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Causes of pressure sore from Handcycle

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    Causes of pressure sore from Handcycle

    Would like to hear from someone with a similar experience. I just got done healing my pressure sore but it opened back up in a matter of minutes. My sitting Handcycle keeps giving me a pressure sore but I can’t seem to figure out why, no matter how I try change the sitting position. Would I have to switch this Handcycle for a laying down style Handcycle ?

    #2
    Can you send a photo of you sitting position from the side and front? Perhaps with cranks in 6 and 9 O'clock position. It may be you have your feet too high causing pressure on the sore.

    I'm concerned you may have it healing from the outside in rather than inside to out. What kind of handcycle? I've been handcycling 44 years and have owned well over a dozen bikes. Setup position is really critical.

    Comment


      #3
      Are you using a good cushion? I use the same type of cushion on my bike as I do my chair (Stimulite Contour XS), trimmed to fit the bike seat. I'm not sure the standard foam that comes with most bikes provides adequate pressure distribution. Especially not for someone with a pressure sore, or at high risk of getting them. I know some guys who use custom sized low profile Rohos, too, for this reason.
      "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

      "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

      Comment


        #4
        Originally posted by Patrick Madsen View Post
        Can you send a photo of you sitting position from the side and front? Perhaps with cranks in 6 and 9 O'clock position. It may be you have your feet too high causing pressure on the sore.

        I'm concerned you may have it healing from the outside in rather than inside to out. What kind of handcycle? I've been handcycling 44 years and have owned well over a dozen bikes. Setup position is really critical.
        Hey Patrick,

        What do you mean by its healing on the outside and not inside?? How would I determine this ??


        i set my feet on the ground and sit at a 6 and 9 position. My back is curved and don’t have support in my lower back, I have to put a foam or a support in my lower back. Im also sitting on a 2” roho cushion on top of a Aylio brand cushion I bought on Amazon. It has two holes cutout on the cushion where the sit bones sit. The left side has the stubborn sore. Any suggestions on healing the sore?

        ive been taking coconut oil and ensure protein packs and pressure relieving past few months and it started to heal. Soon as I tried to bike again, the scar opened up. Im on a top end Force G

        Comment


          #5
          Pressure ulcers should heal from the lowest point in the wound out. If it heals just covering the top layer; there's still a hole underneath which can cause infection, tunneling and opens up.

          The 6 & 9 position means having your arms extended (9 0'cock)and 6 O'clock is having the handles at the bottom of the rotation. this shows if your arms are too extended forward causing a rocking type motion when turning the crank handles. Six and 12 shows if the shoulders are raising up and down "cranking". You want your forearms level as possible, 90o from the elbow with the shoulders down and relaxed in the 6 position

          Just saw you're on a Force G. I thought it may have been an upright bike. Force G you want the legs bent at the knee just a bit. If you have too thick a cushion it puts pressure on the butt because of the angle going from the rear of your body thru the legs is too great. How do you transfer to the bike from your chair? If you're kind of slamming down into the bike. that'll open up any new wound.

          A side photo of you sitting in the bike would really help. One with you holding the handles in the forward position. To help alleviate the stress in transferring, I dug out a channel so the seat of the bike was level with my chair for transfers in and out. Bike is on top with chair in lower part of channel.

          Only way to really heal a wound is to stay off it completely. I had one that wouldn't heal that turned to sepsis. It took two surgeries and 6months total in a Clinitron bed 24/7. That was four years ago and no trouble and back riding full time.

          Without a photo or short video it's tough to diagnose how you're sitting and affecting your wound. I think it's a combo. of like Oddity mentioned and a slight setup of the bike. Main thing now is to get that wound healed.

          Click image for larger version

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          Comment


          • Hemiguy
            Hemiguy commented
            Editing a comment
            Patrick,

            Thank you for adding adequate information. I really appreciate it.

            Where was your injury located that required a surgery, same as mine?? Also how do you know it was sepsis?

            I asked my Wound doctor if surgery was an option And she was looking at me like there’s no such option. What exactly does surgery for pressure sores do??

            I am transferring regularly, not slamming at all. But I will take that into consideration now. I could send you the photo of me sitting on the Handcycle seat but I am bedridden currently. Im gaining weight And bone mass has shrunken. being bedridden past 6 months and another is going to put some serious strain on my health, which is what My immediate concern is.

          #6
          Under the right trochantor I believe Hemi. The normally recovery time after surgery is approx. 6 weeks and then gradually more sit up time in the chair.. My six months was actually split into three times. so was about 8 weeks each. Part of it was getting rid of the sepsis. Sepsis can be deadly in a matter of hours as it travels to the nearest source to get into the blood supply. Surgery usually entails gathering skin or muscle from one area and placing it where the wound is. I'm not good explaining procedures. Mine was first going to be just a suture up the wound with a 6 week lay down in a Clinitron bed. Once the sepsis infection settled in, it tunneled up towards my scrotum entailing a much more complicated surgery. It never really closed up so the doc went back in and did a second procedure with 8 weeks in Clinitron. Third time was I went into sephilitic shock where they couldn't get my blood pressure up over 40 bpm. Was a close one. Turns out there was an abscess under the repaired "meat" he used to fix the original wound. Once that was taken care of, no more problems.

          One thing, after wanting to discharge me from the hosp. when I got back to normal, I insisted on a mri on the site before I left. That's when they found the abysses. So if they hadn't done the mri, It would have continued.

          Have they ever done any tests to insure you don't have any infection under the site? Again, someone more knowledgable could suggest a better explanation.

          The strength comes back pretty fast. I used stretchy bands to at least get a bit of exercise in. Plus using a Clinitron bed, I had to go to anassisted living facility which I thought would be the worse thing to happen. Probably was one of the reasons I battled the sore for many years and not doing what was required to heal it. You may want to start another thread on treatments for pressure sores.

          I'm surprised your wound doc has never heard of surgery to close a wound. Perhaps yours is not that bad... yet. One thing that really helped was the Ride Java Cushion for taking all the weight off the trochantors.I went in for an eval of cushions and of course, the first thing they wanted to offer was a damn Roho. Worst cushion imo and after the eval they agreed it was the worst for me. FOr one thing I could never feel stable sitting on it. The Ride cushion has worked out great and I'm back in the gym with my trainer, well that was until the Covid, working out at home and back to riding my Handcycle and recent addition attachable Stricker handcycle. I've always avoided attachables because they were so inefficient. This stricker is one of the most if not the most efficient bike I've owned. Sure is nice to just hook on, ride to a destination and unhook to go inside. I usuallly alternate between the Freedom Ryder and Stricker.

          Good luck with the healing. BTW, what is your level. Lower injuries seem to have more challenges with PS's than higher injuries.

          Comment


          • Hemiguy
            Hemiguy commented
            Editing a comment
            Thanks for the good wishes. I am a T 12 -L1 complete 5 year with injury. What is your injury level? I wish we could we meet up so I could have you take a look at my Handcycle, you seem very knowledgeable. Did you just lay in bed for 6 months during the healing process??
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