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Thread: Sacral sitting when in wheelchair

  1. #1

    Sacral sitting when in wheelchair

    When i'm in my chair I definitely sacral sit. It's pretty bad. When I sit up correctly I feel a lot of pressure on my lower spine. Is that normal? Should I wear a binder or something.

  2. #2
    What kind of cushion do you have? Did you have a seating/cushion evaluation by a physical or occupational therapist?

    The two main reasons for "sacral-sitting" is that the seat-depth is too long and/ or there is an incorrect seat-to-floor height. The correct seating-position is when the hips are all the way back in the chair against the back-rest and one-to-two inches from the end of the cushion to the back of the knee.
    Reference: http://www.articlesbase.com/disabili...s-4400152.html
    A good rule of thumb is 90-90-90. 90°-hip to leg angle, 90°-knee angle, 90°-ankle to leg angle.

    I sited the above article, because it is clear, simple, short and to the point. You may want to have these things checked out. If, after you are sitting right on the correct cushion for you, you may, depending on your trunk stability, need some sacro-lumbar support in the form of a binder or support garment. I and c6/7 comple and have a very long torso because I am 6'3" tall. I have needed extra trunk stability support since rehab and have been using a binder to help me with that stability. An orthotist can evaluate your needs in this regard and suggest the right garment for you.

    All the best,
    GJ

  3. #3
    Quote Originally Posted by gjnl View Post
    What kind of cushion do you have? Did you have a seating/cushion evaluation by a physical or occupational therapist?

    The two main reasons for "sacral-sitting" is that the seat-depth is too long and/ or there is an incorrect seat-to-floor height. The correct seating-position is when the hips are all the way back in the chair against the back-rest and one-to-two inches from the end of the cushion to the back of the knee.
    Reference: http://www.articlesbase.com/disabili...s-4400152.html
    A good rule of thumb is 90-90-90. 90°-hip to leg angle, 90°-knee angle, 90°-ankle to leg angle.

    I sited the above article, because it is clear, simple, short and to the point. You may want to have these things checked out. If, after you are sitting right on the correct cushion for you, you may, depending on your trunk stability, need some sacro-lumbar support in the form of a binder or support garment. I and c6/7 comple and have a very long torso because I am 6'3" tall. I have needed extra trunk stability support since rehab and have been using a binder to help me with that stability. An orthotist can evaluate your needs in this regard and suggest the right garment for you.

    All the best,
    GJ
    I've had the same cushion I've had since I was injured almost 6 years ago. It's a ROHO http://www.spinlife.com/ROHO-High-Pr...1#.T7ww9L91M7A

    I added a pic idk if that helps any... http://i50.tinypic.com/nz12xy.jpg

  4. #4
    Quote Originally Posted by SequinScandal View Post
    I've had the same cushion I've had since I was injured almost 6 years ago. It's a ROHO http://www.spinlife.com/ROHO-High-Pr...1#.T7ww9L91M7A

    I added a pic idk if that helps any... http://i50.tinypic.com/nz12xy.jpg
    Our bodies change over time with spinal cord injury and it may be that it is time after 6 years to have a fitting for a new or different kind of cushion. That said, (I have a Roho cushion too) sometimes we get a little lazy about checking our Roho cushions for the proper inflation. That may be something that would be a good thing to check.

    All the best,
    GJ

  5. #5
    Quote Originally Posted by gjnl View Post
    Our bodies change over time with spinal cord injury and it may be that it is time after 6 years to have a fitting for a new or different kind of cushion. That said, (I have a Roho cushion too) sometimes we get a little lazy about checking our Roho cushions for the proper inflation. That may be something that would be a good thing to check.

    All the best,
    GJ
    I'm pretty good at keeping air in my cushion. I'm sure the majority of the problem is the chair. It is a clunker Quickie 2

  6. #6
    Senior Member tooley's Avatar
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    Quote Originally Posted by SequinScandal View Post
    I'm sure the majority of the problem is the chair. It is a clunker Quickie 2
    While getting a new chair has a great placebo effect on self-diagnosing your seating it isn't the magic bullet. Try to get your current chair set up as close to where you want it before specing a new one. I know you are planning to meet the Icon in a few weeks, but should you not like it or cannot fund it you will likely be specing a chair that is similiar build to your current one. So play with it first. I'd start by tightening up your backrest upholstery in an effort to get you sitting up straighter.

  7. #7
    Senior Member Kulea's Avatar
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    Try for more dump. See whether you can get the top surface of your lap level by lowering your rear seat height (or if you just want a real quick experiment, put you casters on a higher surface). That will require some way to tilt the backrest forward to maintain the same angle. Since you probably can't do that on the Q2, you might have to throw some towels over the top of the backrest to keep your back upright during the experiment.

    That said, I have been sitting slouched for YEARS. I have never found a cushion that would prevent my desire to slide my butt forward. If I use a belt over my upper thighs (not a waist belt, but a bit more forward) it helps as does extra dump. But, after a while, I will always get fatigued and want to slouch.

    When I try cushions that try to prevent this, end up with excess pressure just below the scrotum, where the cushion is trying too hard to push my pelvis back.
    C-6/7 incomplete

  8. #8
    Quote Originally Posted by Kulea View Post
    Try for more dump. See whether you can get the top surface of your lap level by lowering your rear seat height (or if you just want a real quick experiment, put you casters on a higher surface). That will require some way to tilt the backrest forward to maintain the same angle. Since you probably can't do that on the Q2, you might have to throw some towels over the top of the backrest to keep your back upright during the experiment.

    That said, I have been sitting slouched for YEARS. I have never found a cushion that would prevent my desire to slide my butt forward. If I use a belt over my upper thighs (not a waist belt, but a bit more forward) it helps as does extra dump. But, after a while, I will always get fatigued and want to slouch.

    When I try cushions that try to prevent this, end up with excess pressure just below the scrotum, where the cushion is trying too hard to push my pelvis back.
    Sounds like a good experiment I will try it tomorrow and tell you how it goes. I have the same problem with getting fatigued from trying to keep myself up right that I just give up and go back to slouching after so long.

  9. #9
    Senior Member jschism's Avatar
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    seems a lot of people I see with Roho cushions have bad posture, why do they push those cushions so much?

  10. #10
    Sacral sitting can also be due to insufficient lumbar support. You may need some modification of your chair back, or even a custom back. It can sometimes occur in those who have lost hip ROM due to HO or contracture too. Do you do good hip ROM and stretching daily?

    Sacral sitting can significantly increase your risks for coccyx and sacrum pressure ulcers.

    Roho cushions are used a lot due to 1) excellent marketing strategy, 2) giving low seating pressures for many, but they do have the problem that for most they do not promote or aid posture issues. Specialty Roho cushions like the Quatro, etc. do a better job of this, but stability can be an issue on pretty much all of their cushions. Many are willing to trade off lack of stability for low pressures and pressure ulcer risk.

    I agree that a seating (not just a cushion) re-evaluation by an experienced therapist appears to be indicated.

    (KLD)

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