Based on the linked source; automatically prepared and checked against the original report.
Clinical presentation
A 73-year-old man with advanced multiple sclerosis developed right-sided ischial pain while seated in a manual wheelchair. Although documented pressure overload occurred on the left, his symptoms were right-sided. He used his right hand and foot for indoor movement.
Assessment and diagnosis
Static and dynamic seating assessment found fixed postural asymmetries. Examination reproduced symptoms with resisted knee flexion and passive hamstring stretching. Clinicians diagnosed right proximal hamstring tendinopathy and linked it to repeated muscle contractions associated with foot propulsion. Two attempts to correct posture did not succeed, while the available report identifies no earlier published wheelchair-user cases.
Outcome and broader significance
Pain completely resolved after he changed to a power wheelchair and stopped propelling with his feet. The authors present the episode as an underrecognized musculoskeletal complication and emphasize combining pressure mapping, dynamic seating analysis, clinical examination, and occupational therapy input when assessing equipment and movement. They also report psychological benefits from explaining the problem and providing an effective solution, including better adherence and satisfaction.
