Bi-Articulate Approach to Addressing Shoulder Pain Issues in Manual Wheelchair Users

Pain throughout wheelchair (WC) propulsion is a very real fact of life for individuals who use a manual WC as their primary means of locomotion. A number of studies have reported the prevalence of shoulder pain in manual wheelchair users (MWU’s) ranging between 30–73% [1, 2]. Questions exist as to what may cause the extent of such shoulder pain. It is possible that a lack of education on proper propulsion techniques leads to poor propulsion habits that can be detrimental to overall shoulder health. It is also possible that such acquired techniques translate into shoulder joint forces whose repetition and magnitude may be so high that they are injurious to the user.