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Musculoskeletal pain is common among wheelchair users, but it should not automatically be accepted as an inevitable consequence of using a wheelchair. A systematic review and meta-analysis by Liampas et al. (2021) found that approximately one in two wheelchair users experiences musculoskeletal pain associated with wheelchair use. Shoulder pain was the most frequently reported complaint, affecting 44% of wheelchair users. Importantly, the analysis of five case-control studies

Shoulder pain is a common problem for wheelchair users, particularly for those who rely on their upper limbs for propulsion, transfers and pressure relief. Over time, these repeated demands can place considerable strain on the shoulder complex. Exercise has an important role in maintaining shoulder health, but the focus should not simply be on building strength. Improving muscle endurance, coordination and movement control can help people manage the physical demands of daily