Manual wheelchair (MW) users have a greater than 50% chance of suffering from upper extremity issues such as shoulder impingement, torn rotator cuffs, and carpal tunnel syndrome. Rowheels' revolutionary approach to MW propulsion reduces these issues by allowing users to PULL to go forward, instead of pushing, using its patented 1.3:1 geared hub system which inverts wheel rotation. Pull propulsion transfers loads & stresses experienced by smaller muscles in the front of the shoulders and chest during conventional MW propulsion to larger and more capable muscles in the upper back and posterior shoulder. Studies have found that Rowheels' pull propulsion system also improve user posture, cardiovascular health and reduces repetition/cadencre while increasing responsiveness, average velocity, acceleration and range of motion by as much as 30%! Rowheels are compatible with most MWs and their efficient, lightweight, and stylish design is a game-changing departure from conventional MW wheels.