By Amanda Simmons, PT, DPT
Transferring safely and efficiently is a daily reality for many people living with a spinal cord injury (SCI). Whether you’re moving from your wheelchair to a bed, couch, or another surface, the right technique and setup can make transfers easier, safer, and less physically demanding—while also protecting your skin and joints. Below are practical, therapist-approved tips to help improve confidence and reduce the risk of injury during transfers.
Start With Strong Foot Support
Foot placement plays a bigger role in transfers than many people realize. Having your feet supported can increase stability and confidence, especially when leaning forward and bearing weight through your legs.
- When transferring into a bed or couch, try leaving both feet on the footplate if possible.
- When transferring from the bed back into your wheelchair, you may only be able to place one foot on the footplate—and that’s okay. One supported foot is often better than none.
Proper Setup Is Key
A successful transfer often comes down to preparation. Taking a moment to set up correctly can make the movement smoother and safer.
- Angle your wheelchair about 30 degrees from the surface you’re transferring to.
- Lock your brakes every time.
- Use your armrest for extra height or leverage if you’re able.
- A yoga block can also provide easy added height and leverage when needed.
- Scoot forward out of the back of your chair and slightly angle your hips toward the direction of the transfer.
Hand placement matters, too. Keep your hands as close together as you can—wide hand placement reduces how much height you can get when pushing through your arms. Remember: the closer your hands, the more lift you can generate.
Use Forward Lean and Arm Strength
Forward leaning is essential to unweight your hips and make transfers easier.
- Lean forward and lift first before moving sideways to ensure you clear your sacrum and buttocks.
- Straighten your elbows and round your shoulder blades to help depress and lift upward.
- Keep your focus on forward motion—this helps reduce strain and improves control.
Understand the “Head–Hips” Relationship
One of the most important transfer principles is the head–hips relationship. Simply put:
Your head should move forward and away from the direction your hips are going.
This counter-movement helps unweight your hips and makes lateral movement more efficient.
Protect Your Skin
Avoid dragging your hips or buttocks across the transfer surface or board. Dragging can cause shearing forces, increasing the risk of skin breakdown and pressure injuries. Lifting—even a small amount—can make a big difference in protecting your skin.
Tips for Caregivers Assisting With Transfers
For caregivers, proper positioning and body mechanics are just as important.
- Use a gait belt or hold the back of the person’s pants for better control.
- Place your feet around the patient’s feet and block their knees with yours, positioning your knees in front or slightly to the side of theirs.
- Gently squeeze your knees together for added stability.
- Rock and lean back onto your heels to help unweight the person’s hips and encourage forward weight shift.
- Use your knees and hips to guide movement laterally, not your back.
- Encourage the person to keep their hands on a support surface and push as much as they can.
- Continue using the head–hips relationship by guiding the person’s head forward and away from the direction their hips are moving.
Placing a Slide Board Safely
Slide boards can be a helpful tool when used correctly.
- Lift the inside leg and slide the board (rough or flat side down) under the upper thigh and bottom while the person leans away to unweight that hip.
- Use an angled motion to push the tip of the board into the wheelchair cushion to avoid pinching skin.
- Position the board so it bridges the gap between surfaces at an angle.
- Make sure about one-third of the board is under the person’s thigh and bottom, with the other end securely placed on the transfer destination.
Final Thoughts
Transfers are a skill—and like any skill, they can improve with practice, proper setup, and the right techniques. Small adjustments in positioning, forward lean, and hand placement can reduce effort, protect your skin, and help you move with greater confidence and safety. If you’re unsure about your transfer technique, consider working with a physical therapist who understands SCI-specific mobility and can tailor strategies to your needs.
For step by step transfer tips, download SCI Transfer Tips 2026
For more step by step transfer tips, download SCI Transfer Tips 2 2026
For step by step transfer exercises, download SCI Transfer Exercises 2026
