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The Trouble With Transfers

Understand how a transfer works

Transfers can be such a huge part of gaining back some independence after a spinal cord or brain injury. Simply having the ability to get from one surface to another is grossly overlooked by people that don’t quite understand the possibilities.

  • Lounging on the couch
  • Using public restrooms
  • Getting in and out of most cars (tall cars are tricky)
  • Using gym equipment!

The list goes on and on…

Whatever it is, people with injuries are often unaware of their likelihood of transferring.

Transfers can be broken down into a couple of groups, but if you’ve read any of the other posts on across our blog, we know that every person is different and one or two sizes definitely doesn’t fit all. These groups are:

Thoracic Level Injury Method (with complete hand and tricep function)

AND

Cervical Level Injury Method (referring mainly to the inability to extend elbows due to loss of innovation to the triceps)

If you are still struggling with your ability to transfer, there could be some issues that you may have to work on:

  • Weight reduction – as you can imagine the more useless body mass (fat tissue) you have in the body, the harder a movement will be to execute. Get in contact with a Dietitian to couple with your exercise to speed up the process (or ask us for a recommendation).
  • Strength in Upper Limbs – many people suffer large amounts of strength loss after sustaining a traumatic injury. Whether it is from physical neurological damage that has affected the muscles in the upper limbs or the prolonged bed rest that you endured during your time in the hospital. Generally, strength loss is bound to happen and now it’s time to get to work.
  • Spasms – if you are experiencing high amounts of spastic activity in the lower limbs, triggered by a number of things, it makes it difficult to predict exactly what could happen when you’re setting up for a transfer. Spasms do vary widely from person to person, and day to day, but understanding your triggers is the first step to controlling your environment to make these transfers possible. There is evidence to suggest that exercise over time can reduce the frequency of spasms, but knowing what body positions you are likely to spasm in is a great place to start.
  • Flexibility – in some cases getting into transferring positions can be very difficult for those with inflexible hips, lower limbs, trunks and even shoulder or chest. Beginning a stretching program as soon as possible to address any potential issues could not only be beneficial for transfers but for other areas of your life.
  • Seated Balance – if you are having trouble finding your balance, even when you’re seated and not grabbing onto something or someone, it might be difficult to safely work on your transfers. Seated balance exercises are relatively simple, but the more you can experience moments of instability in a safe environment the better you will be at making the necessary adjustments to keep your balance during those moments. There are hundreds of seated balance exercises out there so get in contact if you want some pointers.
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Understanding how a transfer works

To make a transfer movement as simple as possible I want you to picture your body as a “seesaw”… (please forgive the stick figures but it’s the easiest way to learn). When you are seated back in your seat, the vast majority of your body weight is supported through your hips, let’s say approximately 90%. In the same position, your feet are only getting the remaining 10% or so of your body weight (primarily your lower legs).

If you want to transfer as efficiently as possible, you will want to reduce the amount of weight on your hips, because this is the part of the body you wish you move. Still with me? Good. The lighter your hips are the easier it is to transfer.

Thankfully, for most people, the ability to transfer is relative to their technique and body position.

By shifting your upper body weight forward and supporting yourself through your upper limbs, it is possible to reduce the amount of weight through your hips, therefore, reducing the strength needed to transfer entirely!

Of course, again, every person is different, some people have weak or tight or zero innovation in their lower limbs and that’s why it’s so important to learn this skill with someone with training and experience.

Thoracic Spinal Injury Methods

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Having the use of your triceps is definitely a great advantage to transferring in general, however, there are many constraints to consider. Hand placement, foot position, wheelchair placement relative to the surface you are transferring onto, head position, physical cues and other factors all come into play when learning this new skill. By using elbow extension you will be able to relieve pressure through the hips more easily and shift weight into the hands and upper limbs. But, this doesn’t mean you have to muscle your way on and off of things, this will only increase your chance of injury. The technique is what will save your shoulders.

