The Importance of a Properly Fitting Footrest for Wheelchair Users

When it comes to wheelchair design and the comfort of those who use them, the footrest is often an overlooked but crucial element. For persons with disabilities, particularly children, the footrest plays a significant role in ensuring both comfort and long-term health. Whether you are using a wheelchair temporarily or permanently, the footrest is vital in preventing a wide range of complications and promoting overall well-being. When this part of the wheelchair does not fit properly, it can cause discomfort, and pain, and even lead to more severe physical complications.

In this article, we’ll explore the importance of a properly fitted footrest, the complications that arise from poor fit, and why children with disabilities especially need to have wheelchairs that cater to their unique needs.

Understanding the Role of a Footrest

A footrest serves as a support for the feet and legs while a person sits in a wheelchair. It ensures that the legs are properly aligned, helps distribute weight evenly, and provides comfort for the user. More than just a simple accessory, a footrest plays a critical role in maintaining correct posture, reducing pressure, and preventing unnecessary strain on the body.

For children, whose bodies are still growing and developing, the right footrest is even more important. They need a footrest that accommodates their size and growth, supports their legs correctly, and promotes optimal posture while they are seated.

The Risks of an Improperly Fitting Footrest

When a footrest is not properly adjusted to fit the user’s body, it can lead to a variety of complications. This is particularly true for children, whose bodies are more sensitive and still growing. Below are some of the risks and complications caused by an improper footrest fit:

 Postural Issues and Back Pain: One of the most common problems that arise from an ill-fitting footrest is poor posture. If the footrest is too high or too low, it forces the user to adjust their posture unnaturally. For children, this is especially concerning, as it may lead to spinal misalignment. This misalignment can cause pain in the back, shoulders, and neck. Over time, these issues can worsen and lead to chronic back pain and discomfort, which could be easily avoided with the correct footrest adjustment.

 Pressure Sores and Skin Damage: An incorrectly positioned footrest can cause the user’s feet to rest in an awkward position, putting pressure on certain areas of the legs and feet. For children, this is especially important because their skin is more sensitive than adults’ skin. Over time, prolonged pressure on certain parts of the body can result in painful sores or pressure ulcers. These can be both painful and difficult to heal, leading to further complications if not addressed quickly. A properly adjusted footrest ensures that pressure is distributed evenly, reducing the risk of skin damage.

 Circulation Problems: If the footrest does not support the feet properly or if it forces the feet to be elevated or stretched in an uncomfortable position, it can interfere with blood circulation. Poor circulation can cause swelling, and numbness, and even contribute to the development of blood clots. For children, who are still developing, improper circulation can lead to long-term health problems and developmental delays. The footrest should support the feet in a natural, neutral position that allows for good circulation and comfort.

 Leg and Joint Deformities: Children are more prone to muscle imbalances and joint issues because their bodies are still growing. When a footrest does not support the feet correctly, it can place strain on the muscles, ligaments, and joints of the legs and hips. Over time, this can lead to deformities such as foot drop, where the foot cannot properly lift, or hip displacement. Additionally, poor foot positioning can cause the legs to become misaligned, which leads to further complications in both mobility and development.

 Reduced Mobility and Independence: A footrest that doesn’t fit well can limit the user’s mobility. If a footrest forces the feet into an uncomfortable position, the user may find it difficult to move their legs freely. For children, this can reduce their ability to explore their environment, play, and engage in daily activities. A well-fitted footrest allows children to maintain a good level of independence by supporting them in activities that promote mobility, such as self-propelling the wheelchair or participating in physical exercises and therapy.

The Importance of a Properly Fitting Footrest

For individuals with disabilities, particularly children, a footrest that fits properly is not just about comfort – it’s about maintaining overall health, supporting growth, and preventing complications that could negatively affect the body. Below are several reasons why it’s important to ensure the footrest fits well:

 Prevents Long-Term Health Issues: A well-fitted footrest helps prevent the long-term physical complications mentioned above, such as joint deformities, posture problems, and skin damage. By adjusting the footrest so that it supports the body correctly, these problems can be avoided before they even begin. This means that children can grow and develop without being hindered by unnecessary discomfort or health problems.

 Supports Proper Posture:  Correct posture is essential for spinal health and general well-being. The footrest works in tandem with the backrest and armrests to promote a balanced sitting position. When the footrest is at the right height, it encourages the user to sit upright, with the feet flat and the legs at a comfortable angle. This reduces the strain on the back and spine and helps prevent poor posture habits that could otherwise lead to discomfort or injury.

 Enhances Comfort: Comfort is a crucial factor in any wheelchair. A footrest that fits well ensures that the legs and feet are comfortably supported, which means less strain and fatigue. For children, comfort is especially important, as they spend a lot of time in a wheelchair, either for mobility or therapeutic reasons. A properly adjusted footrest will allow them to focus on activities rather than on discomfort or pain from poorly supported feet.

 Encourages Active Movement:  A wheelchair that fits properly, including a well-adjusted footrest, encourages active movement. Children can engage in physical activities with more freedom and comfort, which is essential for their development. Physical activity promotes muscle strength, coordination, and balance, all of which are essential for children with disabilities. A footrest that supports active movement will empower children to be more involved in their environment.

 Promotes Confidence and Independence: When a wheelchair fits well and provides all the necessary support, children feel more confident and independent. A child who can sit comfortably and move around easily in a wheelchair is more likely to be motivated to explore and participate in various activities. This boosts their confidence, independence, and overall quality of life. For children with disabilities, the ability to move freely without constant pain or discomfort is a powerful tool for self-empowerment.

From a Professional’s perspective 

Dave Calver, co-founder of Participant Assistive Products and an occupational therapist, explains that all postures in a seated position come from the position of the pelvis. Having a properly adjusted footrest, helps to ensure the pelvis stays in a neutral position, distributing pressures equally and helping to maintain healthy postures in the legs, torso, and neck. Worth noting that when footrests are too high for the user, this creates increased flexion in their ankles, hips, and ultimately their torso. The knees are lifted off the seat, pushing all the user’s weight back onto the ischial tuberosities (sit bones) and sacrum, greatly increasing the pressure on them and increasing the likelihood of skin breakdown and pressure ulcers. This position also forces the pelvis to tilt backward, creating postural problems in the torso and neck. Prolonged sitting in this position can create fixed postures or contractures, which are extremely problematic for users.

Conclusion

A  wheelchair footrest might seem like a minor part of the overall wheelchair design, but its importance cannot be overstated – particularly for children with disabilities. An improperly fitting footrest can lead to a host of complications, including poor posture, skin damage, circulation problems, and even permanent postural changes. A footrest that is properly adjusted can prevent these issues, support healthy growth and development, and improve the overall quality of life for wheelchair users.

For children, whose bodies are still developing, it is crucial to ensure that their footrest is tailored to their size and needs. A well-fitted footrest not only promotes better posture and comfort but also supports their independence and physical development. Investing in a wheelchair with the right footrest for a child is an investment in their health, happiness, and future.

As caregivers, family members, and medical professionals, we must ensure that every aspect of the wheelchair is carefully considered to meet the user’s needs. Only by paying attention to these details can we provide individuals, especially children, with the support they deserve to lead a fulfilling and active life.

Click here to check out Cub, an All-Terrain accessible pediatric wheelchair that is tailored to fit the user's needs.