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kaneo

Strength and Agility Training

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Hello All,

I had a RBKA August 6 of this year after a traumatic injury and was fitted with a prosthesis early October. I typically wear my prosthetic 8-14 hours per day and stopped using assistance (ie. cane) after the first week of wearing it. Walking, stairs, ramps, etc pose no issue but as I work as a paramedic I seek guidance as to particular training I can do to improve flexibility, strength, and balance. Unfortunately I find rehabilitation centres close to me seem to only focus on getting a person upright which is why I only went to one physio appointment and never went back.

On that note I hope to be back at work full-time in Jan/Feb but hope someone can provide me some links or information to programs that I could follow either by myself or with assistance to get me to a more functional level. My biggest obstacle will be carrying equipment (>50 pounds) up and down stairs and over uneven terrain without anything to hold on to for support.

Any help would be appreciated.

-Kane

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Some of our members have very active, physically demanding jobs, so I hope that someone can offer you some useful "tips." (I worked as a secretary until my retirement, so I'm afraid I'm not a lot of use here!)

One thing I would suggest, though, is that you look about for either a BETTER physical therapy program, or possibly look into taking a few sessions with a personal trainer.

I also gave up on physical therapy fairly soon after getting my prosthesis...the clinic I was assigned to was, as you suggest, aimed at just "getting you upright" and leaving it at that. However, prior to getting my prosthesis, I went through several rounds of various and sundry foot surgeries...and then I had the most astonishing bunch of physical/occupational therapists who drove me just as hard and as far as I could go! Those folks made a genuine difference in the quality of my life!

You might want to look into college programs, or even something as simple as the local "Y." I know that there are trainers out there who have an interest in working with a motivated person with a disability and can help you in setting up an exercise routine to strengthen your core and work on flexibility.

Good luck to you!

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Some of our members have very active, physically demanding jobs, so I hope that someone can offer you some useful "tips." (I worked as a secretary until my retirement, so I'm afraid I'm not a lot of use here!)

You called???

I also do a very physical job carrying/pushing heavy boxes, walking long(ish) distances over uneven ground, wearing my prosthesis for long periods etc etc etc.

The best thing I can suggest is to concentrate on your gait first. If your gait pattern is off then whatever you do is going to end up causing you harm eventually. I have to constantly return to physio every so often just to re-educate myself because my gait tends to get worse when I work as I pick up bad habits such as hip hitching and vaulting on my sound leg in order to clear hazards such as cables on the floor.

Once your gait has improved the best thing to condition your body for what you want to do is to just start doing it. Problem is that you want to be up to full speed before you return to work. So you need to start off slowly doing the same type of exercises and activities as you would prior to your amputation. You need to push yourself everyday, it is going to hurt at times. You need to find the balance between a little bit of pain to get the gain you're after and not doing so much you do yourself harm.

This advice is the exact opposite to what most doctors will tell you but in general doctors have low expectations for amputee rehabilitation. I've seen photos of amputee rehab in Cambodia and over there you are expected to live a normal life which includes crossing rickety rope bridges and fast flowing rivers, all the things you'll be told to avoid in the future.

Hope this helps.

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Hi Kane,

Once again am agreeing with Cheryl here.

Not sure where you are, but know here in the UK, rehabilitation is much like you describe ... just enough to get you upright and walking. I am a bit different to you in that I am bilateral b/k but after a revision amp a couple of years ago found the five weeks or so rehab offerred from the NHS just not enough to rebuild the strength needed ... so as Cheryl suggested to you, I found a private physio, I also did some hydrotherapy and found both enormously helpful in building up strength, flexibility etc. It was pretty expensive, but the hour I saw this guy was exercise the whole of the time on a one to one basis, but I started off on a weekly basis, then after a while fortnightly, then monthly ... but was given an exercise routine do at home in between, then after continuing with regular gym sessions. All well worth it, it made quite a difference.

Wish you luck with your endeavour to get back to where you want to with your job as a paramedic ... I don't envy you carrying all that equipment up and downstairs ... but you'll be surprised whats possible if you really want to do something.

