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Tin Soldier

Need Foot Advice

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Hi Folks "Tin" here.

I am a fairly recent amputee - both feet just above ankle - so pros are fitted with a flexible ankle joint. I should point out that feet were provided by the military as I was serving with the army in Iraq.

Anyway, I have had my rehab, etc, am now out in big wide world, however, need some advice. My walking is generally OK - I use a folding stick so that when it is not needed it can go in my pocket.

How do other amputees of the feet adopt a normal walking gait? I tend to walk as if I am mashing grapes. I think because I cannot feel anything under my feet when I place them. I dont particularly want to go back to rehab - so thought I would try the boards first.

If anyone can help - I'd greatly appreciate it. I know from reading the threads here that this may be trivial to some - but to me it is a problem.

Regards.

Tin

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They should have picked up on your gait pattern in rehab! :o

Instead of 'mashing grapes', you need to move your legs when you walk, as though you still have feet...and trust your limbs. If you're still shuffling, you may need to go back to forearm crutches for a while, until you gain enough confidence.

Lizzie :)

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Hi Tin. First, wanted you to know how much we appreciate what you were doing for us "over there". Can't tell you how glad we are you're back home. Next, the "grape-stomping" feel is normal for awhile, or at least it was for me. Without knowing how long you've had your prosthetics, it may simply be something you'll overcome with more practice--keep walking! It may not even be real--or, at least, not noticable to others. While I know you don't really want to do it, it's probably good advice to get back to rehab for some gait analysis to see if any problems really do exist, and for advice on how to overcome it. If you don't like the level of help you're getting at your normal rehab center, look into other sources. You are entitled to the aid you need.

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Hi,

It does sound like it may be a combination of both you getting comfortable & some foot adjustments. Your foot should go through the motions of a real one. Meaning, heel strike to ball of foot to roll over & push off the toe. Well, for the most part anyway. When your at the pros tell him what you feel when you walk. For ex. are you feeling stuck, are you rolling off the toe, etc. Your input is pretty crucial to this stage. The guy can only see how the foot strikes, but if it doesn't feel right to you, he needs to know that.

Good luck,

Linda

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Hi-

I am not sure how long you have been walking, but it took me several months to get a normal gait again. I did not have any rehab, but my prosthetist helped me when I went in. I also took the gait training class at the ACA convention and they pointed out subtle things I was doing wrong and when I corrected them, it helped immensley!! I do know that the adjustable ankles are very stiff and non-giving. They do not offer much spring or return of energy. I am actually getting ready to switch to a more energy storing/athletic foot myself.

But you will improve a lot as you keep walking and if you can get someone to acess your gait, either prosthetist or rehab, so you can correct it. As my prosthetist said...once you learn to walk incorrectly with your prosthesis, it is so much harder to correct it. The muscles seem to get use to the new way of walking... and you will use a lot more energy during the day if you have your gait off. But I think you are still getting used to them. It is much harder with two prosthetic feet, so do not be so critical off yourself. It will take time. Keep us updated on your progress!

Debbie

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Hi Tin, Linda is right your walking on broken glass at the moment and it's a trust thing-still early days and more time will prevent that. Be patient I know it's hard but you'll get there. Keep at it.

Mel.

ps slow but steady-get it right now and put in the time early saves you getting into bad habits.

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Hi--

I'm not sure what I can add to what has already said. I do believe it something you need to talk with your prosthetic guy or gal. They work with these problems all the time. They know what to look for and how to corrected. I wish you all the best as you try to get use to you new legs!

Patti

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Thanks All. I knew you could come up trumps. Everyone telling me what my "gut" already knows. Time for a re-vist to rehab. However, military rehab is unlike any NHS one. It is split into 5 x hourly sessions A DAY. Made up of swimming - gym and exercise.

However, I agree that I dont want to get into bad habits now. I only lost my feet in October 2004, however, due to other injuries to my legs, was wheelchair bound for 6 months, so only started walking on my "feet" in October/November 2005. So far, I have done OK - so I'll keep you posted on how my "walkign on glass" goes. The confidence thing is all in my mind. With a stick I am fine - without it I panic.

Thanks again.

