Why Custom Wheelchair Make a Big Difference

Most people buy a wheelchair the way they'd buy shoes online: they find a model they like, see it comes in 16, 18 or 20 inch seats, assume 18 inches is the adult standard, and order. Within a fortnight their hips pinch, their shoulders ache after a long push, and the chair that fitted the specification sheet won't fit the bathroom door.

That isn't a sign the chair is badly made. It means it wasn't built around the person in it. Customising gets talked about as a luxury, the expensive version of something you probably can't afford. It's nearer the opposite: a chair that fits stops the frame causing problems that cost more than the upgrade.

The Real Cost of a Bad Fit

This is where customisation earns its place, and it isn't about comfort.

Seat width that's too generous. Extra width puts your wheels further out than your body, so every push starts with your arms reaching outwards instead of staying near your sides, and a few hundred times a day that costs you your shoulders. It also leaves room to slide, so one hip loads harder, and a sagging sling seat pulls the thighs inward. Wheelchairs Mobility UK's seat width guide is the clearest account of that chain I've found, and longer-term users describe the same thing: the spare inches felt harmless, then turned into joint pain.

Seat depth that's too long. If the front edge presses behind your knees you can't sit back against the rest. Most people slump to escape it, and sliding forward moves the load onto the tailbone rather than the sitting bones, which is a pressure sore route, not a comfort issue.

Backrest height. A back that stops below your shoulder blades leaves your own muscles holding you upright all day. Taller isn't automatically better: if you propel yourself, your shoulder blades need freedom, and a back that traps them changes how you push.

The cushion you added afterwards. A 2" foam cushion costs £29.99 and does useful work, but it also lifts the seat and brings you closer to the front edge, undoing borderline measurements.

Measure Before You Spend

Get four numbers, sitting on a firm flat chair, back against it, feet down, in your usual clothes.

• Hip width. Straight across the widest part of your hips or thighs, never around them, or you measure circumference and order a chair far too wide. Two hardback books against either side make it a one-person job.

• Upper leg length. Back of the buttocks to the crease behind the knee, both sides, using the shorter. WHO guidance is a seat roughly 30 to 60mm shorter, leaving two or three fingers behind the knee.

• Heel to knee crease, in your usual shoes, which sets footrest height.

• Weight, current rather than estimated, plus how close it sits to the chair's limit.

Then measure two things that have nothing to do with your body: the narrowest gap the chair must live with, and the boot. Measure a doorway from the face of the open door to the stop, not the door leaf, and expect a 762mm internal door to leave perhaps 700mm.

If you're replacing a chair, measure that one too, and weigh what you're lifting: a 12.7kg folding chair is a different job for the boot than a 22kg one. Then check seat width against overall width. On the Ugo Atlas bariatric, four seat sizes from 20" to 26" pull overall width from 70cm out to 85cm, which is the difference between a doorway that needs a word and one that needs a builder.

What you notice Cause Fix

Sliding forward, then slumping Seat too deep or back too low Shorter depth, firmer backrest

Pressure behind the knees Seat too deep, footrests too high Raise legrests only if thighs stay supported

Shoulders ache after pushing Seat or wheels too wide Narrower seat, less camber

Chair fits, doorway doesn't Overall width, not seat width Narrower model, or widen the opening

Small Adjustments People Overlook

None of this needs a new frame.

• Axle position. Move the rear axles and you change how hard the chair is to push and how willing it is to tip. Quick check: reach down with a straight arm, and if your longest finger lands on the hub, your centre of gravity is right.

• Camber. More camber shortens your reach to the push rims and improves turning, at the cost of width. A built-to-measure frame can fine-tune it; a standard one can't.

• Legrest height. Raising the plates to win ground clearance looks like the obvious fix and takes thigh support away, so this footrest and legrest guide is worth reading first.

• Castor size. Larger front castors roll over thresholds and kerb joints more easily, but lengthen the chair and blunt it indoors.

The settings are linked, so changing one means rechecking two others. Get an occupational therapist to watch you do it if you can.

Custom Isn't Always the Answer

We sell wheelchairs, so this costs nothing to say.

A built-to-measure frame suits someone in a chair most of the day whose body doesn't match the sizes available, and the clearest cases sit at the extremes, where a catalogue has no size for you. For an occasional user, or someone whose needs shift week to week, a well-adjusted chair usually beats a fixed custom one. So measure, adjust what you have, then consider built-to-measure.

Questions People Ask Us

Can I fix a seat that's too deep with a cushion?
Only partly, and not for long. Packing yourself further back raises the seat and moves you away from the armrests. A lumbar wedge helps, but it stays a workaround for a seat that's the wrong length.

Should I size up if I'm between two widths?
Not automatically. Too narrow risks pressure and rubbing, but a wider self-propelled chair is harder to push and needs wider doors. Sit in both if you can, rather than choosing from a number.

How long does a custom chair take to arrive?
Built-to-measure frames are made to order, so allow several weeks. Configured standard sizes are what we can generally send next day. If you need something this week, a well set-up adjustable chair and the right cushion gets you most of the way there.

Will the accessories I own fit a new chair?
Sometimes, but often not. Legrests, anti-tip wheels, bags and backrests vary by frame and mounting. Send us your current chair's make and model and we'll check.

Should I widen the doorway or buy a narrower chair?
Try the chair first. A chair narrow enough for the door yet tight on your hips is the worse outcome. If building work is happening anyway, aim for 850mm clear at the doors, as UK regs require in a wheelchair-user dwelling.