Cervical Spinal Injury Method

If you don’t have any tricep activation, or barely any to the point of not being functionally useful for the task, you will be relying on a few other important muscle groups to get the job done. Passive elbow extension through external shoulder rotation, shoulder abduction, and shoulder depression, will be your set of muscles used for pressure relief of your hips. Now, this might seem more difficult, but as I’ve mentioned before, it’s all about technique. If you have the right directions and guidance it is possible to figure out a way to transfer that is specific to your situation.

When you master the horizontal transfer to a surface that is a similar height to your chair you might want to learn how floor to chair transfers could be a possibility for yourself! This transfer is extremely useful for getting in and out of your chair and onto the floor, so if you ever were to fall out of your chair and need to get back in, or maybe want to get on the ground to play with your children, it’s just another tool in the shed.

If you’ve found this information useful and might be interested in trying to learn the skill of transferring, please don’t hesitate to get in touch and book an appointment with us or message us on Facebook. The possibilities are in front of you, now you just have to pursue them.

Find out more in our video below.

Meet the team

Be Physiology

At Be Physiology we focus on exercise and movement for the management and improvement of neurological and chronic conditions.

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Trent Brock | Mobile Exercise Physiologist

Trent Brock

mobile exercise physiologist
I have had 3 major passions throughout my life; exercise, competitive sports, and a strong will to help others. Those 3 factors made it an easy decision to pursue a career as an exercise physiologist. By encouraging and facilitating evidence-based exercise rehabilitation, I can help individuals living with various chronic conditions, particularly those living with neurological conditions.
I see exercise physiology as an extremely beneficial practice that enables clients to experience an improved quality of life. Personally, being able to provide insight into exercise and other tools that can equip clients with helpful skills and wellbeing improvements is extremely fulfilling. Being able to improve not only an individual, but their support network’s day-to-day life fills me with great joy and motivates me to continue to be better so that I can do better. I understand that everyone has a different view of exercise and there is no one-size fits all approach, so I operate with an open and adaptive mind, supported by evidence-based practices. If you or anyone that you know is looking to improve their quality of life and begin a journey to improved living, or just have any general questions, get in touch and let's have a chat!
Michelle Marais AEP

Michelle Marais

mobile exercise physiologist
My passion for movement, health, and helping others led me to become an Accredited Exercise Physiologist. Through this role, I facilitate exercise-based rehabilitation for individuals with various chronic conditions, with a primary interest and area of expertise in neurological conditions.
To me, exercise physiology is about equipping clients with valuable skills that make daily tasks easier and empowering them to achieve their goals while enjoying the process.I take great pride in being a part of my clients' rehabilitation journey and exploring new methods with them to find the optimal exercise approach that works best for them.If you have any questions or are interested in starting your journey to a happier, healthier lifestyle, please feel free to reach out to me.
Angus Sullivan AEP

Angus Sullivan AEP

Mobile Exercise Physiologist
As an accredited exercise physiologist, I see my role as an opportunity to facilitate a safe and effective environment for my clients to explore their physical capabilities, identify areas where they would like to improve, and then prescribe meaningful and appropriate activities to achieve these improvements.
I currently work predominantly with individuals living with disability and have a keen interest in acquired brain injuries (ABI), traumatic brain injuries (TBI), cerebral palsy (CP), spinal cord injuries (SCI) and rare neurological conditions.
To me, exercise physiology is not only about achieving narrow objective goals (eg. 1 Rep Max bench press), but improving an individual’s lifestyle and making activities of daily living easier (mobilising, transferring, feeding, and more).
I love what I do and enjoy learning new methods and discussing different opinions about exercise. I am always happy to chat about it so please get in contact if you have any questions or knowledge that you wish to share!
Our team of mobile exercise physiologists

Walter White

manager of good vibes
Being active has taken on a whole new meaning and I am 100% here for it. I like to fink I'm pretty active, and I keep up de vibes during team meetings - just making sure everyone's hands are always moving (across my butt) because I know dat any exercise is good exercise.
I keep close to everyone, real close, just to keep dem on their toes when dey walk by too.
Fings are always better when I am der so if you need some good vibes, I will be der for you.
Brb just going to have a snooze.
Love and licks,
Wally
Brittney Kenward

