Guide to Selecting Wheelchair Legrests

Legrests are one of those parts of a wheelchair that people tend not to think about until something is causing discomfort. But the legrest you choose has a more significant effect on posture, pressure distribution and daily comfort then most people realise. Getting it right from the beginning saves a good deal of trouble later.

This guide explains the main legrest types, what each one is designed to do, who each type suits best and a few things worth knowing that most product descriptions leave out entirely.

Footrests and legrests: understanding the difference

Before getting in to the types, its worth being clear about what a legrest actually is as opposed to a footrest, because the two terms are often used interchangeably when they refer to different things.

A footrest is the standard front support fitted to most wheelchairs. It consists of a hanger, which is the arm that attaches to the frame, and a footplate on which the feet rest. It supports the feet only. A legrest does all of this and adds a padded calf pad that supports the lower leg along its length. Legrests are therefore more substantial, provide more lower limb support, and are most commonly found on tilt in space chairs, reclining wheelchairs and chairs used by people who need the leg elevated for clinical reasons.

The main types of legrest

Standard swing-away footrests

Swing-away footrests are the most common type fitted to everyday manual wheelchairs. The hanger pivots outward and in most cases detaches entirely, which clears the space directly in front of the seat and makes transfers considerably safer and easier. The standard hanger angle is 90 degrees, which keeps the feet positioned directly beneath the knees.

For users with longer legs, hangers are often available at 60 or 70 degrees, which angles the footplate further forward and prevents the footrest from interfering with caster movement while keeping the seat at a practical height. The hanger angle is something worth checking specifically when buying, particularly for taller users, as an incorrect angle forces a compromise between seat height and foot positioning that affects posture throughout the day.

Fixed footrests

Fixed footrests are found primarily on rigid frame active wheelchairs. Rather then swinging away, the footplate is a fixed part of the frame with a flip-up function that allows the plate to be raised when not in use. Fixed footrests add rigidity and reduce the flex that comes with swing-away mechanisms, improving energy transfer during propulsion. For active daily users this is a meaningful performance advantage. The trade-off is that a different transfer technique is required, as there is no swing-away function to clear the space in front of the seat.

Elevating legrests

Elevating legrests allow the lower leg to be raised from a 90 degree position to anywhere up to horizontal. They consist of an adjustable hanger, a padded calf pad and a footplate, and the whole assembly can be elevated and locked at the desired angle. They are often recommended for users with oedema, poor circulation or conditions that require the leg to be kept straight, such as following knee surgery or for users with spasticity that limits knee flexion.

There is a commonly held assumption that elevating legrests are the better choice for most users because they appear to offer more functionality. The clinical picture is more complicated then that. When the legrest is elevated it extends the leg, which increases tension in the hamstrings and pulls the pelvis into a posterior tilt, the slouched position where the lower back rounds and pressure increases at the sacrum and coccyx. The further the legrest is elevated, the more pronounced this effect.

Elevating legrests are most appropriate when there is a specific clinical indication for keeping the leg elevated, not as a general comfort upgrade. A standard swing-away footrest set at the correct height typically produces better posture and lower pressure for users who do not have such an indication. Please bear in mind that elevating legrests also add length to the wheelchair when raised, increasing the turning radius and making the chair harder to manoeuvre in smaller spaces.

Articulating legrests

Articulating legrests are a more sophisticated version of elevating legrests, found mainly on powerchairs. The key difference is that articulating legrests extend in length automatically as they are elevated, which compensates for the fact that the leg becomes longer when the knee is straightened. A standard elevating legrest set to the correct length when lowered will be too short when raised, placing the calf in the wrong position on the pad. An articulating legrest adjusts for this automatically.

Articulating legrests are particularly useful for users who need to move their legs frequently, who have fluctuating tone or spasticity, or who are using the legrest as part of a therapeutic positioning programme. For a manual wheelchair user who only occasionally needs elevation, a standard elevating legrest is usually sufficient. For powerchair users with more complex needs, articulating legrests are the more practical solution.

Hanger angle and its effect on posture

The angle of the footrest hanger receives far less attention then it deserves. Most standard wheelchairs come with a 90 degree hanger, which is the clinically preferred position. It places the knee at a right angle and supports the thigh along its full length on the seat cushion. As the hanger angle becomes more acute, moving toward 60 or 70 degrees, the footplate moves forward, the knee angle opens and hamstring tension increases.

For users with tight hamstrings or limited knee flexion a more open hanger angle may be necessary. But it should be seen as a clinical compromise rather then the preferred option, and its postural implications should be factored in to any seating assessment.

Calf pad positioning

When a legrest with a calf pad is fitted, the pad position matters as much as the hanger angle. A calf pad set too high compresses the back of the knee, restricting blood flow. A calf pad set too low fails to support the leg properly and increases pressure on the footplate. The correct position is with the calf pad sitting along the mid-calf with no contact directly behind the knee. This is worth adjusting at setup rather then leaving in the factory default position.

Frequently asked questions

Are elevating legrests better for circulation then standard footrests ? 

Not always. On a standard manual wheelchair they raise the legs toward horizontal but do not bring them above heart level, so meaningful fluid drainage is not achieved. They also increase hamstring tension which can worsen posture and pressure distribution. They are clinically beneficial when there is a specific indication such as post-surgical positioning or significant spasticity, but are not a straightforward upgrade for general use.

What is the difference between an elevating and an articulating legrest ? 

An elevating legrest raises the lower leg but does not adjust in length as it rises. An articulating legrest extends automatically as it elevates to compensate for the fact that the leg becomes longer when the knee is straightened. Articulating legrests are better suited to powerchair users with complex or frequently changing positional needs.

Can I add legrests to my existing wheelchair ? 

In many cases yes, provided the legrests are compatible with your chair's receiver tubes. Universal style elevating legrests fit a wide range of standard folding wheelchairs. Its worth checking the hanger receiver size and tube diameter before ordering.

Why do rigid frame wheelchairs use fixed footrests instead of swing-away ? 

Fixed footrests add structural rigidity which improves energy transfer during propulsion. Users of rigid frame chairs typically transfer without bearing weight through the feet, so the swing-away function is not needed. Swing-away mechanisms introduce flex that is inconsistent with the performance priorities of an active wheelchair.

Does hanger angle affect propulsion ? 

Yes. A more acute hanger angle positions the footplate further forward, increasing the overall length of the chair and its turning radius. It can also shift the user's weight forward, affecting how the rear wheels respond during propulsion. A 90 degree hanger is generally better for both posture and propulsion efficiency.