At one time or the other most people tend to suffer from back pain, whether it is minor pain with little to no impact on daily life or distressing with significant impact on daily life. Very often this pain results from acute trauma caused by our usual daily tasks where the spine suffered due to our posture. This pain could be exacerbated when you are confined to a wheelchair.
Posture is very important because without a good posture there is the risk of long-term spinal problems. These problems could negatively impact your ability to partake of activities independently and freely without feeling any pain.
Posture is one’s ability to hold your body while lying, sitting, standing, or performing certain tasks. This is associated with reaching, pulling, lifting, and bending. To maintain good posture, you must be aware of keeping yourself in such a way as to avoid putting pressure on your back and the muscles associate with your back, or the ligaments or tendons.
Your spine is made with curves in an ‘S’ shape. When you view them from the side your lumbar and cervical spine form an inward or lordotic curve, while the thoracic spine has a subtle outward or kyphotic curve.
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You must always review how your body is positioned in order to support good posture as well as pay attention to the tasks you are performing in that position. On top of that you should assess whether how the position you’re in impacts the environment.
Does it impact the environment in a positive or negative manner?
Also assess whether you can make adaptations to the environment or the tasks you’re performing, in order to promote a good posture? Like for instance reducing a workload or changing a workstation?
The Position of Your Pelvis
One of the most important elements in maintaining a good posture has to do with supporting the stability of your pelvis. The pelvis of your pelvis is the foundation on which the rest of your body is built.
Therefore, it’s stable and neutral position must always be maintained, otherwise everything that relies on it will be affected.
When a pelvis is in a neutral position it is not in full tilt and does not create hyperextension or flexion. When it is positioned in this way, it encourages the natural spinal position showing the 3 natural curves.
The Sitting Position
When seated, make sure that the chair fits right. The width, depth, seat height and back height are very important when determining a good sitting posture. Your knee and hip joints must be at least as close to 90 degrees as possible. When the angle is less than that then the chair is too low.
When seated, the weight of your body is moved to the chair via your sitting bones – these are the two bones at the bottom of the pelvis. When seated, your balance should be positioned entirely on these two bones. If seated a bit more to the front or the back of these bones, you must gauge whether the depth is appropriate.
If you are from the older generation then you may have heard parents tell their children not to pull their shoulders back. Well, this is wrong advice.
As the shoulders sit on top of the rib cage, which is a cylindrical shape, they are attached to it through connective tissue. Connective tissue are the tendons, ligaments and muscles. Therefore, the shoulders do not directly have a resting surface like all the other joints. They rely on positioning through internal and external pressure.
A relaxed shoulder position is naturally supported by correct spinal positioning. As such, deep and regular breathing improves natural shoulder positioning.
This term is described as the increase in the normal lordotic lumbar curve which leads to an expansion of the anterior tilt and hip flexion. In such cases it is best to completely avoid the wearing of high heels.
If you are using a footplate on the wheelchair, ensure that it is adjusted correctly. Try to do exercises that build up your core muscle strength and avoid sleeping on your stomach.