Q: I’m a C6 quad and I can do simple transfers independently using a sliding board. That’s fine at home, but I hate having to lug a board around when I go anywhere. Similarly, I drive a ramp-equipped van, but I’d love to be able to transfer into a car independently to make rentals and transport easier when I’m traveling. What are some things I can do to get stronger with my transfers? 

A: As a C7 quadriplegic, I understand how important transfers are for independence, especially when away from home. There is a variety of exercises that can enhance your upper body strength and make transfers easier, or maybe even reduce your need for a sliding board.

But before I explain exercises and fitness strategies, I think it’s important to make all your transfers as easy as possible. There are no medals for doing difficult transfers, and we want to keep our muscles, joints and ligaments as healthy as possible for as long as possible. If that involves using a sliding board some of the time, then I recommend using one when you can.

For those times when a sliding board doesn’t make sense, learning to transfer without one will require new techniques, balance and use of your muscles. When you’re ready to start practicing technique, please look for “Mastering Everyday Wheelchair Transfers,” coming soon on newmobility.com.

Author Ben Clark, a C7 quad and founder of the Adapt to Perform YouTube channel, performs dumbbell shoulder shrugs. They are an effective way to strengthen upper back muscles that can help keep you stable during transfers.

Strength Matters

Once you have your technique down, there’s no doubt that increased strength is helpful not just to make transfers easier but also to protect the shoulders. Let’s look at a few exercises that can help.

• Lying shoulder squeezes are an exercise where you lie face down and retract or squeeze your shoulder blades together. By engaging the muscles between your shoulder blades, this exercise helps improve posture, enhances shoulder stability and can alleviate upper back and neck discomfort. It’s particularly beneficial for keeping your shoulders stable through your transfers and reducing the risk of injury. If lying face down is too difficult, you can lean over your lap while seated in your wheelchair or even do shoulder squeezes while seated in an upright position. Do 20 squeezes every day, holding each squeeze for 10-15 seconds or as long as you can.

• Dumbbell shoulder shrugs are a simple yet effective strength-training exercise that is a step up from the previous exercise. To perform dumbbell shoulder shrugs, you typically sit upright with a dumbbell in each hand, then lift your shoulders in a controlled upward motion, as if trying to touch them to your ears. Shoulder shrugs are an excellent way to build strength in your upper back muscles and stabilize the shoulders. If you have limited grip, Active Hands gloves can help secure a dumbbell, and wrist weights work too. This exercise can also be done with a resistance band tied under your footplate. Do this exercise three times per week, performing the movements in three sets of 10, with two minutes’ rest between each set.

• Straight arm rows help transfers in a number of ways, including working muscles of the upper back and providing static strength-building for the triceps. Even when you’re not actively extending your triceps in a transfer, the muscle still keeps the elbow stable. The stronger the triceps, the easier the movement. To perform a straight arm row, you secure a resistance band in front of you at shoulder height, holding onto the band — or wrapping it around your wrist —and extending your arm in front of you. Then pull the band toward your hip while keeping your arm straight. If you have balance issues, you can do one arm at a time. This exercise can also be done with a cable machine if you have access to one. Do this exercise three times per week, performing the movements in three sets of 10, with two minutes’ rest between each set.

You can easily find dumbbells and resistance bands in most stores that supply fitness equipment, online marketplaces and even secondhand stores. You don’t need heavy or expensive equipment to get started and make a big difference.

Balance, Coordination and Flexibility

Balance, coordination and flexibility are essential aspects of successful transfers. Strengthening these skills can significantly enhance your ability to transfer safely and independently. Here are some specific exercises and practices to help you improve in this area.

• Balance Practice: Start by sitting upright in your wheelchair without using the backrest, or on a flat surface like a bed. Initially, you might need assistance or cushions for support. Gradually decrease the support until you can comfortably sit unsupported.

• Weight Shifts: While sitting without a backrest, practice shifting your weight from side to side and forward and backward while maintaining your balance. This mimics the movements required during transfers.

• Yoga: Many yoga poses and stretches can be adapted for wheelchair users. Yoga is an excellent way to improve flexibility, balance and strength while remaining seated in your wheelchair.

• Stretching: Perform stretches that target the muscles in your arms and shoulders. Reach one arm across your chest and gently pull it with the opposite hand to stretch the back of the shoulder. Repeat on the other side. Put your hands on your wheels behind your hips and squeeze your elbows together. This will stretch the front of your shoulders and your chest.

Practice your stretching and balance every day if you can. Yoga can be done a few times a week. You can find videos on my YouTube channel, Adapt To Perform Yoga.

Fit Into Your Routine

With all of these practices, consistency is key. A great aid for consistency is linking exercises with things you already do. For example, do your lying shoulder squeezes before getting out of bed in the morning; do your stretches while your coffee is brewing; do your dumbbell exercises before you have lunch, etc. Linking exercises with your already-established routine helps you remember that it’s time to do them and increases your likelihood of being consistent.

Remember, progress takes time, so be patient with yourself. Gradual increases in strength and stability will help you become more independent in your transfers. Always prioritize safety, and if you experience any discomfort or pain, consult with a health care professional. Your determination and commitment will certainly pay off, making travel and daily life more accessible and enjoyable. Keep pushing forward!