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Thread: Power chair elbow pain

  1. #1

    Power chair elbow pain

    Ever since going to a power chair I developed severe elbow pain, specifically on the side I have the joystick on. I do not have this pain in my power assisted chair. It seems to me that in the power chair my arm is locked into a static position pointed straight ahead with the point of my elbow firmly on the armrest. The supposed padding that my permobil comes with is worthless. I have thick sheepskin with an inch of T foam under it and have even worn an elbow pad in addition. Pain is so bad I cannot take any pressure on the inside of my elbow or on the backside. I have since developed a bone spur which I never had previously, or at least was not symptomatic.

    This comes after a shoulder surgery which failed and now I feel was unnecessary and was brought about by altered mechanics due to the poor back at comes with the chair. Yes, there were changes in my shoulder that could be used as justification for the surgery, but it is more likely that those changes were there previously and were exacerbated by the power chair back. I never had a problem with my right shoulder before I got this power chair. Then within two years I had pain so bad I submitted to having a surgical procedure. Now I've got elbow pain which I also never had before.

    My DME reps and seating PT pretty much have washed their hands of the situation. Others in the area are even less knowledgeable.

    This power chair, my first after 24 years in manual and power assisted chairs was supposed to be the answer to preventing further problems.

    However, I've never suffered such physical deterioration as I have is getting this power chair.

    Anybody have similar sobering experiences?

  2. #2
    I don't ever remember having the point of my elbow directly digging into the armrest. Is your armrest height and position of the joystick adjusted properly?

  3. #3
    Senior Member Kulea's Avatar
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    Since you used a manual, I am guessing your arms are functional. If so, then your armrest should be as low as possible and your joystick should be as close to the armrest pad (as close to your shoulder) as possible. Also, if it adjustable, your joystick should be inline or inside the armrest pad, but definitely not outside of it. This serves 2 purposes. It keeps you from using the armrest to carry the weight of your arm (and shoulder) at all times, and from continually leaning on your armrest (which is the weight of your head and torso). Your arm will stay bent, with your elbow back, so your shoulder will carry its weight. Second, you will be much more functional using your arms, without the armrest in the way. Your arms will get exercise rather than just be immobile on the armrest. An added benefit is that you'll get much closer to tables and desks and such.

    Don't ever rest your elbow on the armrest, that means it is too high, or your joystick is too far forward or outside the line of the armrest.. Rest only your wrist, or maybe the inside of your forearm right above the wrist. Just get out of the habit of putting ANY weight on your elbow.

    If none of those adjustments work, then you need upper body stabilization to keep you from leaning on your elbow.
    Last edited by Kulea; 11-04-2015 at 02:31 AM.
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  4. #4
    Senior Member Kulea's Avatar
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    I just realized that from experience, that advice about your elbow applies everywhere. Don't rest your elbow on tables or desks, or anything. Whenever you put your elbow down, the temptation is to lean on it, and not move/flex the joint. Or, worse, lean on it while you are moving your hand/wrist. If you are ever feeling the need to lean on your elbow, then there is something wrong with your seating.
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  5. #5
    Thank you for the advice. I have I believe what are called half length desk arms and I noticed that my natural resting position carries all of the weight essentially on the elbow. In order for me to have my forearms on the armrests I have to actually pull my shoulder back into a bit of extension which causes bad pain on the front of the shoulder due to the excessive tension across the biceps tendon.

    I have the joystick mounted in a position which I are naturally rests on it, not excessively far forward. However, I've had to move it slightly angled outward because if not it would be on top of the lateral support on the edge of the cushion on my chair and the armrest would not swing down properly. This despite modification of lateral support itself to get it down lower.

    All in all, I've suffered more physical and functional deterioration in the last four years I've had this power chair that in the previous 23 in my manual and manual assisted chair. The high back restricts shoulder mobility and causes extremely bad shoulder pain. Having to swing the joystick in and out repeatedly during the day to get near anything, such as a table, sink or steering wheel is just extremely painful on my shoulder.

    I will have to take this up with my vendor and seating PT, but at this point they are passive aggressive with telling me basically to get lost. And they are supposedly one of the better ones in my area. And they are even thinking that the five-year mark, which for me will be next year, a new power chair may not even be possible for Medicare reimbursement.

