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Heather Mills - Amputee Forum
EllenK

Way of walking: with or without a limp

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Hello all,

I have been a prosthesis user all my life (AK) and although I had all kinds of systems (knees, sockets), I always have a bit of a limp. Not severe, but noticeable.

Sometimes I see ads from prosthetic companies with amputees walking totally limp free, so I wonder if they are the 1 in a 1000.

So I would like to know: how is your walking? Do people notice?

Ellen.

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Hi,

I am a chopart amputee, and I have always walked with no limp, unless my foot was sore then I would limp some. I am facing a bk amputation by Spring, and I am hoping when the time comes to walk, that I can do it with no limp.

Mary

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It is harder for an AK to walk without a limp, not impossible, just harder. There are so many variables to consider. Height, hardware (including feet and knees), socket fit and length of stump. The longer the stump, the more leverage you have to operate the leg.

Something you would have to consider one at a time with your legman.

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Hi Ellen,

as an AK I walk with a significant limp although I am using my leg for 14 hours daily and should be better on it.However I am living in Brazil and I don't have a great choice of knees.I use an Otto Bock 3R15 monoaxis knee and a SACH foot.I tried a dynamic foot and didn't like it because you have the sensation of floating and the lack of a significant ground touch made me insecure.More modern knees are extremely expensive and no private insurance company pay them here.The national health system has only one type of knee and that is logically the cheapest one.Therefore I am limping with that one which I can afford.The only "luxury" I have is a CATCAM socket.

Joachim

LAK + LAE

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Well I'm a BK, so I think "limp-free" is easier to accomplish for me...no knee to have to consider! I'd say that I walk without a limp probably 90+ percent of the time. However, if I've been up and around for a very long time and I'm tired and starting to get sore, I start to limp. It can go from just "slightly" to "really noticeable" depending on the circumstances...but usually just being able to sit and rest for a bit will get rid of it.

I think that prosthetics companies most likely DO use their very-most-successful clients for promotional videos, wanting to show their products to the very-best-advantage...but it might be more useful for the average amputee to see a series of "comparisons" with the product being used by amps of various ages, experience, and amp levels....................

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I am a LBK and I do have a limp ranging from very slight and barely noticeable on a good day to very severe on a bad day. In my case though the rest of my leg, knee and hip are deformed and I'm sure this is a large part of the problem. It doesn't stop me being fairly active though just means people often ask if I have injured my leg and are somewhat shocked by the answer!!

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Sometimes I have a little limp, sometimes I don't. Depends on the day and what I've been doing. But, you know what? It doesn't matter. I'm walking. And lots of other things.

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Hi i am a KD, even with such long leverage i walk with a very slight limp on a good day. It's so dependant on the foot i use, that limp comes from heel strike to toe off, as the ankle wont articulate well as the normal ankle. Also, if the stump size does shrink during the day, I'll 'sink' into the socket and that small height difference will give me the 'bigger' limp.

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I use an artificial limb 2 years. Amputation below a knee, very shortly. I too limp. To me say that I at first haven't correctly started to go and have got used to such gait, it is necessary to be retrained. Other experts say that I limp therefore as short the stump and I can not operate. I don't know as to learn not to limp. Can be it is necessary to strengthen what that muscles that they held a body at walking. It would be good to find the information how correctly to go on an artificial limb.

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I am a LBK with a 6 inch residual limb below the knee. People can rarely notice that I am a person with limb loss due to a limp unless I'm having a bad leg day or tired which does happen.

Neal gave a very good explanation of the conditions causing a limp for an AK. The length of the residual limb is critical because if one doesn't lift the prosthetic leg up to follow through with a strike down of the heel to follow through with the toe, the result would be a limp. I am grateful to be an BK because I know an AK has more of a challenge walking, but can still live an active life with limb loss.

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I looked as dances Heather Mills, and I even to go is normal I can not. What to do any more I do not know. After all it is very bad. The back already starts to be ill me from a lameness.

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Hi, Tonya...were you given any exercises to do to strengthen your "core muscles?" Having a strong core (the muscles in your trunk, abdomen, back, etc.......) can help to make it easier to use a prosthetic leg and take the pressure off your back and hips.

If they did not give you exercises to do, try looking up "strengthening core muscles" to see examples, or ask a physical therapist or personal trainer to show you some exercises. If you work on making ALL your muscles strong, that will help you with your walking.

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Hi , Cherylm . Thanks for council. But unfortunately I can't find the expert in our country which could deal with such problems as at me. All orthopedic enterprises are translated for the reduced working week because the state doesn't have money for maintenance of invalids. I tried to find for the money of the expert, but nobody understands my problem. I can go only to a gym where to me will help to strengthen muscles. I now try to find the sponsor who will finance artificial limb manufacturing abroad in which I can is high-grade to live and go.

