Why Sitting Can Cause Skin Breakdown: Pressure, Shear Microclimate Explained - Part 2
Posted by Michael Russo, BS, RRT, CEAC, ATP - Home Medical Equipment Expert on
Many caregivers are surprised to learn that prolonged sitting can cause significant damage to the skin and underlying tissue. But it’s true, especially for people who can’t move on their own.
There are three main reasons why skin breaks down in people who use wheelchairs:
1. Pressure
Pressure happens when the body pushes down on one area for too long. For example, when someone sits without moving, their tailbone or hips press into the seat. This blocks blood flow, which can damage tissue and cause a pressure injury.
2. Shear
Shear is a hidden force that pulls the skin in different directions. It often happens when a person slides down in their wheelchair or bed. Even if the skin doesn’t break open right away, the tissue underneath can tear and die from the inside out.
3. Microclimate (Heat & Moisture)
Sitting for long periods also creates heat and sweat between the skin and the cushion. This makes the skin softer and more likely to break. It’s especially risky for people with thin or fragile skin.
Why It Matters
People who have limited movement—like those with a stroke, Parkinson’s, MS, or spinal cord injuries—can’t always adjust their position on their own. That’s why advanced wheelchairs with tilt, recline, and breathable cushions are so important. They reduce pressure, control shear, and help manage skin temperature and moisture.
← Previous: What Is a Pressure Injury? →
Next: How Tilt and Recline Help Prevent Pressure Injuries →
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