How do people in wheelchairs exercise?---
This sounds like a very simple question but the answer is probably more complicated than most people would expect.
The first major factor is whether the person usually uses a manual wheelchair or a power wheelchair. This is important because quite often (but not always), the person's ability level determines the type of wheelchair he/she uses. For example, if your spinal cord was damaged at the cervical (neck) area, you may have movement in the arms but perhaps impaired or little movement in the fingers or wrists – this person is more likely to use a power wheelchair to get around town than a manual one.
It is obvious why this makes a difference. Someone in a wheelchair that they have to push up a hill him/herself would get more exercise than someone who simply pushes a lever to do the same thing. That is why when I push myself up a hill, I have a 50% chance of someone mentioning something like, "You must have good cardio" or "You must have strong arms."
Does that mean people who use power wheelchairs cannot exercise? Of course not.
Notice how I said earlier that people with impaired hand/arm function may need a power wheelchair to "get around town." I said that on purpose because it is not the same as needing a power wheelchair to "get around." People with impaired hand/arm function may be able to use a manual wheelchair under certain situations that do not require racking up the miles, such as getting around the house or the neighborhood – or in sports.
Ah, sports. This is a topic that will be gaining momentum this summer as the Paralympic Games in London approach. Many able-bodied sports have been adapted over the years, providing an outlet for people with various disabilities to exercise. As the Paralympics show, some of them turn their exercise into actual athletic competitions.
There are also weight room exercises that wheelchair users can take advantage of. The recent TV series Push Girls shows several scenes of working out with weights. There are also adaptive weight rooms out there specially designed for wheelchair users.
These are also in addition to exercises that you might see in rehabilitation centers and therapy, which can give you quite the workout – many things that are taught in those places require a LOT of core strength (especially important if one does not have full use of his/her lower- to mid-body muscles).
Of course, this is all nice and everything but the hard truth sometimes is that it is not always affordable to take advantage of sports programs or exercise rooms. This is where the unfortunate stereotype of "using a wheelchair because you are fat" comes in.
If you cannot use all of your muscles vital for "normal" exercise (such as walking) and cannot afford exercise programs, it is much more likely that you will become overweight. When you become overweight, you may start having difficulties pushing your own chair (if you use a manual wheelchair). This may lead to shoulder injuries, which becomes a secondary obstacle to pushing your own chair and you may require a power wheelchair. When you use a power wheelchair, you're exercising even less and may get more overweight.
As you can see, it's a slippery slope and one that is difficult to escape from once it starts.
Another factor that may lead to that slippery slope may include prescription drugs, particularly steroids (which some people may need to get enough strength for some functions such as breathing). Steroids can make someone gain weight, which leads to the same situation. This is why I am not a fan of the stereotype of the "fat person using a wheelchair because he/she is fat" – often there is a reason for that and it would have nothing to do with one's eating habits.
As a manual wheelchair user, that is why I try to get as much exercise as possible, whether it be a casual stroll through the neighborhood or playing sports. I know some people with more limited hand/arm function who try to do the same if they can. Unfortunately there is still no simple solution that works for everyone but it is quite important to do what we can to stay in shape.