Prolonged sitting can easily result in pressure injury (PI) for certain people who have had strokes or spinal cord injuries. There are not many methods available for tracking contact surface pressure and shear force to evaluate the PI risk. Here, we propose a smart cushion that uses two-dimensional force sensors (2D-FSs) to measure the pressure and shear force in the buttocks. A machine learning algorithm is then used to compute the shear stresses in the gluteal muscles, which helps to determine the PI risk. The 2D-FS consists of a ferroelectret coaxial sensor (FCS) unit placed atop a ferroelectret film sensor (FFS) unit, allowing it to detect both vertical and horizontal forces simultaneously. To characterize and calibrate, two experimental approaches are applied: one involves simultaneously applying two perpendicular forces, and one involves applying a single force. To separate the two forces, the 2D-FS is decoupled using a deep neural network technique. Multiple FCSs are embedded to form a smart cushion, and a genetic algorithm-optimized backpropagation neural network is proposed and trained to predict the shear strain in the buttocks to prevent PI. By tracking the danger of PI, the smart cushion based on 2D-FSs may be further connected with home-based intelligent care platforms to increase patient equality for spinal cord injury patients and lower the expense of nursing or rehabilitation care.