Improving Your Transfers – Erik Kondo

One of the best ways to improve your transfers is by watching other people’s methods and techniques. One of the worst ways to improve your transfers is by watching other people’s methods and techniques.

The benefit of trying to mimic someone else’s transfer is that they may have come up with a method that you have not thought of. Thus, providing you a Tip/Trick that makes your transfer easier. The problem is that trying to copy someone else’s method doesn’t provide you with an understanding of the mechanics of the transfer that enable it to work for the demonstrator.

A person's transfer technique is highly dependent upon their individual level of Strength and Flexibility. Where the concept of Strength takes into consideration the person’s functional disability, and Flexibility also accounts for the presence/absence of spasticity, rods, etc. Generally speaking, greater Strength and Flexibility makes transfers easier. Therefore, it is common for demonstrators with relatively high levels of Strength and Flexibility to unknowingly demonstrate techniques that are unlikely to work for people with less Strength and Flexibility.

It is my contention that in order to improve your transfers, you must understand the underlying mechanisms that either enable or hinder them. The primary means to rapidly improve your transfer comes from using effective leverage to increase your functional level of Strength. Biologically increasing your muscle Strength and Flexibility is highly beneficial but takes time to accomplish. Increasing your use of leverage is accomplished by using your brainpower to plan and execute proper movements which exploit mechanical advantage created by specific body positions and actions. On the other hand, poor body positioning reduces leverage and has the effect of making transfers harder to accomplish.

Every time you transfer, you are configuring your body into a machine that moves itself from one position to another. Rather than being made of motors, pulleys, levers, and struts, your body is made muscles, tendons, joints, and bones. Machines utilize the principles of physics to work. Unfortunately, for some people, their pre-existing beliefs, emotions, and ego tend to get in the way of learning effective transfers.

Most transfers incorporate what I call “S-Concepts” to accomplish the task. Think of them as building “simple machines” out of your body. I have listed some of the commonly used S-Concepts below:

The Swing

Just like how a park swing moves your body back and forth via hanging chains, the body Swing uses your arms as the chains. When Swinging down in height, you utilize gravity to pull you to your destination. When Swinging up, you use your muscles to Swing higher to your destination. A typical transfer involves Swinging to your Leading Hand and away from your Trailing Hand. Your body’s Center of Mass follows the direction of the straight line between your two hands. Therefore, it is very important to recognize where you are putting your Leading and Trailing hands before engaging the transfer. You need to visualize the path your body will follow so your butt ends up in the correct location.

The See-Saw

The See-Saw is a lever made up of your body parts. Generally, the goal of the lever is to raise your butt in coordination with the Swing. Without use of your lower body, your butt is raised by your arms. The See-Saw is used to reduce the effective weight of your butt. Thereby making the lift easier. Same as a child’s See-Saw, when one side goes down, the other side goes up. Therefore, when your arms make the fulcrum point, lowering your head, creates an upward force on your butt. Gravity pulls your head and shoulders down and this force makes your butt “lighter”. It now takes less Strength to lift your butt and engage the Swing. Generally, the lower your head, the higher your butt goes.

Structure

The above discussion doesn’t take into consideration the effect of the person’s legs (assuming they have them). Legs left behind at the starting position imped the Swinging motion. If the person’s feet legs stay in place, they create an anchor and stop the transfer like a boat anchor. Or they create friction as they drag along the ground, increasing the Strength required to make the Swing. Therefore, it typically makes sense to bring one or both legs forward towards your Leading Hand. In this case, your butt Swings toward your forward positioned leg(s). Note: Flexible legs will bend easily, stiff or knee locked legs may hinder the Swing.

If your leg(s) is on the ground and in the forward position, they have the potential to carry weigh through proper bone alignment rather than muscle engagement. Your legs create a Structure that supports some fraction of your body weight as you Swing. Every bit of weight that is channeled through your legs to your feet on the ground is weight that you don’t have to transfer. For example, it is possible to squat with all your weight on your feet without using your leg muscles. Another way to think of it is that your legs become a stand/pole that briefly supports some of your body weight as your butt passes over it.

Spin

The Spin is not a simple machine. It represents rotational motion around an axis. In some cases, the axis could be your feet/legs which have created Structure and are carrying weight. Many transfers involve a compound motions of Swing then Spin or See-Saw (lift) then Spin. In these cases, your butt needs to rotate (Spins) into position rather than simply Swinging into the final position. The Spin can also be part of the Swinging motion.

A common transfer for a paraplegic, such a Wheelchair-to-Couch, usually involves the S-Concepts of See-Saw, Structure, Swing, and Spin to less of a degree and the Floor-to-Wheelchair utilizes them to a greater degree. All else being equal, more difficult transfers require greater effective use of the S-Concepts. There is a much smaller margin of error. As a result, many people are able to make basic everyday transfers using poor technique. But their poor technique becomes habitual and hinders them some being able to perform more difficult transfers.

It is important to recognize that the ease and difficulty of a transfer is relative to the physical function of person doing it. Generally speaking, the greater the disability, the more difficult it is to transfer. The lessor the disability, the easier the transfer. A transfer that is “easy” for one person, may be difficult or impossible to someone else. But regardless of a person’s disability, the S-Concepts discussed here still apply. They apply if a person is doing an independent transfer or is getting full assistance for the transfer. In the case of assistance, the helper(s) will utilize the S-Concepts in some manner.

Even if you can’t physically execute the S-Concepts due to your degree of disability, you may have to explain them to someone helping you so that they can incorporate them into the transfer. Therefore, understanding the S-Concepts and how they relate to your transfer is critical for success. Here are examples of three types of Floor-to-WC transfers on my Instagram.