What is it?
A pressure injury (also called a pressure sore or bedsore) is damage to your skin and the tissue under it from staying in one position too long. The blood supply to that spot gets squeezed off, and the tissue starts to die. The most common spots after SCI are the tailbone (sacrum), sit bones (ischial tuberosities), heels, hips, and elbows.
Pressure injuries are the most common reason people with SCI go back to the hospital. They are also the most preventable.
How to spot one
- A red spot that does not fade when you press on it
- Skin that feels warm, hard, or boggy
- A blister, scrape, or open wound on a bony spot
- Foul smell from a wound — sign of infection
- Fever or chills with an open wound — sign of deep infection
You may not feel pain because of your sensory level. Skin checks twice a day are how you catch trouble before it grows.
The five rules of prevention
- Look every day. Use a long-handled mirror or a phone camera. Twice a day — morning and night. Check tailbone, sit bones, hips, heels, elbows, and the back of your head.
- Shift your weight every 15–30 minutes when sitting. Lean side to side, push up if you can, or do a forward lean to take pressure off the sit bones. Set a phone timer at first.
- Turn every 2 hours in bed. Side, back, side. Use pillows to keep heels off the bed and to pad bony points.
- Keep skin clean and dry. Pat dry after a bowel program. Use a barrier cream around any incontinence. Change wet clothes fast.
- Match your equipment to your body. A pressure-mapped cushion (Roho, Jay, Stimulite) and the right mattress make a huge difference. Re-fit when your weight changes.
What to do at home if you spot something
- A red spot that fades in 30 minutes — back off pressure and re-check in 24 hours.
- A red spot that does not fade, or skin that is broken — stop sitting on it. Call your team within 24–48 hours.
- An open wound — gentle saline rinse, cover with a clean non-stick dressing, photograph it (with date), and call your team.
💡 Nutrition counts
A wound needs protein and calories to heal. Aim for 1.2–1.5 grams of protein per kilogram of body weight per day, plus enough vitamin C (500 mg). Take zinc only if your team prescribes it. Hydration also helps.
📞 Call your doctor if
- Any open wound or new break in the skin.
- A wound that smells bad, has yellow or green drainage, or red streaks around it.
- Fever, chills, or new spasticity (sign of deep infection).
- A wound that is not getting better in 2 weeks.
At your next clinic visit
Take photos of any healing wound at the same angle and lighting once a week. Bring them. Wound size, depth, and tissue quality guide whether you need a wound care nurse, antibiotics, or a surgical consult.
Education only. Not medical advice. If you have a clinical question, talk to your rehab team. For emergencies call 911.