When people talk about wheelchair use and shoulder pain, attention often goes to pushing the wheels. But the day also includes transfers to the bed, to an armchair and to other spots around the home. Some are essential; others depend on how activities are organised.
Reviewing them does not mean giving up moving around or becoming less independent. It means asking yourself where your arms are doing the work, for what purpose and with what difficulties. Pain calls for a healthcare assessment: observing your routine helps you describe it, but does not identify its cause on its own.
In brief
To understand which transfers to review, look at the starting point, the destination, the reason for the transfer and the return. Report pain, repeated attempts and activities you are giving up. The number of transfers is not a score to be reduced at all costs: the effort of each individual transfer and the independence it allows also matter. A chair can be included in the assessment only if it adds a useful activity and if the transfer is appropriate; it is not a treatment for shoulder pain.
Your shoulders work even when the wheelchair is stationary
Specialist material from the Swiss Paraplegic Group points to the load on the shoulders during transfers and to the importance of how they are carried out. [1] For people who use their arms during transfers, this makes it worth describing the preparation and the arrival too. A new difficulty should be reported to whoever oversees your mobility, not tackled by copying a generic manoeuvre.
To prepare for the discussion, don’t just say ‘I’m tired in the evening’. You can describe when the problem becomes noticeable: while you prepare the transfer, during the movement, after you have settled, or only on the way back. You do not need to repeat the manoeuvre to prove the pain.
Not all wheelchair users make the same movements or have the same control of their trunk, hands and arms. This guide is mainly for people who use their arms during transfers, independently or with help. For those who are transferred with a hoist, the practical picture is different and should be discussed with the professionals involved.
Start from the reason for the transfer, not the count
A transfer may allow you to go to bed, see to your personal hygiene, work or take part in an activity you want to do. Calling it ‘one too many’ just because it takes effort does not describe its value.
Other changes of seat stem from unclear organisation. Are you transferring because you need to use a different surface, or only because the one you are sitting on cannot reach the room? Are you choosing the place best suited to the activity, or the one that happened to be free?
A useful distinction is between transfers with a necessary purpose, transfers chosen for a concrete benefit, and transfers to discuss because it is not clear what they add. There is no need to give them a mark: the point is to make the reason visible.
The comparison of the different roles of a wheelchair and an armchair helps to clarify this division. Here we are not looking for the winning seat, but for the points in the day where it is worth asking one more question.
Going there and coming back are two different transfers
‘I can get onto the armchair’ is only half the information. Also ask yourself how you get back to the wheelchair, at what time and in what conditions. The return may happen after other activities, when the help available is different or when the layout of the room has changed.
Direction also matters in the description: a height difference you go down on the way there becomes a climb on the way back. It is a concrete difference to report to the professional, not an invitation to choose a different height on your own. Describe the two transfers separately, keeping to the technique and the help already planned.
Note any asymmetries you notice without correcting them on your own. ‘I have to stop to get back’, ‘the available side changes’ or ‘the second manoeuvre takes more attempts’ are observations to bring to the review, not instructions for inventing another technique.
To gather heights and space requirements without turning this article into a measuring guide, use the in-depth article on the measurements to take for transfers at home. Here, keep the focus on the person’s experience of each transfer.
A simple map of the transfers to discuss
Fill in the map by thinking back over a typical day, without adding any tests. You don’t need to count every movement or wait until you have a perfect diary before asking for help. The situations that describe the problem are enough.
| Transfer or situation | What to note | Question for the review |
|---|---|---|
| Wheelchair → bed | Goal, difficulty reported, usual help | Does the transfer still match the method that was assessed? |
| Bed → wheelchair | Differences compared with the outward transfer | Does the problem change in this direction? |
| Wheelchair → armchair → wheelchair | Desired activity and difficulty in both transfers | Does the second seat add a concrete benefit? |
| Changing room | Reason for the change of seat | Is a change of surface necessary for this activity? |
| Settling after the transfer | Repeated adjustments or difficulty finding support | Should the assessment also cover the arrival? |
Next to each row you can write ‘pain’, ‘fatigue’, ‘repeated attempts’ or your own words. These are not diagnoses and do not measure the mechanical load on the shoulder. If you give your pain a personal score, agree with the professional on how to use it: do not compare it with made-up thresholds to decide whether to carry on.
