For anyone with impaired mobility and sensation, a pressure sore should be considered a big red flag, marked “DANGER” when it comes to personal care.
We most likely know the horror stories of sores opening on bony parts of the body after too much pressure, of maggots being used to eat the dead flesh, and months in bed, lying in awkward positions to keep the pressure off the damaged areas.
When pressure cuts off the blood supply to an area, usually from sitting or lying in one position for too long, then the tissue can break down and lead to a sore. Basic prevention measures are to change position often, use special pressure-relieving mattresses and cushions, check vulnerable areas of the skin regularly, ensure good nutrition, and seek medical treatment if a sore develops.
If you’re not clued up, then do some online research into pressures sores, but be warned if you click on ‘images’: I was about to eat my dinner, and it put me right off!
What about sport and pressure sores?If you’re an active wheelchair user, then the chances of a pressure sore are reduced in one sense from regularly changing position. But sitting in different forms of transport, like a hand-cycle, a sports chair, a kayak, a sit-ski etc., introduces new dimensions, unusual shapes and areas that can add pressure. I’m always surprised to find that these bits of equipment rarely come with decent pressure-relieving seating.
When using any new piece of equipment or seating, investigate it for potential pressure problems, and be generous with extra foam, gel, sheepskin—anything that you know works well in relieving pressure for your skin.
Sometimes I’ve thought that being active is an excuse to be less concerned about pressure sores. I’ve been reminded, though, that it actually means being even more vigilant, having our radar turned up high for anything which might compromise our healthy skin.
One paralysed friend spent six months in hospital after acquiring a pressure sore when a tiny pebble fell into the seat of his kayak as he manoeuvred himself in. Despite being careful, he was tired, didn’t double-check his seat, and was unluckily caught out. It meant that he missed out on big parts of a journey of a lifetime, sea kayaking the coast from Canada to Alaska.
I, too, was caught out this summer, and had to spend three weeks lying on my front, after paddling a kayak that I’d never tried before whilst on holiday. I bruised my bottom badly after a few days in the kayak, due to insufficient layering of foam and gel which I had added to the seat. Three weeks of inactivity was hard, especially being disciplined enough to stay off when there was no open wound. But when it comes to pressure sores, it’s just not worth taking risks.
Reducing the Risk . . .Whatever you choose to sit on, it’s best to know your own skin tolerance and find suitable options that work for you. Hand-bikes and sit-skis for example, often come lined with one-half inch of closed-cell foam. I’ve never had any problems, but then I usually add something extra for longer days out, like a gel pad to give more relief from ‘shear’ movement. However, here are a few items I’ve found useful to ‘top-up’ the pressure-relieving safety of my sports kit.
Additional Information:‘Skwoosh’ cushions provide gel seat pads, particularly for kayaking but in different thicknesses, they are useful for many everyday activities.
‘Jay’ cushions, particularly a Jay Protector Gel pad for horse riding.
For camping, ‘Thermarest’ sleeping mats from the ‘Camp and Comfort’ series – thicker than others, OR ‘Exped’ down mats – thicker than Thermarest and more insulating, but take longer to blow up.
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