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Hi,

I, too couldn't start learning to walk on my leg for six months after my accident as my femur was also broken and I couldn't put any weight on it. I got my first leg in June 2005 and initially just couldn't see how I was ever going to have a remotely normal gait without sticks.

But now, finally, it seems to be coming. I am walking around pretty normally inside without a stick, and when outside am becoming less and less reliant on it. It does happen, but everyone goes at their own pace, and I suppose you just have to remember that.

But yes, my physio has really helped me with my gait, and I doubt very much whether I would be walking as well as I am without her now, so I would say that it is very much worth making sure that you see one, if not at your militaty rehab, then somewhere else.

good luck!

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However, military rehab is unlike any NHS one. It is split into 5 x hourly sessions A DAY. Made up of swimming - gym and exercise.

Isn't there a physio you can go to just for gait advice?

In the meantime, try watching yourself walking, using a full length mirror...or shop windows...anywhere where you can see your reflection. Stand upright and look forward. Move your legs forwards and backwards (using your quads & glutes), remembering to swing your knees through when you walk. Also aim for heel strike & toe off - trust your feet. Use crutches if you need to & don't see using crutches as defeat or 'going backwards'...it'll only be temporary and with your improved gait, you'll soon be walking without crutches or a stick! :)

If you try to do all that, instead of shuffling, then you should soon stop mashing grapes. :) As Mel says it's still early days...

Lizzie :)

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Isn't there a physio you can go to just for gait advice?

Thanks for the advice Lizzie. Just so happens I am due a check up anyway. So, come February, I will have all my problems sorted. 10 x half hour sessions a day will soon sort me out. THanks.

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It does sound like it may be a combination of both you getting comfortable & some foot adjustments. Your foot should go through the motions of a real one. Meaning, heel strike to ball of foot to roll over & push off the toe. Well, for the most part anyway. When your at the pros tell him what you feel when you walk. For ex. are you feeling stuck, are you rolling off the toe, etc. Your input is pretty crucial to this stage. The guy can only see how the foot strikes, but if it doesn't feel right to you, he needs to know that.

Excellent post, Linda. :D

TinSoldier,

I know that you can sometimes forget what it was like/how to walk with both of your own feet before (I know I do), so I suggest watching people walk as a bit of a reminder.

You'll see exactly what Sanicki (Linda) is saying. That there are certain stages/actions of walking that we all take; heel strike then off from the toe.

In the long term, it's quite important for you to get this right as an amputee, as most of the dynamic response/spring action feet work best when you use these actions. Actually, you won't get the best from these feet if you don't walk in that way. That's because some of these types of prosthetic feet have a long piece of carbon fiber in them. If you're not walking in the 'heel strike, toe off' way, then the energy (spring) from the carbon fiber will not unload, so you'll end up keeping all that energy inside the foot, rather than using it to help push you off for your next step. This would make the feet very difficult to walk on.

Let me give you an example:

Before I even asked for my new feet, the Renegade from Freedom Innovations, my prosthetist first watched the way in which I walked. When I asked him why, he told me that these feet would be unsuitable for me if I DIDN'T walk in the 'heel strike, toe off' way.

If you click on the underlined word 'Renegade' above, it will take you to a picture of the foot on the Freedom Innovations site. Move your cursor over the picture of the Renegade, and you will see how the foot is designed to walk with a demo. This should help explain what I mean.

Luckily for me, my prosthetist was happy with the way I was walking, so he ordered them for me.

I believe that you will be offered feet like this, because of your military background. You don't want to have to turn down such great feet because of the way you are walking. But, this is all fixable. A good physiotherapist will definitely know how to sort this out.

Actually, I have had this sort of physio therapy too. One thing I learned for doing it properly was to use my pelvis more when I am walking. So when I am stepping with my right leg, for example, then I am to shift my weight from my left side - tilting my pelvis - and then the same with my other side.

Anyway, best of luck. Let us know how it goes. :)

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Instead of 'mashing grapes', you need to move your legs when you walk, as though you still have feet...and trust your limbs. If you're still shuffling, you may need to go back to forearm crutches for a while, until you gain enough confidence.

Agree with Lizzie, you should be walking as though you still have feet. Are you sure your sockets are fitting you comfortably, I am also bilateral, and have, over the years, come across problems walking normally with the feet if the sockets are not fitting correctly.

Ann

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