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What You Should Know About Muscle Atrophy ( Muscle Loss ) In The Elderly From Regular Wheelchair Use. Learn About Prevention and Exercise Tips

What You Should Know About Muscle Atrophy ( Muscle Loss ) In The Elderly From Regular Wheelchair Use. Learn About Prevention and Exercise Tips

In this article, we will be discussing only one complication in detail as well as ways to reverse or prevent it: muscle atrophy. Muscle atrophy is a process in which muscle tissue is literally breaking down or wasting away.

This usually results when muscles aren’t used for a long time, which is observed in individuals who are bedridden, paralyzed in one form or another, or sedentary as a lifestyle choice. Persons who regularly use a wheelchair without moving (on their own or with assist) are also at risk for developing muscle atrophy. We talked a lot about this in a previous article called ” What happens to elderly seniors that are sitting in wheelchair all day with no physical activity”.

Luckily, many cases of muscle atrophy can be reversed or prevented with proactive measures which all revolve around one commonality: movement. Stretching and exercising contribute to muscle lengthening and contraction while moving blood and oxygen to the tissue.

The following information is a list of movement regimens that wheelchair users can incorporate into their daily routine. Note, each exercise will look slightly different for each user depending on how much voluntary movement each person has:

Daily Movement Regimens For Wheelchair Users:

Neck Stretching And Strengthening Exercises


Place your hand gently on the top of your head in order to pull and stretch the neck in all directions: chin to chest, chin to sky, right ear to right shoulder, and right ear to right shoulder.

You can also roll your neck from side to side, but avoid rolling it around the back for this sometimes causes spinal problems. Hold each stretch from 10 to 30 seconds each. You can also have this done by someone else if you cannot voluntarily move your neck.


Place your hand on your head in order to push into your hand in multiple directions. Hand placement should be one on the left side, one on the right, one on the forehead, and one on the back of the head. Push gently into your hand to contract neck muscles up to 10-20 seconds each.

Neck Stretch Exercises

Shoulder Girdle & Rotator Cuff Stretching And Strengthening Exercises


Note all of the directions that the shoulder girdle can move in: flexion, extension, abduction (away from the body), adduction (towards the body), shoulder blade upward/downward rotation, and bringing hands together in front together (horizontal adduction/abduction).

Below is a stretching chart that can be used for the shoulder and neck.

Shoulder Exercises For The Elderly



Dumbbells and theraband exercises are a great way to go if you have full use of both shoulders.

Click the link below to view some good shoulder exercises you can perform while sitting in the chair.


Latissimus And Serratus Stretching and Strengthening Exercises


The Latissmus dorsi muscles outline the mid to lower back while the serratus muscles outline the outsides of the ribcage. These can easily be stretched by rotating from side to side in the chair and pulling on the arm-rests for more resistance.

Additionally, bringing one arm up over the head and leaning over the armrest on each side to provide a great stretch.

Smart Chair Yoga For Wheelchair Users: Stretching Serratus and Latissimus Dorsi Muscles



With those stretches previously discussed, slowly bringing yourself back up from over the arm-rests into a neutral position provides a great latissimus and serratus muscle workout.

Also, reaching backwards for items from side to side (i.e. reaching back for weighted items on a table slightly behind the chair) provides a similar workout.

** Note: ** if you have unsteady core muscles or sitting balance, make sure you have someone around to spot you so that you don’t tip out of your chair.


Abdominal Muscle Stretching and Strengthening Exercises


The stomach muscles can be stretched by scooting your buttocks forward in your seat, bringing the arms together over your head, and arching the back.

WikiHow: How to Stretch Your Back While Sitting


Ab crunches can be performed in sitting by elevating one or both knees up towards the chest. For this exercise the slower the better for good results. Exercises can also be performed laying down in bed or on the floor performing the exact same motion.

abdominal crunches in sitting exercise

Wiki How: How to Exercise Your Abs While Sitting


Back Extensor Stretches And Strengthening Exercises


Back extensors can be lengthened by folding yourself in half as far as you can go, or in other words bringing your nose to your knees. Round out your back as much as you are able to feel the stretch.

Back Extensor Stretches for the Elderly

Body Balance Physical Therapy: What exercises should I do for my Low Back Pain?



Oftentimes, back extensors are strengthened by using other exercises meant for other muscle groups. Visit this site for some back extensor strengthening exercises that can be completed in sitting while strengthening other muscles of the body:


Hip Flexor Stretches and Strengthening Exercises


The hip flexors draw your upper legs upwards in preparation for sitting, walking, etc. In order to stretch these muscles, you either need to stand frequently if you are able or lay down on the bed. For a better stretch, lay flat on the bed while letting your feet and lower legs up to mid hamstrings hang off of the edge of the bed.


Hip flexor strengthening is often achieved by the same abdominal strengthening exercises mentioned previously, which is by lifting the legs towards the chest in sitting. 


Quad Stretch and Strengthening Exercises


The Quad muscle can be stretched in sitting with assistance from someone else. Move your footrests outward and make sure the brakes are on. Have someone pull one foot at a time under the chair while you keep your upper leg straight and flat on the seat.


Quads can be strengthened by regularly standing up and down from the chair with or without the assist of the arm rests. Others include wearing ankle weights and performing leg kicks in sitting.



Hamstring Stretch and Strengthening Exercises


In sitting, prop one leg up at a time on a low table while keeping your knee straight but not locked. If this is too much, some people get a decent hamstring stretch by using elevated footrests and propping both up as high as they can go.

wheelchair hamstring stretch

Love To Know: Wheelchair Exercises


Tie a theraband in a loop around a sturdy pole or stud (or have someone hold it in a loop). Place one foot at a time in the loop and pull against the band while in sitting with your knee bent. The idea is to pull your feet towards the under part of your chair so that you are creating tension in your hamstrings.



Calf and Ankle Stretching and Strengthening Exercises


Using a belt (or your hands if you can reach or a loved one who is willing to assist), wrap your hand your belt loop around your mid foot and pull your toes upward. The knee can be bent while you are sitting.

Calf Stretches for Seniors while sitting in a wheelchair or chair

Stretching Exercises Guide – Calf Stretching


Push your toes into the foot rests or the floor and hold your heels up off the floor for 20-30 seconds.


Anterior Leg Muscle ( Shin ) Stretching and Strengthening Exercises  


The shin can be stretched by pointing the toes as far as you can, or by placing the top of the foot under a soft ledge (chair, sofa, bed) and pushing the toes into a pointed position.


Drape open ankle weights over the top of your feet while your feet are flat on the floor. Keep your heels on the ground and lift the weights with your toes.


In Summary:

These are just a few exercises you can do for seniors to strengthen and stretch muscles that may atrophy or weaken from prolonged sitting in a wheelchair.

Before trying these exercises make sure the person doing them are cleared by their physician or physical therapist to engage in physical activity. Let us know if you find these exercises helpful in the comments below.



About Samuel

Samuel is a physical therapist with over 20 years medical experience. He has extensive knowledge in functional rehabilitation in the acute care hospital and in-home care settings. He has spent most of his career helping seniors transition from hospital or rehab care to living independently at home. In his free time he likes to travel and read autobiographies.

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Comment ( 1 )

  1. […] to keep moving, strengthen their muscles, and keep their flexibility, because as we get older, our muscles start to deteriorate. There are many smartphone apps and video games that have different types of classes and exercises […]

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