Wheelchair Transfer (part 1): From Chair To Ground

Knowing you’re able to transfer in and out of your manual wheelchair is extremely important.  You may think, “I’m never going to put myself in a situation where I might fall, so why practice?”  It isn’t because I think you’re necessarily going to fall.  Yes, its possible you’re front wheels may hit a crack in the sidewalk and you do a face-plant onto the floor… Is it likely? Probably not…  The truth is, most of the time I’m on the floor next to the wheelchair isn’t because I busted my ass, it’s because I chose to hop out (yes, I said “hop”).   Maybe I’m at the park having lunch with my wife, and I hop into the grass to relax for a while.  Or maybe my tire goes flat and I need to sit on the ground next to the wheelchair to fix it.

Psychologically, it’s important you’re able to independently get into your wheelchair from the floor. You’ll feel more relaxed in all types of situations, which will expand your entire comfort level.  If you are afraid of falling because you know you can’t get up, you’ll live life with a weary “what if” mentality.  What if I fall?!  What if I’m helplessly stuck on the floor?!  What if nobody is around to help?!  It is this exact mentality that will truly disable you, more so than the physical wheelchair.  You’re thinking: I’m confined to a wheelchair 24/7, how much more disabled could I possibly be?  Well, the answer is much more!  At some point in time you’ll need to stop defining your disability by the physical “wheelchair”, and start defining it by your actual abilities vs. limitations.  For example, I’m paralyzed in a wheelchair, but if I choose to fly up to New York and cruise around Manhattan with my friends I’m able to independently do so.  And, if while in Manhattan we want to illegally j-walk (yes, I said walk) across the street at a moments notice to catch a cab I’m able to pop a wheelie down the curb and do so, never needing to look for an ADA accessible ramp to the road.  And, if we get impulsive and decide to fly over to Colorado in the winter to ski, I’m able to rip down the mountain with them.  Yes, I’m paralyzed in a wheelchair 24/7, but there is nothing disabling about the experience I just explained!  Eventually, you’ll realize something very important about your new injury… The actual wheelchair is a minor part of the bigger picture.  The actual wheelchair will not define your disability. In fact, it will be defined by your lack of ability, aside from the wheelchair.

This is why I encourage you to learn as much as possible, which will slowly dissipate all the deep internal fears of “what if…”.

EXERCISE:  Wheelchair to Floor

If scripted, getting from your wheelchair to the ground can be quick and effortless.  On the other hand, if unscripted (ie: suddenly bust your ass), getting from your wheelchair to the ground will always be a new adventure…

1) Scripted (voluntary):

Assuming you have decent upper body strength, hopping out of your wheelchair onto the ground should not be difficult. First, put on your breaks, if you have them.  Next, scoot your but forward towards the edge of the wheelchair seat.  (Below)

Move both feet from the wheelchair footplate to the floor in front.  The next step involves hand placement, and depends on whether you’re right or left hand dominant.  If not sure, the hand you write with is most likely your dominant hand.  So, with your non-dominant hand (for me it’s left hand) grip the wheelchair base next to same knee… Next, lean forward, stabilizing your core with the gripped non-dominant hand.  (Below)

Then, once your core gets low enough to the ground, plant your dominant hand on the floor palm down.  At this point, you should be falling forward, non-dominant hand gripping the wheelchair base rail next to same side knee.  Your dominant hand should be on the floor taking on more and more of your weight.  It’s important to be careful not to hurt your wrists during the process.  Eventually, I suggest you try making a fist and putting the weight through your knuckles, rather than palm down. An open palm will eventually start to hurt/damage your wrists, due to the 90-degree angle the hand and forearm create.  If in a wheelchair, you only have 2 functioning limbs, therefore it’s extremely important you minimize the wear and tear.   If the floor your transferring to is hard (ie: concrete, wood, tile) this may hurt your knuckles.  But, if the floor is soft (ie: carpet or grass) you’re better off using knuckles instead of palm down.  Finally, all you need to do is use some elbow grease.  Transfer your weight to the dominate hand as your body mass begins to “fall” out of the chair.  (Below)

This may seem extremely awkward if this is your first time practicing the exercise. Notice how your arms want to bow outward, making it difficult to lift your core weight.  If so, I strongly suggest practicing until this un-natural exercise becomes second nature.  I promise it will pay off dividends in the future.  If successful with the exercise, you should be sitting on your butt with knees close to chest.  (Below)

To Floor Transfer 3

2) Unscripted (involuntary):

This is simply another way of saying “busted ass”.  By the time you realize you’re going to bust ass, it’s usually too late, and next thing you know, you’re on the floor. To simulate, I suggest having someone there to help practice, preferably on 2 feet.  They’ll be able to help simulate a real fall by slowly tipping your wheelchair back until your shoulder blades are touching the floor and you’re looking up at the ceiling.

They can gently tip your wheelchair back onto the floor, simulating a “busted ass” situation. More importantly, if you end up stuck like a turtle on it’s back, they’ll be able to help you back into the wheelchair.  It’s extremely important to tuck your head forward when you practice flipping backward.  If the fall is a result of the wheelchair flipping back there is a decent chance you’ll hit your head on the ground.  If/when you ever fall, tuck your head forward to stop this from happening.  Becoming paralyzed sucks… Becoming paralyzed, then cracking your head open on the kitchen floor REALLY sucks….

I had only been paralyzed for 3-4 weeks the first time I busted ass.  I was still newly injured, living in-patient at Jackson Memorial Hospital in Miami, Florida.  Earlier the same day my physical therapist had taught me how to pop a wheelie up a street curb.  Later that evening I was rolling to dinner with my mother and girlfriend at the time.  The hospital had a decent cafeteria, which was in the building next-door.  On the way, I spotted a street curb…  Feeling bold and confident, I told them both to “watch this”…  I rolled quickly toward the curb, popped a wheelie, slammed my front wheels on top of the curb… My back wheels lifted off the ground, but never made it to the top of the curb… The Result:  With momentum, my back wheels came back down toward the ground in front of the curb.  They hit the ground and I was flipped backward out of the wheelchair.  I had never been on the floor in this situation, and was unable to get back into the wheelchair on my own.  Luckily a doctor passing by offered his assistance, basically picking me up and placing me in my wheelchair.  The feeling I had was a depressing helpless one.  I promised myself, if physically possible, I would never feel dependent and/or helpless again.  Alone in my hospital room the next day I practiced transferring from the floor into my wheelchair for 3 hours straight.  I didn’t stop practicing until I knew the helpless feeling was gone.  From that day forward I never asked nor needed help getting in my wheelchair, regardless of the situation.

Read Part 2

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