Shearing: Force applied to the internal structures, mainly when sitting up in bed or
with poor posture in the wheelchair. Like a hand in a glove, the ischial tuberosities (or
other bony structures) are forced away from their natural position, shearing the tissues
and, more importantly, the blood vessels.
Moisture: If you are unable to dry yourself, ensure that you direct someone to do it
properly. If you have a bowel or bladder accident, ensure that you wash properly or
this can also cause burning of the skin.
Tight clothing: In particular the seams from jeans or tight shoes can mark the skin.