P. PUSHING

P. PUSHING

My advice

Its about your power to weight ratio, your pushing technique, and your wheelchair. In particular, its about how heavy your chair is, your weight, and your chair set up.

Keeping relatively fit and slim definitely helps, but it is very hard to do that unless your chair set up, chair selection, pushing technique, and choice of gloves is good enough that pushing is not too onerous.

My experience

I feel trapped whenever I am in a situation where I have to drive or get a taxi every time I want to go anywhere. In addition, I have always been concerned that using an electric chair would make me unhealthy, as I would get no exercise. These feelings may be irrational but they have continued to motivate me to keep using a manual chair as long as I can.

Now as I approach 50 I can still push more than 3km on the flat and I can push up a 1 in 10 slope for short distances, or long ones with frequent stops. I cannot do wheel stands or go up or down a step that is more than about 8 cm in height.

I have continually looked for ways to make pushing easier and more fun. For me the key issues have been the following:

• Pushing technique –  No finger function means quads need to push on the tyres not the push rims. We need to do this to get enough traction between our hands and the tyres. For many years I wasted energy pushing down on the wheels too hard, because I thought I needed to for traction. The key skill is to only push down enough to maintain traction. This means you can put as much of your energy as possible into moving the wheel forward. In recent years I have taken this to the extreme. On flat paths I no longer push on the top of the tyres at all. I now push on the corner/side of the tyres, and maintain traction by squeezing inwards on the tyres rather than pushing down. I find this increases the length and speed of my pushing stroke and reduces the effort. This means I can reach higher speeds and maintain them longer on flat terrain. On uphill paths I find that this technique no longer works. I have to revert to pushing on top of the tyre to get enough traction to go uphill.
• Braking technique – To slow down on gentle slopes whilst still going forward I lean backwards, and hook my thumbs under the push rims. On steep slopes I put my gloved hands on the tyres. I hook one arm around a push handle to keep my balance when necessary. To stop on steep slopes, corner, or slow down at the bottom of a slope I hook one arm around a push handle and then hook the opposite thumb under the push rim and pull up on the push rim. This is highly effective. It brings one wheel to a complete stop, thereby turning the chair sharply but also stopping your forward motion.
• Tyres – to get better traction between my gloves and the wheels I use tyres with mountain bike tread. This means I can put more energy into pushing forward rather than pushing down
• Gloves – gloves are indispensable for both pushing and braking. I have tried many types. I have found half finger gloves with tough and grippy palms to be the best so far. I use cycling gloves that have synthetic palms with a little padding. A little padding creates good traction because the tread on my tyre digs into it. Too much padding would be bad though. I wear out one pair a month.
• Type of Chair – I now use a lightweight titanium chair. Its about 8kg whereas my last aluminium chair was about 12kg. Weight is critical. Every kilo less is a terrific bonus. You can test this by remembering how much it slows you down when you are carrying something. I switched to titanium when it occurred to me how much it slowed me down pushing around with a kilogram or 2 of shopping. I realised staying in my aluminium chair was like always pushing around with 3-4kg of shopping.
• Chair set-up: 1. I have the back height set so it is below my shoulder blades. I believe this is critical as it allows a full shoulder rotation which means I can push properly; 2. I have push handles so I can hook one arm to maintain my balance; 3. I use 5 inch casters so they can cope with some roughness but the chair is not too difficult to turn; 4. I have the chair balance set to make the tradeoff between minimising the weight on the front casters for easier pushing, but not making it impossible to push up a slope without tipping over backwards. This balance means its quite tippy; 5. I have the footplates tucked in to reduce length; 6. I have the rear wheels angled slightly to improve manoeuvrability, but not too much because I still want to be able to get through narrow doorways. 7. In summary, it’s the kind of set up a T1 or T2 para would normally have.
• Route planning –  I live in a big city and I find there is nearly always an easier way to push somewhere than the most direct route. Often there are lifts in buildings that get me up hills, or streets with smoother gradients than others. When I go somewhere I think about all the alternative routes and choose the easiest.

I still have lot of problems.

• Small steps or bad kerb ramps and steep slopes are insurmountable barriers to me. They require me to find a way around, or ask for help.
• I do fall out at least once or twice a year.
• If I am going somewhere with someone I have to ask them to push me up even gentle slopes because I push more slowly uphill than they walk. Going down hill is the reverse situation. I have to brake as I would normally go faster than they walk. As a result I usually meet people at a venue rather than go there with them because I am slower uphill but faster downhill, and its pretty much impossible to talk meaningfully and push at the same time anyway.

Pictures:

The chair below is very similar to mine and is set up in a very similar way, in terms of back height, seat dump, foot plate tuck and caster size.

CLICK HERE for a pic of the type of tyre I use

CLICK HERE for a pic of the gloves I use

pushing videos to illustrate the text above

Here’s what the experts say

CLICK HERE for a video that provides a good intro to set-up issues.

CLICK HERE for videos on how experts say quads should push. Its ok except for several things: 1) it says to push on the push rims which is ridiculous; 2) it says gloves are optional which is also ridiculous; 3) the way it says to slow down is inefficient and awkward; and 4) the quads in the video are bit too reclined in their chairs to get good power.

CLICK HERE for a great article by the late jeff Shannon on the pros and cons of manual and powered chairs for quads

CLICK HERE for pdf with some sensible stuff about pushing, but way too much worry about shoulder pain

Rule number 16 – Successful quad pushing requires 1) good body position (chair set-up) 2) good traction between hands and tyres (gloves and tread) and 3) reduced drag (weight)