Brittney Kenward

co-founder / Operations manager
I’m NOT an exercise physiologist, but I do take my hat off to my team and get to admire the work they do each and every day. Be Physiology means that we’re able to apply our passion, and our experience, to make exercise physiology more accessible to the people who need it the most.
You might hear the team describe me as ‘the person who does everything else’, and that can be translated to ‘marketing and operations'. My background is marketing and business, which I’ve lived and breathed since 2011. I’ve worked in both the agency and corporate spaces, across many industries, with many amazing people and now with Be Physiology, I get to explore the health industry further and continue to meet the most incredible people who are the ones to define motivation.
If you’ve met Harry and Aj, you’d know that they don’t really need marketing - they’re genuine, have ridiculous amounts of charisma, knowledgeable, and extremely passionate about helping people to be a better version of themselves. But, sometimes getting an introduction is the hardest part and that’s where I come in.
If you want to chat, a coffee, a laugh, I’m always here to make one or all of them happen.

So call me and let’s keep sharing the love!
Keegan Betts AEP

Keegan Betts AEP

mobile exercise physiologist
As an Accredited Exercise Physiologist, my work is driven by my passion for movement, health, and empowering others. With my experience working with individuals of all ages who have neurological conditions such as autism, stroke, and cerebral palsy, I focus on delivering activity-based therapy to optimise their independence.
Seeing people empowered and handling daily tasks easier is incredibly rewarding, as well as being able to give others the tools to improve their mental health and prevent secondary health conditions.
I know the importance of creating a welcoming and safe environment particularly when improving our health and I always strive to ensure everybody feels supported by the team around them and receives the highest level of care.
Get in touch today and let's make it happen.
Kristen McCluskey

Kristen McCluskey

Mobile Exercise Physiologist
If you spend as little as 10 minutes a day exercising, it will still make a huge difference to your overall physical and mental health - this is a fact and it is very often underappreciated! The benefits of exercise don’t discriminate and the rumours are true, exercise is medicine.
Spinal cord injuries, neurological conditions and women’s health are areas I find to be very dynamic and that I am particularly passionate about, but all aspects of exercise physiology are unique and have a significant impact on people’s everyday lives and I want to continue bringing it to those who will benefit the most from it.
I'm passionate about learning new methods and learning what my clients enjoy and how they approach exercise. I am always happy to chat about the many benefits and outcomes of exercise physiology so please get in contact if you have any questions or knowledge that you wish to share.
If you’re interested in learning more about who I am or want to ask any questions, don’t hesitate to get in touch at .
Charlotte Gill

Charlotte Gill

marketing assistant
My name is Charlotte, and I'm a sports enthusiast currently studying for a marketing degree. Although I am not an exercise physiologist, I have a passion for sports having a background in ski instructing and adaptive skiing. Like the team, I believe exercise is medicine and share a similar passion and values to help and motivate others I meet.
I've been fortunate enough to work globally with a background in event management, ski instructing, administrating, and climbing supervisor. However, working alongside the Be Physiology team as my dream role in marketing is a highlight. If you have had the pleasure of meeting the team, you will know their genuine, funny, knowledgeable, and passionate to help others. These are values that I also pride myself in, and I am so fortunate to be surrounded by like-minded colleagues.
Harry White AEP

Harry White AEP

co-founder / supervisor
Exercise physiology combines two of my favourite things: health and helping people. As an accredited exercise physiologist with more than seven years’ clinical experience, I have treated people presenting with a wide variety of health conditions and concerns, postural issues, chronic injuries and rehabilitation needs.
My expertise is spinal cord injuries and neurological disorders and helping my clients to achieve an improved quality of life through rehabilitation and functional training. Rehabilitation for spinal cord injuries and neurological disorders can be slow but incredibly rewarding for clients when results are achieved, no matter how small. Assisting people through learning useful skills and functional training is the most important role that an EP can play to help people lead a more fulfilled life.
Working for many years with people who have suffered serious injury or live with a disability, I know that taking a proactive approach to your health changes your life. If you care for your body, it will take care of you.
I’m passionate about helping people live a long, healthy and active life, so call today.