For those of us with spinal cord injuries, our butt is our most valuable asset. With limited or no sensation, pressure sores or red spots can quickly and easily develop. Ideally, we use a specialized cushion to disperse weight evenly to prevent skin breakdown.
One of the most common questions I see on forums for spinal cord injuries is, “What’s the best cushion?” The problem is that people aren’t asking the right question. Why? Because the best cushion for me may not be the best cushion for you.
What is pressure mapping?
Pressure mapping involves using a computerized system that allows a therapist or seating specialist to see how pressure is distributed over the surface of a cushion. The therapist places a thin mat between the cushion and the chair user. I’ve done this two ways: 1) by transferring in/out of my chair, or 2) by leaning side to side while the therapist rolls the mat into place.
The therapist connects the mat to a tablet or computer with a cord. And voila! You see the surface pressure of your tush on a screen; colors closer to red indicate high pressure, while bluer areas reveal less pressure.
When “the best” cushion fails the test
I’d always used a Low Profile Roho cushion. When I experienced a pressure sore after a lapse in judgment, I ended up with a Stage 4 pressure sore on my left ischial that required a skin flap surgery.
I switched over to a High Profile Roho – a “better” cushion for especially bony butts. Guess what? My skin broke down again. Another flap surgery ensued.
I found out about pressure mapping soon after this in 2000. My rehab facility didn’t have the equipment, so I drove to Lexington, Kentucky, to get mapped.
The therapist pressure mapped me on my High and Low Profile Roho cushions, as well as a demo Jay cushion. (There weren’t many options at the time.) By far, I had the least amount of “hot spots” on the Low Profile Roho. Why? Because it was the best cushion for me at that time.
A more recent experience
Recently I developed a red area and couldn’t get it to clear up. Over the years, my hips have tilted due to mild scoliosis. Plus, when I had the skin flaps, the surgeon chipped away my ischial bone. Unfortunately, it’s re-calcified and protrudes from under the thin, scarred skin.
I made an appointment with the seating specialist. The mapping showed an area of high pressure exactly where my skin had broken down.
The seating specialist grabbed a two-inch wedge and placed it under my right hip and trochanter. Not only did my hips sit evenly, the spot I saw on the screen disappeared in front of my eyes.
I’m not saying it’s always going to be an easy fix. What I am saying is pressure mapping is a valuable diagnostic tool that allows you and your therapist to answer the question, “What is the best cushion for me?”
The next time you need a cushion, don’t ask a stranger which cushion is the best. Call a seating clinic and get pressure mapped on a variety of cushions. If you take the time to get pressure mapped, it may help you avoid future skin breakdown.