The map is an editorial tool to support the conversation, not a clinical scale. It should help you explain what happens, not certify that a transfer is safe.
Reviewing does not mean cutting out every tiring activity
Shoulder pain cannot be explained just by looking at the armchair. Swiss Paraplegic Research studies upper-limb function in relation to activity load and participation after spinal cord injury. [2] For your assessment, therefore, also report what you do before and after the transfer, without attributing the cause to a single surface.
Bring a personal priority to the physiotherapist: ‘I’d like to sit at the table with the others again’ or ‘The problem is getting back into bed in the evening’. This helps to discuss a change that keeps the activity, instead of dropping it just because it has become difficult.
The professional can assess technique, aids, seating and organisation as a whole. It is not the purpose of this guide to choose a transfer board, a hoist or a new adjustment in their place.
Weigh the proposal against what matters to you. Fewer transfers but longer waits for help, or a set-up from which you cannot reach your work, may not be the result you want. The choice should be judged in terms of participation, not just the number of movements.
When Sollevita can be part of the discussion
The features of the Sollevita care riser recliner include vertical height adjustment, side access and adjustments for resting. They make it possible to discuss how the chair relates to the other surfaces and to the activity planned at that spot. On their own, they do not determine the technique or compatibility with an aid. [4]
The useful question is not ‘does this function protect the shoulder?’ but ‘does it address the problem we have identified?’. If the transfer is being reviewed because of height, the relevant information is the actual set-up of the seat. If the difficulty appears after arrival, it may also be necessary to discuss the activity carried out there.
The manually moved wheeled base allows assisted moves indoors with the person seated, within the product’s limits of use. [4] It may be relevant when the change of seat serves only to reach another room. This organisational option does not prove that the pain will decrease.
The person accompanying you should also be considered. Someone who today moves around independently in a wheelchair should not lose that freedom by adopting a solution designed only to reduce transfers. A wheelchair and an armchair can remain different tools for different moments.
An example: reaching the living room without losing the freedom to choose
Imagine someone who uses a wheelchair during the day and would like a break in an armchair before dinner. The transfer has a purpose: that break is their preference. The question is not whether to cut it out automatically, but whether the transfers there and back are still appropriate.
If they later want to go to another room, it should be discussed whether staying in the same seat with a companion is really useful. They might prefer that on that occasion, or choose the wheelchair to keep moving around on their own.
This is an illustrative example, not a clinical case or a promise of fewer transfers. It shows why the same function can be useful at one moment and less suitable at another.
Nor should a transfer between surfaces be confused with a change of position needed for the person’s care. Guidance on skin, support points and postural changes does not disappear because you stay in the same chair.
When pain needs assessing without delay
Persistent or increasing pain should be discussed with your doctor and with the professional who oversees your mobility. If it changes the way you transfer or stops you from doing your usual activities, do not wait until the map is complete before asking for help.
After a fall or an injury, significant new pain or losing the ability to use the arm calls for a prompt assessment. The Hospices Civils de Lyon, for example, describe post-traumatic dislocation as a condition to be assessed and treated quickly. [3] This does not mean that all pain is a dislocation: it means not attempting further transfers to find out on your own.
Do not mask a new difficulty by repeating increasingly demanding attempts or improvising manoeuvres with a family member. Ask how to manage the transfers you need while you wait for the review.
The Sollevita Team can clarify a handset control, a function or the space the chair requires. It cannot attribute the cause of the pain to the wheelchair or state that a chair will resolve it. The healthcare assessment and the technical discussion must work together while remaining separate.
Reference sources
[1] Swiss Paraplegic Group — Mobilisation / Transfers (in French)
[2] Swiss Paraplegic Research — Neuro-Musculoskeletal Functioning and Mobility (in French)
[3] Hospices Civils de Lyon — Shoulder dislocation and instability (in French)
[4] Sollevita / La Castellana — Product documentation
Features taken from the documentation provided to the editorial team; the link leads to the product page, not to a clinical verification.
The healthcare sources support the principles referred to; they do not recommend or certify Sollevita. Tables and examples were prepared by the editorial team; they are not clinical tests or documented cases.
Assess the set-up starting from the transfer that matters
Tell the Sollevita Team what activity you would like to do in the chair and what you need to check with the professional: height, side access, support points or moving around the room. You can then focus the discussion on the relevant functions, keeping your preferences and your independence at the centre.