Tell and whether there were cases in the countries where do you live that at the expense of the help of sponsors did an artificial limb?

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I agree that the length of the limb makes a difference. I have a VERY short residual limb, no choice in that, but do have my knee, for which I'm grateful. Because of the shortness of my limb, I don't walk as smoothly as someone with more length. I don't care anymore. I get out there do the best I can do. Which ain't bad! :tongue:

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I thank God, for that that I have a knee. Probably I would reconcile, with that that I limp. But I am young enough, I have many vital plans and desires. But my lameness disturbs to me is high-grade to live. I very much am tired, the back is ill and I can't long go even with a stick. And still I am afraid that strongly I load a healthy foot which should be protected, I can't distribute in regular intervals loading on both feet. I think it is necessary to strengthen muscles which are responsible for various phases of a step. Only what it is muscles I don't know.

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Hi Tonya,

Cathy Howells, the physiotherapist at my prosthetics centre, has written a book specifically for amputees who want to be fitter (which is probably most of us). The book is called "The Amputee Coach", and you can find out more about it at http://www.theAmputeeCoach.com. The only exercise equipment you need is a theraband (a wide plastic strip, like "rubber" balloons are made of). It includes exercises for AK and BK, and is useful, even for people like me with nearly 50 years of experience (born with congenital limb deficiency). It starts at the beginning, helping you to get up off the floor when you fall (and all of us do from time to time).

Perhaps you could buy a copy and show it to your physiotherapist or trainer at your gym, if you use one? The exercises are all designed to be done at home, though, so you can start by yourself.

Kate

(I used to be an active contributor to this forum, but that was a few years ago...).

I thank God, for that that I have a knee. Probably I would reconcile, with that that I limp. But I am young enough, I have many vital plans and desires. But my lameness disturbs to me is high-grade to live. I very much am tired, the back is ill and I can't long go even with a stick. And still I am afraid that strongly I load a healthy foot which should be protected, I can't distribute in regular intervals loading on both feet. I think it is necessary to strengthen muscles which are responsible for various phases of a step. Only what it is muscles I don't know.

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Perhaps you could buy a copy and show it to your physiotherapist or trainer at your gym, if you use one? The exercises are all designed to be done at home, though, so you can start by yourself.

Hi , Kate

Thanks for the answer

What means to buy a copy?

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Hi Tonya,

Having a short stump b/k can make things more difficult, but, as others have mentioned there might be reasons why you may be limping.

To be given with, check the length, or get your prosthetist to check the length of your prosthesis with your leg in it .... is the prosthesis still the correct length? are you too deep or not deep enough in the prosthesis? having your stump too far in or too far out of the prosthesis will alter the way you walk. If you can get your prosthetist to check your hip levels, or, stand in front of the mirror and check where your knees, hips and shoulders are ... do they look level? Also is the socket comfortable, because there's no way you are going to want to put your weight through it, if the socket is painful, and that will affect how you walk.

I am bilateral b/k and also had problems with my back, and, after a revision op a few years ago, leaving me with a fairly short stump on one side too and found myself in a similar situation to you, whereby was walking very lop-sided.. What helped me was exercises, I was lucky enough to get some physiotherapy for a while, and even now try and keep it going on my own at home because it does help, not only with the walking but also with the backache, so is worth trying.

Appreciate that physiotherapy is sometimes hard to come by, but as others have suggested there is a wealth of information out there in books and on the internet, giving exercises that will help, that you can do at home on your own. In particular core stability exercises, some of which you will work out you can't do, but others you will find you can probably do with your leg on or off, I still find it easier to take the legs off to do those sort of exercises, especially the short one, but start gently, and if anything hurts then stop doing it. Also maybe gradually strengthening your leg, with basic leg raises, and putting increasing weight through the prosthetic side when standing, as well as increasing walking. All very gentle, but do a bit each day and you'll gradually learn how much you can do.

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Hi i am a KD, even with such long leverage i walk with a very slight limp on a good day. It's so dependant on the foot i use, that limp comes from heel strike to toe off, as the ankle wont articulate well as the normal ankle. Also, if the stump size does shrink during the day, I'll 'sink' into the socket and that small height difference will give me the 'bigger' limp.

Have they looked at the foot you use? I have a foot that requires very fine tuning to alleviate the flat spot when walking. It isn't as noticable in some shoes, but I notice it. It can drive me crazy if it isn't right. If the length of your leg is right and the socket is fitting properly, there could be a problem with the knee needing adjusting to your cadence or a problem with your foot.

I don't mean anything negative, but you could also have a mental block or just plain bad habits. This is an area where physical therapy would be helpful.

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Hi Tonya8888, It sounds as though you have been left on your own with very little support.

I think if your foot is not the right kind for you, or if it has not been aligned properly, or if your prothesis is not the right length, it could have alot to do with the pain you are feeling in your back.