  6. #6
    Senior Member Kulea's Avatar
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    While I don't know the specifics of your situation, presumably, if you came out of a manual chair, your PC seating setup should be nearly identical to the MC setup. If you are getting shoulder pain from your backrest, and elbow pain from your armrest/joystick setup (that is complicated by that shoulder pain), then it seems clear to me that your seating setup is wrong for your situation. This is not the fault of using a PC, it is the the fault of not sitting properly in the PC.

    BTW-your shoulder (and elbows) SHOULD be back, that is a natural posture. If sitting in your MC caused no pain, then my suggestion is to set up the PC exactly the same as the MC. Sit in your PC the same. That is, if you never used the armrests on you MC, then don't rely on your armrests on your PC, except to lightly carry the weight of your HAND when using your joystick. In fact, my arm barely touches the armrest when joysticking. My elbows are outside of and often below the armrest. My armrests are there strictly to keep me from falling out, and to push against when repositioning myself in the chair. I don't use them for supporting any substantial weight, and rarely ever have my elbows on them. If someone has upper body movement, then armrests were never meant to be used as you are using them (which is why they don't have much padding). In your natural resting position in your MC, did the armrests carry all of your weight on your elbow? The natural resting position should be EXACTLY the same in your PC. Your armrests should NEVER be carrying any substantial weight, they are ARMrests, not bodyrests. And, like I said, if you don't have the trunk control to resist relying on your armrests, then you really need some upper torso stabilization (perhaps a chest strap). But, before any of that, your seating setup needs to correct.
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  7. #7
    I'm pretty much in agreement with Kulea. I also never use the armrest to "rest" my elbow/forearm while using the joystick. My T-bar armrest desk arm pad is at the lowest setting, with the joystick controller pretty much level with the pad, so my elbow is a good few inches ABOVE the arm pad. I keep the controller (Qtronix) folded back, only extending it forward as needed to fit narrower/tighter space. The lowered and folded position then means my ELBOWS are positioned DOWN and BACK, elbows a little extended out and to or behind the chair back bars. This also results in my shoulders being down and back. This helps reduce/prevent neck/shoulder/back pain.

    I also use a backrest a bit lower than I might need for support and balance assist, keeping it just enough under the shoulder blades to not restrict movement of upper back, shoulders and arms. The compromise has benefits, in that I sit straighter, consciously and unconsciously work on counter-balance and maintaining my balance, stability and posture, with the result being my having less back, shoulder and neck pain.

    I too feel locked in place with a higher back, feeling more immobilized, and sitting more slouched, and feeling and being more thrust forward. I need the room to stretch and arch my back, and squeeze shoulders back and together.

    If you are putting a lot or all of your weight onto one elbow/arm, then you are NOT sitting properly, clearly leaning and sitting crooked. I don't know if you rest your arm due to your shoulder issues but it seems to me that putting any extra weight onto that arm would increase problems. Even if you are putting weight on the non-problem side to avoid pain on the problem side, you are still causing problems with the imbalance, and the resulting pain on the arm you're leaning on.

  8. #8
    I have a tilt/recline chair which unfortunately requires a high back and which puts me into a position where I cannot keep my shoulder blades retracted back. As a result I have less room in my shoulder joint when I lift my arm and suffer premature impingement. In my manual chair the back ends below the shoulder blade, allowing me to sit back in a relaxed position. My permobil c300 which is four years old has absolutely no back adjustments. The way it is is the way it's going to be. I've had a custom foam back overlay made which did absolutely nothing. I've played with the armrests in terms of height and forward placement, all to no avail. Sitting in this chair is like sitting on two sheets of plywood (base and back), completely exhausting.

    The permobil back absolutely stinks in that it is not molded with lateral support in mind. It's a flat sheet of plastic provides no lateral support and leaves one constantly struggling to stay upright. The only solution is the lateral supports which lock you up right and prevent you from moving at all to the point where you cannot even reach for something on your desk or when you're eating. You feel completely helpless.

    I've had the armrests recently adjusted down as they definitely were too high and causing excessive pressure on my elbow joint.

    My seating clinic people, who are supposedly some of the best around, do not want to hear about these problems. As far as they're concerned you got your chair and that's it for a least a five year Medicare period, though from what I understand getting a new chair after five years can now be more difficult. I take very good care of my chair and it looks brand-new. Unfortunately that does not look good when it comes time for a review for a new chair. It almost pays to beat the crap out of the chair so it breaks down and looks terrible. But who does that serve in the meantime? You're only hurting yourself by neglecting your chair.

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