Course Description:

The shoulder complex is composed of three joints (i.e., glenohumeral, acromioclavicular, and sternoclavicular) that help to maximize mobility at the price of reduced stability. The decrement in shoulder stability results in a limited ability for the shoulder to withstand repetitive loading, which is a concern for wheelchair users. Since wheelchair users must use their upper extremities to propel their wheelchairs and to transfer themselves, sustaining a shoulder injury can be detrimental to their mobility. Furthermore, in what would otherwise be considered unremarkable in a population without disabilities, opting to have surgery might not be as feasible for wheelchair users due to the strict postsurgical protocols required for full recovery. The prevalence of shoulder pain among wheelchair users has been reported to be as high as 73%, with subacromial impingement and rotator cuff tears being the most typical causes of shoulder pain. There are many reasons why wheelchair users develop shoulder problems, which include long-term wheelchair use, postural deficits, and faulty propulsion mechanics. Although the treatment for various shoulder conditions are similar to that in non-wheelchair users, medical management of a patient who is also a wheelchair user requires special attention to his or her individual needs and current functional level. Having adequate knowledge of special considerations for wheelchair users will be imperative when treating shoulder pain in this patient population.