If your foot is not functioning properly it can affect your hips and your spine. I would suggest you return to your leg guy and see if the way your foot is working can be improved.

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Hello all,

I have been a prosthesis user all my life (AK) and although I had all kinds of systems (knees, sockets), I always have a bit of a limp. Not severe, but noticeable.

Sometimes I see ads from prosthetic companies with amputees walking totally limp free, so I wonder if they are the 1 in a 1000.

So I would like to know: how is your walking? Do people notice?

Ellen.

Hi

Sorry for the incredibly late reply but thought I'd add my opinion.....

It takes loads of practice (Im an AK and a physio) but is possible if you have no additional functional limitations in yourself or in the prosthesis.

IMO some things to do to help to reduce a limp should include:

A very well fitting close contact socket as you need good awareness of where your foot is without visual feedback (socks, liners etc do not help in this case as they reduce proprioception but are obviously necessary for most of us)

A professional assessment of the correct length of the prosthesis (dont go too short, try to match your sound limb)

Lots and lots of balance training exercises (balance improves confidence)

A long room with a full length mirror at the end (to iron out a limp you have to be able to see it yourself first!)

Previously I've asked a patient to walk with a plastic beaker of water in each hand and avoid spilling any (this helps to limit hip hitching but the prosthesis has to be the correct length)

Lots of amps dont swing the arms or rotate the trunk enough so this should be assessed, along with hip hitching which usually results from reduced trunk rotation, poor confidence in foot clearance, or a prosthesis which is genuinely too long

There are a few more significant points too but its certainly possible with practice (if you have a reasonably good knee unit which is set up correctly too of course)

In the past I've worked with people for a long time before they have noticed a limp and asked if I'd hurt my knee :)

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I have a limp but am not worried about it in the slightest. I should be as I'd be less likely to get issues from other parts of my body, but I'd survived nearly 30 years so far without issues. Comfort is my biggest priority, full stop.

The one key thing I have checked regularly is that my back is straight, and thankfully it is. The length of your limb is critical for this.

I agree with everything Tint says, especially the fit of the socket, without that, it'll be very difficult to walk really well.

It's great to see how far you have come Tint, it was obvious you would turn out to be an impressive amputee when I first met you :wink:

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I have a limp but am not worried about it in the slightest. I should be as I'd be less likely to get issues from other parts of my body, but I'd survived nearly 30 years so far without issues. Comfort is my biggest priority, full stop.

The one key thing I have checked regularly is that my back is straight, and thankfully it is. The length of your limb is critical for this.

I agree with everything Tint says, especially the fit of the socket, without that, it'll be very difficult to walk really well.

It's great to see how far you have come Tint, it was obvious you would turn out to be an impressive amputee when I first met you :wink:

Aw thanks Ian thats really nice of you to say mate :)

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I'm also an AK and pretty much do not walk with a limp. The exception is when I have some kind of prosthetic problem and of course up hill, down hill, etc. I worked very hard at learning to walk as close to normal as possible when I first became an amputee almost 30 years ago. I watched myself walk in a full length mirror and anything else I could use to see how I walked and then I just practiced walking until it looked "normal".

One thing I've noticed over the years is that my posture has gotten a bit weird which I think is more noticeable than my gait. So lately I've been working on that - standing up straight and pulling my gut in - looks much better. I think this can become a problem for anyone in their 50's and important to do some kind of core exercise - which I also try to do.

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I'm also an AK and pretty much do not walk with a limp. The exception is when I have some kind of prosthetic problem and of course up hill, down hill, etc. I worked very hard at learning to walk as close to normal as possible when I first became an amputee almost 30 years ago. I watched myself walk in a full length mirror and anything else I could use to see how I walked and then I just practiced walking until it looked "normal".

One thing I've noticed over the years is that my posture has gotten a bit weird which I think is more noticeable than my gait. So lately I've been working on that - standing up straight and pulling my gut in - looks much better. I think this can become a problem for anyone in their 50's and important to do some kind of core exercise - which I also try to do.

Do agree Gibby, I try and do the same. I've been bilateral b/k for over 40 yrs, and back when I started it was really just about getting to walk and getting on with life, no one really paid much attention to gait or encouraged ongoing exercise etc. etc., over the years I had different types of prostheses, some full length, some knee length, never any physio or input re walking styles. I am now in my 50's too, and some ten years or so ago developed problems with not only get prostheses made that I could walk in but also hip, back, neck and shoulder problems, for quite a few years my life was just about trying to get things done the best way I could. Fortunately, revision surgery gave me access to rehab and I discovered exercising again which has made a tremendous difference.

What I notice is, that whilst for the main in the UK, new amps usually get pretty good input, physio, gait training, gym etc., those of us from way back never really got a lot of this input, especially exercise-wise. Do think that many established amputees could benefit from all of this, but its still a struggle for many to get input to get them on the right track.

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