Ann

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Hi, I echo the above in that in the UK rehab is only about getting you walking as I found out when I tried to get an appointment - after many years as a BK - to discuss advanced balance issues after I took up TKD.

One thing I have found useful is a balance board as it forces me to keep my weight more evenly distributed, by choice I will put 95% of weight on my right leg as it is more comfortable that way although I am now having back problems because of it. I now do TKD (2/3 times a week) and circuit training (once a week) and find both helpful for balance and buidling up strength in that leg (and also in my arms for when I am using crutches/stick). I am lucky though as each of the instructors I work with and especially my main one are incredibly supportive and helpful about working out the best way to do some of the exercises or suggesting suitable variations/alternatives when I can't - I wouldn;t have stuck with it without them. Maybe there are some suitable exercise classes where you are but if not and if you can afford it then a personal trainer would be the most efficient way of getting ready for your full return to work.

Good Luck.

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I agree with everything said above. Physio should help us strengthen what is left. We need to use other parts of our body to compensate for what we lost. I too only saw a PT once and was out of there at his suggestion. He said that I was doing a fine job of walking.

As we all know actual walking is the smallest part to using a prosthetic. The major part comes in using it the proper, safest way. I used my prosthetic leg for 7 months before my new prosthetist told me what I was doing wrong. I started working more on balance and gait until I was happy with the way I controlled my leg. I can balance for a few seconds on my prosthetic side only.

Start by holding onto a chair and raise your good leg off the ground. Find a good balancing point on your prosthetic then let loose of the chair. Do this for a few weeks and I think you'll find that you have much better control over your prosthetic. Flexibility is something that is nonexistent with a prosthetic leg. You will probably never have the freedom that the natural knee gave us. Since we have to wear liners and sleeves and the prosthetic comes so high up around the knee it really hinders the natural movement of the knee. You can buy rotators to enable the foot some flexion at the ankle, but I've never used one.

I know a couple of amputee paramedics. I'll try to find their names so that maybe you can contact them.

Good luck

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Thank you for all the wonderful advice. I do think a personal trainer with some knowledge in the area of amputations would be the most beneficial. I also do need to start focusing more on balancing on one leg on my prosthetic side in addition to strengthening my body as a whole. I almost find it hard to get motivated at times as I get around very well as I was lucky to have a reasonable amount of muscle mass prior to my injury. That being said my balance needs to improve and I need to work on that gait to eliminate the slight limp I still have. Thanks again for the help.

-Kane

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Hi,

Core strength and stability is something that you will develop as time goes by, especially if you want to get on with your life and have a demanding job.

Most exercises.

That you are given get boring after a while and become a chore to do so with all the best will in the world they tend to be forgotten about or skipped over when the mood suits you.

A few points that helped me along,

I did all the exercises that the physos gave me, even went to the local gym and got some advice from a personnel sports trainer. But to be honest with you I don’t really think that they really understand what it is like. So I decided to look into other ways myself.

I started practising standing on my arty leg (as an aka it’s a lot harder than it looks) once I got to the stage where I could stand one legged I started moving my good leg out and pointing it forwards and back wards again it takes a lot of concentration and really helps with core strength and stability but most of all balance.

The other thing that I did (well still do ) is take up power kiting , now this is really fun , the kite does its best to pull you all over the place , you do your best to control it , and with out realising it , you are constantly adjusting your stance /balance , having a “play “ with one of these is the best exercise going , simply because you are having to constantly adjust your position whilst under a fare amount of strain .but the best part is its fun , and it gives you a real workout in the balance and core strength department with you even knowing about it. Well worth a try.

The other thing that I still do is on the Nintendo Wii on the balance board whilst playing on the winter sports, i.e. downhill skiing /slalom or snowboarding, not really sure if it does any good but every little bit helps & it is fun.

All the above methods are considered well outside the “correct methods” but they worked for me.

Hope that this helps.

Mick

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