Introduction to Common Overuse Injuries in Wheelchair Users
Patricia M. McClintock
An injury is defined as any act that damages or hurts. Overuse injuries develop due to repeated microtrauma regardless of whether a person is able-bodied or is a wheelchair user. Present literature is beginning to address overuse injuries, but only as they pertain to athletes with disabilities. It is important to remember that an overuse injury can occur with any repeated motion with any individual. Overuse injuries can occur for athletes and non-athletes equally.
Overuse injuries to the upper extremities are common with wheelchair users because their upper extremities are used for propulsion, transfer, and activities of daily living (ADL). Being able to perform ADL is imperative to maintaining independence and ambulation to the person with a disability; prevention of pain or disablement to the upper extremities is critical. Several studies have shown that shoulder pain is prevalent in 33% to 78% of athletes who are wheelchair users. Carpal tunnel syndrome is present in 23% to 73% of wheelchair users. Blisters, abrasions, and lacerations are also frequent injuries although not necessarily overuse injuries. They can account for up to 18% of wheelchair athletic injuries according to Curtis and Dillon. By reviewing these statistics, it is obvious that a prevention program should be incorporated into the daily life of a wheelchair user.
There are several medical concerns that need to be addressed with wheelchair users, particularly people with spinal cord injury, before beginning a prevention program. These include autonomic dysreflexia, thermoregulation, pressure sores, spasticity, and venous pooling.