Wheelchair users have reported how important it is stay fit and strong (1), and there is a wealth of information available online to help (2)

There are many reasons for using a wheelchair (3), and your fitness routine must accommodate your particular needs and preferences. Safety is key. An assessment from a professional, such as a registered Physiotherapist, is a good way to get the program that works for you and keeps you safe.

Here are some ideas to get you started. Remember, if you’re new to exercise, go slowly. Add to your routine in increments that allow your body to adjust.

1. Cardiorespiratory fitness.

The simplest way to work on cardio fitness for manual chair users is to push yourself around in your chair. Find some uncluttered space and use your arms and legs together if possible. Add a notch of challenge to this by increasing speed (make sure you’re in a traffic-free, flat area).

Other options are to use a seated bike (for arms or legs), rowing machine or elliptical that you can access from a wheelchair. Build up your time gradually, and stretch afterwards.

And there’s the wide world of wheelchair sports to explore and enjoy, sports like basketball, netball, tennis, table tennis, badminton, hockey, and sledge hockey (4)

2. Strengthening.

If you use a manual wheelchair, shoulder and arm strength is very important, as overuse injuries of these areas are common.

Use resistance and/ or repetitions to build up strength (weights or resistance bands).

Examples of arm/upper back and neck exercises that can be performed in a wheelchair are:

· Just wheeling yourself around will strengthen your back, arms and shoulders.

· Biceps curls. Take a weight in your hand and bend your elbow, then slowly straighten.

· Arm raises overhead (overhead press) with a weight. Bend your elbows so that your hands are next to your shoulders. Raise your arms above your head. Return to the starting position slowly.

· If you can’t lift your arms overhead, you could try putting your hands on the wheelchair arms and lifting yourself up a few centimeters. This strengthens your back and triceps.

· Chest press. Holding a band wrapped around your back and under your arms, reach forwards so that the band is stretching as you straighten your elbows.

· Sit tall with a chin tuck and squeeze your shoulder-blades together, keeping your shoulders down. This helps with posture.

There are many more exercises that can be completed for leg and core strengthening, and they should be adapted to your abilities. Check out (1) for more information, exercises and routines.

3. Flexibility.

Stretching is important as it’s easy to tighten up sitting in one position.

Ideally you would do some stretches out of the wheelchair. For example, lying on your back or your tummy will open the hips and stretch the back. Lying on your back, putting your feet together and allowing the knees to come apart will also open the hips.

Some examples of stretching in sitting are:

a. Biceps. Stretch your arm horizontally behind you until you feel biceps stretching gently.

b. Triceps. Put your right hand on your left elbow and stretch your bent arm overhead, then swap arms.

c. Chest. Open up your chest by taking both arms (at 90 degrees or lower) behind you until you feel a gentle stretch across the chest.

d. Upper back. Clasp your hands together and reach forwards with your arms at 90 degrees. You should feel a gentle stretch in between your shoulder-blades.

Sometimes stretching before exercise is needed if you are stiff. Always stretch after working out and stretch often whilst in your chair. Hold stretches for 30-60 secs or as your therapist recommends.

4. Balance. If safe, you could work on sitting balance by sitting tall and forward from the back of the chair, trying not to assist with your arms. Try moving side to side while upright. Check out this video (5): it shows working on balance in your chair using a cushion. If you are able to stand then this should be incorporated safely into your program.

5. Functional activities. This might include working on moving around in the chair indoors or outdoors. It may include standing at a kitchen counter with your wheelchair safely behind you, with the brakes on. If you are able to get outside check out the links below for wheelchair accessible trails in Toronto. (6)

Happy Exercising!

R. Sian Owen PT

Registered Physiotherapist

(1) Exercise in a wheelchair

https://www.shape.com/lifestyle/mind-and-body/people-dont-know-about-staying-fit-wheelchair

https://www.womenshealthmag.com/uk/fitness/workouts/g37402259/wheelchair-workouts/

(2) For seniors

https://frontiermgmt.com/blog/5-great-exercises-for-seniors-in-wheelchairs/

https://agerrtc.washington.edu/sites/agerrtc/files/files/Aging_Exercise.pdf

(2) General

https://www.nhs.uk/live-well/exercise/exercise-guidelines/wheelchair-users-fitness-advice/

(3)