Skills Training with Cauda Equina

Skills training with Cauda Equina Champions Charity. I recently visited Trowbridge for wheelchair skills training with a client diagnosed with Cauda Equina. Trowbridge is the county town of Wiltshire – not to be mistaken for Trowbridge, in California sitting 25 miles north of Sacramento just East of Interstate 70. A vast spacious place with little character.

Motorway driving

After travelling down the M4 corridor. Using the smooth, smart motorway from J8/9 to Reading. It seems to be running well with no hold-ups! I exit at J17 and use the A350 South to my destination. I’m not here to take in the harbour or visit the tourist information, maybe another time. This visit is for wheelchair skills training.

Trowbridge in Wiltshire sits on the banks of the River Bliss. As I enter the town border, the welcome sign tells me there is a house of historical interest, a museum and a few other things that can keep any visitor interested. I’m not sure what the pint glass represents. If anyone knows, please comment!

What is Cauda Equina?

What is Cauda Equina Syndrome?

Cauda Equina (CE) is the collection of nerves at the end of the spinal cord. Cauda Equina comes from Latin the horse’s tail. The spinal cord ends at the upper portion of the lumbar (lower back) spine. The individual nerve roots at the end of the spinal cord provide motor and sensory function to the legs and the bladder. The cauda equina is the continuation of these nerve roots in the lumbar and sacral region. Like all parts of the spinal cord, these nerves send and receive messages. In this area of the body, these messages are to and from the lower limbs and pelvic organs.

Cauda equina syndrome is a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed.

Symptoms include sciatica on both sides. Weakness or numbness in both legs that is severe and can possibly worsen. Numbness around or under the genitals or around the anus is also a symptom.

Due to the symptoms, mobility aids are sometimes used to aid with getting around and helping a person live life to their full potential.

What is Cauda Equina

Cauda Equina Chapions Charity

Cauda Equina Champions Charity (CECC) is a patient-led organisation. It aims to raise awareness of cauda equina syndrome. The charity supports those living with the condition and provides bespoke, tailor-made services for service users and their loved ones.

Wheelchair Skills on the Road

Referral & Connections

Through the power of the World Wide Web, CECC and Freedom Wheelchair Skills are connected. Claire, the founder of CECC, who suffers from Cauda Equina, and I share information on what we offer individuals to help each organisation make referrals. Claire offers a CECC member a wheelchair skills session from me. She puts me in contact with a member and comms are open to start arranging the training.

Pre-training Assessment

Skills training with Cauda Equina. In order to maximise the training time, a pre-training assessment call is made with the client or someone who knows them well to discuss their individual needs, goals and abilities. This information helps plan the training and helps make the best use of the time available. During this call, the client and I also chat about life. Using this time to get to know each other helps with introductions on the day of training. It’s an opportunity for the client to get to know me and my reasons for running Freedom Wheelchair Skills and offering this vital face-to-face service. Also, a chance for them to ask any questions.


During the assessment call, a venue is discussed, and it is decided that the client’s home would be a suitable place to start before heading out into the local area. Putting skills into practice in ‘real life‘ situations.

The client’s home is in a fairly modern area with the usual street furniture creating challenges – kerbs, camber, parked cars, and slopes to name a few. These create great opportunities to develop much-needed skills.


Starting with a basic pushing technique. Skills are demonstrated, explained and practised. And they advance onto lifting front casters (this skill helps get over obstacles).

Independence isn’t just about doing something physically by yourself, but having the confidence to ask for assistance and instruct someone to assist safely. Verbal independence.

Due to the client’s condition and the configuration of the wheelchair, independent kerb ascent was not practical. Learning and developing the skills of how to instruct someone to offer support was as enhancing as it would be to do it independently. Although I am confident that the client would be able to ascend a larger kerb independently eventually, but the wheelchair hindered this.

Wheelchair Skills on the Road


Alongside the wheelchair skills training, peer support is also offered. The wheelchair skills training is peer-led but combined with verbal advice, facts and knowledge related to the horrible word ‘disability’.

Information on life skills. Flying for example, how do you get on a plane? Wheelchair purchase – not set up, I’m not qualified for that. But signposting to trusted companies. I won’t talk about any medical choices either, but I am happy to share my own adventures with hospital stays, operations and my experience with personal care. Discussion on these themes can reassure people they can live an active, positive life with a permanent physical or mental challenge.

Wrapping up & feedback

To summarise the client did well with the wheelchair skills. A new level of independence was created. Being independent with the ability to walk, wall surfing and using a walker, the client flourished with a new level of independence when using a wheelchair.

Here is some feedback.

Do you feel more confident after your training? YES

Did you learn new skills? YES

Is there anything you didn’t learn that you would have liked to? NO


Stuart was very personable and put us at ease immediately. He was very patient and had a friendly, open teaching style. He was very open to questions and provided lots of information related to mobility. I learned lots and have lovely cards that enable me to follow up. Thank you, Stuart. I highly recommend your service.


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