For most people who are manual wheelchair users, they will tell you that their independence heavily depends on their ability to transfer in and out of their chair. This can also be true for individuals who use power chairs and scooters. This guide explores techniques and exercises to improve chair transfers.
Safe and effective wheelchair transfers can be quite a challenge, especially if you are someone who has compromised trunk function or has little to no function in their triceps muscles. Add a chronic overuse shoulder injury or two to the mix and transferring can become just downright frustrating.
Believe it or not, the inability to feel the floor with your feet (think sensation) can also be a factor that causes more disconnect for someone while trying to transfer in or out of their chair.
So, the question is, can we improve chair transfers through exercise selection? Yes!
I want to start by saying that there is no one right way to transfer. Safe and effective transfer can look very different from one individual to another. Having said this, there are some key groups of muscles that we will want to focus on strengthening to improve our ability to move from one surface to another and to keep our muscles and joints happy while doing so.
Strengthening Pectoralis Muscles for Pushing Out of Your Chair
These muscles are used immediately to help us push ourselves up off the seat of our chair as we begin the transfer process. Strengthening the pec muscles will help us significantly with supporting our body weight up and off the chair especially for those using the pivot method.
Exercises to try: Pec fly or pec deck machine, chest press on a bench, incline chest press (if accessible to you), cable chest press (or banded if working out at home), overhead ball slams with medicine ball (try using a lighter ball 2-6lb that can bounce).
Building Back Muscles for Stability
Although the Latissimus Dorsi (back muscles) are considered ‘pulling muscles’, they are also acting as strong stabilizers for our trunk in the first ‘lift off’ part of the transfer process. These back muscles are engaged and relied on for those using slide boards and need to pull themselves over with their upper body to the next surface or seat.
Exercises to try: Cable Lat pulldowns (I like wide grip if you don’t have any shoulder pain), seated cable rows, single arm bent over dumbbell row, Lat sweeps with pulley or cable machine
Enhancing Triceps Function for Smooth Chair Transfers
These little guys are assisting muscles to the pecs for pushing us up away from the chair. Some individuals that have quadriplegic levels of function may not have fully functioning triceps. This doesn’t mean you can’t transfer or try and work on these muscles! Even if you have one working side or a partially functioning triceps, you may want to work on bodyweight triceps extensions and/or even isometric holds (like dips), to help build your muscle endurance as prep for the chair transfer itself . Otherwise, you may want to look at single arm cable triceps extensions or single arm triceps kickbacks with a dumbbell or small soup can.
Preventing Shoulder Pain: Rotator Cuff Muscle Exercises
Without healthy rotator cuff muscles, our risk of injury and/or pain during a wheelchair transfer can increase significantly. The rotator cuff muscles support the mobility of the shoulder joint. Making sure we target all four of the rotator cuff muscles can help keep our shoulders pain free and happy, especially when we are doing multiple transfers per day. I recommend starting out with a very light Theraband and a doorknob for the anchor point. To learn more about rotator cuff strengthening, please visit our online subscription site, Ocean Insiders Club.
Trunk Muscle Training for Balance and Control
Having trunk control and stability will help significantly with our balance and control for transfers and can make us feel safer in the process, especially if you are just starting for the first time.
There are many ways to train trunk muscles, but I always suggest starting out on a mat or the floor (if accessible). Belly breaths and learning to strengthen your diaphragm can be useful, as well as connecting to your transverse abdominus (TVA) which I cue a lot when working with my clients.
Anti-rotational activation can also be helpful and can be done at the cables seated in a chair. The Pallof press is a great go-to and can be done seated.
If these all sound unfamiliar to you, I recommend you reach out to a coach to learn the basics of trunk functional strengthening with relation to where you are at and your abilities. This will ensure that you are focusing your energy in the most useful way towards bettering your chair transfers.
Improving your transfers will require some practice and rehearsing of the actual transfer itself, especially as a starting off point to see where you feel challenged the most. Having a strength training program along side of this that targets the 5 main muscle groups above will arguably be one of the best ways to help you see progress quicker and get to mastering that transfer. You can find and follow along to all the exercises above on our Exercises page using the “Transfers” filter.