongest body asset, especially for individuals who have quadriplegia. We want to bring this asset into play at the end of your stroke, just before you begin to arch your back to sit up. Your hands should be at about 1:00 and your arms not fully extended yet. Right here, while your body and head are still falling forward, push your shoulders down while at the same time fully extending your arms. This combined action is what is going to give you your speed and allow you to glide between pushes. It is essential to good wheeling. Notice how easy it is to get back up to a full upright sitting position when you use this technique. This little "kick," if you will, is essential to good wheeling and will make it a breeze to return to full upright position while giving you your speed and glide. Which in turn will also allow your arms to rest between pushes.
Remember to drop your arms to get your hands back to 10:00. Do not lift them over the handrims.
The Body
Once your chair is rolling along , try to lean your weight on the rear wheels. This will give you a longer glide, plus make the front end of the chair lighter and easier to maneuver. This is essential because the back wheels are larger and therefore can go over any roughness easier than the front wheel. The larger rear wheels also make fewer revolutions than the front wheels, and this means that there is less friction generated in the bearings of the back wheels. ( Just think of a skateboard and a bicycle rolling down a hill. Which will roll furthest after the hill?)
If you have put all these pieces into play, with some practice you should be rolling along fairly easily. Take some time to practice, and concentrate more on your style and timing than speed. As you get the timing down, the speed and distance you go with each push will increase.
Helpful hint: If you are using plastic coated handrims because you don't have a good grip, try using knobby tires as well. This will give you more leverage because of the tire's bigger diameter and, because of the knobby tread, it is easier to grip. You can use the tire to get started (1st. gear) and then the hand rim (2nd. gear) once you are moving