How to Prevent Back Pain When Propelling a Wheelchair


    1. Choosing the right manual wheelchair with appropriate adjustments. We recommend picking a wheelchair with an adjustable rear wheel axle. Generally speaking, the position of a rear-wheel axle should be adjustable in every direction. 
    2. Have the knowledge about how to operate a wheelchair correctly. 


Why is self-propelling a wheelchair more likely to cause back pain?

People who are used to self-propelling a wheelchair long term are no stranger to experiencing pain in one form or another. Repetitive Strain Injury (RSI) is common amongst self-propel users, with 59% of users obtaining this secondary injury. 49 – 73% of self-propelled wheelchair users have Carpal Tunnel Syndrome, and 30 – 50% of wheelchair users with paralyzed lower limbs have shoulder pain. Users with low-level spinal cord injuries are more likely to experience these secondary injuries as they spend most of their time in a wheelchair. An active self-propelled wheelchair user can do as much as 3,000 wheel pushes a day! A Repetitive Strain Injury sustained from this repetitive motion can not only reduce daily life function and quality of life but also dramatically increases the demand for extra care. 

How to adjust wheelchair wheels to avoid back pain?

Adjusting the position of the wheelchair axle affects not only the stability and agility of the wheelchair but also the effectiveness of the user’s self propel. An excellent self propel should be as long as possible, and the frequency should be as low as possible. By reducing the repetition of pushes, the user minimizes the chance of experiencing back pain.


1. Optimize the horizontal position of the rear wheel axle

The following images demonstrate what happens to the wheel propel, depending on the horizontal placement of the rear wheel axle, which is being adjusted forward, and backward. 

For users who have just started using a self-propel wheelchair or are in recovery, we recommend that the rear wheel position be positioned further back. However, for users who are more familiar with self-propelling a wheelchair, the more “unstable” rear axle position makes lifting the front wheels easier to move over obstacles.


2. Improve the vertical position of the rear wheel axle

Another position to consider when adjusting the location of the rear wheel axle is the access that the user has to the hand rims, which depends on the vertical placement of the rear wheel axle. The axel can be adjusted up, and down. 

When the user is propelling themselves, they need to be able to reach the hand rims comfortably. If the seat is positioned too high, they won’t be able to reach their full propel potential. If the wheelchair seat is positioned too low, the user risks injuring their shoulders to try and reach the hand rims. Therefore, finding the ideal seat height for a manual wheelchair can be the key to increasing propelling efficiency. 

We’re here to help

Not every wheelchair can be adjusted. You might need to find the best adjustable manual wheelchair first. With the correct rear wheel axle position and proper propelling methods after training, the best wheel propelling can be achieved, and the probability of Repetitive Strain Injuries reduced. KARMA Malaysia is always here to assist. Talk to a KARMA representative today! 

Call us: 03-5612 1921 / 010 – 238 1921

Email us: [email protected]

KARMA’s rear wheel adjustable manual wheelchairs: