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Thread: How am I sitting? Pushrim/seat placement and pushing efficiency

  1. #1
    Senior Member ~Lin's Avatar
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    How am I sitting? Pushrim/seat placement and pushing efficiency

    Ok, I hope I got the jist of what I'm asking into the title! And in a way that others could post pictures or ask similar questions here.

    In another thread, some comments reminded me of some questions I'd been meaning to ask. So I posted this:

    Quote Originally Posted by ~Lin View Post
    What are the consequences when your finger isn't around the middle of the quick release button? I've been meaning to get some photos of me in my chair and post asking about that. Now that I'm remembering again I'll try to get that today or tomorrow...

    I think my hands are pretty far away from the middle of the wheel. I'm not entirely sure since I'm going by feel and not able to look at myself. I've wondered about what the difference is when you don't fit the chair that way. But I also started thinking about the youtube video JeffAdams made showing the difference between transferring from the lower wing of the icon and how thats better for your shoulders. So I thought maybe having the pushrims lower might be better for my shoulders? But in this thread it sounds like being lower (higher pushrim) gives you further reach, which means going further with each push and therefor better for the shoulders?

    I have 2" of dump now and have been thinking about increasing it because I have some difficulty carrying things on my lap. I'm concerned about my hips hurting from the more closed angle though.
    And feisty responded:
    Quote Originally Posted by feisty View Post
    this is a great question. I'm wondering if getting further down in my chair will give me a longer stride in my push, bc I feel like I make tons of short pushes due to my inability to really reach alot of the wheel. does lowering your ass allow you to reach back further in your push?
    So I'm hoping to get some answers to those questions! In addition, I wanted to ask about the way I've been sitting due to my knee. I've mentioned before having issues with my knee. I have a 75 degree front frame and a reversed footplate. But it still wasn't enough for my knee. I started just dangling my left leg against the front frame. This way with no upwards pressure/weight bearing on my knee I get much less pain. I also pulled the footplate a little closer in for my right leg. This way when I need to get around in a tight space or tighter turning radius I can pull my foot back onto the plate, but as soon as I'm done or the pain gets too much I can rest it again. But, does it change my seating to the point I might have ramifications down the line?

    Any other comments on my positioning are welcome. I've been having coccyx pain since I got the chair/cushion, and have also been having ischial pain after I'm in the chair a couple hours. I've tried contacting the DME, but medicaid won't cover a better cushion without a current or previous pressure sore. I currently have a curve by the comfort company. I tried contacting another DME just to get a second opinion, and they said the first was correct when it comes to medicaid. But that I SHOULD be able to exchange for another cushion under the same classification code... I was going to start a thread about that, anyone know of any other cushions that would be the same code?

    Here are my photos:



    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  2. #2
    Senior Member jschism's Avatar
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    here's an article about getting an effective push and talks some about set-up. the part about the finger to center of wheel is discussed on page 2. you have to read around all the ads.
    http://findarticles.com/p/articles/m...g=content;col1

  3. #3
    Junior Member racer's Avatar
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    Just taking a quick look you appear to be sitting high and too far forward. Your chair may have 2’’ of dump but it’s completely negated by your cushion. It fills in the angle/space like a wedge. In fact you almost have negative dump. So basically the way you are sitting you can barely access the pushrim. However if you are able to get deeper in your chair and utilize the dump somehow(new cushion, let air out of current one, or change rear seat height) this will undoubtedly place more pressure over your ITs which you said are sore to begin with. Sitting deeper will also force your knees into more flexion. The way to “come back” in the chair is to move your rear axle position forward to get the wheels under you or in front slightly. Of course this will make the chair increasingly tippy but it will place more of your body weight over the rear wheel decreasing rolling resistance and give you better accesses to the handrim . So basically you need to consider all of these parameters and balance the adjustments according to what your body can tolerate and your comfort and skill level.

  4. #4
    Senior Member ~Lin's Avatar
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    Did you mean you think I'm sitting too far back? Because I can't be too far forward, I'm behind 90 degrees? I can't change that angle up, the current one is what works for pushing and my back issues. Its adjustable and I recline a bit when I'm resting, but if I try to push the chair with the back in that position I tip over backwards (I've had it happen accidentally when I didn't realize I was in that selection.) In my current angle, the chair is still really tippy and I have to lean forward to start moving from a standstill, and the casters pop up a lot just during normal pushing. I posted a thread about that before wondering if the chair is too tippy, but from that thread I decided I don't want to move the COG back.

    I'm trying to get a new cushion, but not sure how thats going to go. I watch ebay but don't have the money yet and they still are pretty expensive. I mentioned in the OP about the insurance issues. I'm also going to try to get one through the department of vocational rehabilitation. My current one is 2 inches thick and is just foam. So do you think my thighs are sinking into the cushion and not my butt or something? I'm trying to understand how the cushion negates the dump.

    I absolutely can't tolerate more flexion to my knees. Like I was talking about above, its already too much flexion for my left. Since I did move the footplate back a bit, I can move it further forward again though if I change the dump so I don't increase the flexion on my right knee. But I'm still concerned about my hips tolerating the added flexion. Though when I'm resting in the more reclined back angle, I do scoot my butt a bit forward to open my hip angle and rest them as well. So my hips might be just fine. But then you've added another concern, since you said it may bother my ITs even more.

    Thanks for the reply, but I'm sure you can tell I'm a bit confused! It may just be because I'm really tired right now. And Jschism, thanks I'll read the article tomorrow! I couldn't concentrate on it yet.

    Edit: I was looking at the pictures, and I think I'll try to get another one taken tomorrow without the side guard. I wonder if its just the fact that I have a big butt negating the dump!
    Last edited by ~Lin; 03-16-2012 at 12:26 AM.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  5. #5
    You`ve got a high position, you need to lower down your rsh and fsh for still with the same dump, another options is changing to a low profile cushion.

  6. #6
    Senior Member jschism's Avatar
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    the article will discuss your wheel/body postioning. There are several books that go into more detail about positioning and stuff, but I can't remember where is saw it. It's one of those things that make one ask, "Why wasn't I taught this in rehab"?

  7. #7
    Senior Member ~Lin's Avatar
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    My fsh is currently 18, and my rsh 15.5 My cushion is only 2 inches thick, I didn't think there was anything thinner? And I've been wanting a thicker cushion, something with gel over the foam or different types of foam with something softer on top for my coccyx and IT issues.

    I think I can only increase the dump one inch, from looking at the manual and then what's on my chair.
    Last edited by ~Lin; 03-16-2012 at 01:44 PM. Reason: forgot the .5 on the rsh
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  8. #8
    Quote Originally Posted by ~Lin View Post
    My fsh is currently 18, and my rsh 15. My cushion is only 2 inches thick, I didn't think there was anything thinner? And I've been wanting a thicker cushion, something with gel over the foam or different types of foam with something softer on top for my coccyx and IT issues.

    I think I can only increase the dump one inch, from looking at the manual and then what's on my chair.
    The cushion of the pics is not a 2 inches thick, that one you`ve got in the pics is a high profile cushion.

  9. #9
    Her cushion is 2.75" in the rear and 2" in the leg trough's. It looks a lot thicker because it is contoured; I thought it was thicker too.

    You could benefit from sitting down more into your tires.
    C5-6 Complete - 8/13/1982

  10. #10
    Junior Member racer's Avatar
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    Hey Lin,

    After reading your reply I would avoid playing with your rear axle position. Actually it’s not really in that bad of a position. I think you may be tippy now because of your back angle(you are reclined slightly). I think you should focus on your cushion situation. If you look at the picture I attached, the yellow line is the angle of your seat dump but that is not the angle you are actually sitting in. You are sitting along the angle indicated by the green line which is like 90 degrees or more. If you want to feel what that much dump is supposed to feels like sit in your chair without the cushion for a few . Like others have stated you need to come down into the chair. There are so many cushion options, just sample as many as you can. You don’t have an SCI so I assume your sensation is intact? Because you are not at high risk focus on a cushion that positions you correctly and preserves the dump angle. If you are able to come down in the chair you may need to lower your foot plate proportionately to avoid excessive nee flexion as well.
    Take care,
    Ian

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