The single most important functional skill required by all SCI patients is the ability to perform pressure reliefs to prevent decubiti, or pressure sores, from developing on the buttocks and on the skin over the ischial tuberosities and other boney prominences during sitting.

Functional Skills - Pressure reliefs should be performed every 15-20 minutes, in the beginning until skin tolerance improves.

1. Pushup - The patient with adequate strength in the triceps places the hands lateral to the buttocks on the wheelchair seat, armrests, or wheels, extends the elbows, depresses the shoulders, and pushes down to raise the body.

2. Weight Shift - The patient leans far enough forward to unweight the ischial tuberosities, or, leans to one side, and then the other side, to unweight one side at a time. Other techniques appear in Move the Trunk in a Wheelchair and Move the Buttocks in a Wheelchair.