Winter is here, and we all know the numerous hazards that the season poses. Walking or driving to work or school can prove to be challenging. For some prosthetic users, the season can magnify balance issues and demand an extra dose of attention, especially when walking to avoid falling or slipping on ice.
For those of you who spent the past few months working on balance and stretching your residual limb, winter can be forgiving. However, this does not make you immune to some risks, which is why we created this guide.
What to Expect
In this section, we break down the common issues that you will face this season. And at the top is falling and slipping. When walking in wintery weather it can be difficult to know where your prosthetic leg is relative to the ground, making prosthetic wearers especially prone to experiencing missteps. This problem can be prevented or mitigated by wearing good quality winter or snow boots and taking one careful step at a time.
(*Note: Winter shoes and boots tend to have a higher heel height possibly creating pressure along the front of your bone for either BK or AK prosthetic legs. Above-the-knee prosthetic wearers may have difficulty flexing their knee with a higher heal height.)
Painful joints are another common seasonal complaint. Prosthetic wearers with arthritis can expect stiffer and more painful joints. Regular intake of prescribed supplements and medication can help ease the pain. However, for those whose painful joints are aggravated by the cold weather, incorporating mild exercise routines can help. If you belong to the last group, consider stretching exercises (see also the third section of this guide for stretching exercises that you can do once a day). Other mild exercises include indoor swimming and walking on a treadmill.
Driving presents challenges for everyone on the road during snowy conditions. If road conditions are getting worse, it’s always best to avoid driving. But if you absolutely have to get somewhere, make sure to install snow tires and drive slowly. It’s also a good idea to keep blankets and food in the car in case you need to wait for improved road conditions.
You also need to watch out for emotional challenges, such as winter depression. This is a common occurrence during winter months that can make you perceive pain more acutely. Therefore, everything feels worse, including medical conditions.
Mitigate the effects of winter depression by consuming foods fortified with Vitamin D, such as milk, grains, and tuna, among others. You can also take a Vitamin D supplement.
Another issue that you need to watch out for is Seasonal Affective Disorder (SAD), also known as the “wintertime blues.” Symptoms include decreased energy due to reduced exposure to daylight. Those who live in the northern states are at high risk due to a shorter daytime.
Prevent SAD by opening blinds or curtains to let natural light in. If this is not possible, you may want to consider using a light therapy box, which uses full-spectrum lights that mimic natural outdoor light.
And lastly, watch out for social isolation or loneliness. According to the BBC News, the combination of cold weather and loneliness can be dangerous. But sometimes, winter hazards can be a problem for those who genuinely seek companions. If you know of a friend or family member who has been spending a lot of time at home alone, offer to accompany them. You can also join an Amputee Support Group to meet like-minded people.
While driving is one of the riskiest activities during winter, walking presents just as much risk, especially to prosthetic users. But we also know that there will be moments when you need to brave the cold.
One of the first things you should consider in order to safely walk this winter is to prepare. This means giving yourself enough time to not only plan your route but also to navigate the snow or ice. Never assume that a path is cleared for walking so you may have to go on a few detours to get to your destination safely.
Second, wear shoes or boots that provide traction on snow and ice. When choosing footwear, make sure you get those that are made of rubber and neoprene composite—both materials offer better traction than plastic and leather soles. You may also want to check out footwear that features abrasive soles or cleats, such as those produced by Yaktrax.
Third, take extra precaution when climbing into or out of vehicles, or when ascending or descending stairs. It’s best to move slowly but surely. Use handrails for support, and remember to keep your center of gravity over your support leg.
Fourth, as much as possible, use designated walkways. While it can be tempting to take shortcuts over snow piles, it’s best to go the slow but sure route.
Fifth, take short steps. While it may seem impractical, it can help you maintain stability. Another way to improve your balance is to bend slightly forward and walk with your foot flat on the ground. Doing this allows you to shift your center of gravity just over your foot. And offers extra knee stability.
But be prepared to fall. And if you fall, flex your back and head forward to avoid hitting your head on the ground. Also, avoid stretching out your arms to brace yourself. This is a surefire way to fracture a wrist.
Lastly, clear the snow and ice from your porch, steps, and walkways. Whenever the weather permits, use a shovel and ice melters to prevent snow and ice accumulation. You can also use kitty litter, salt or sand to improve traction.
Staying Agile, Strong, and Balanced
Winter doesn’t have to mean all doom and gloom, especially for your body. If you’re a prosthetic user, you can negate your "prosthetic factor" and remain limber through stretching and strength training. In particular, stretching will help keep your hip and leg muscles in optimal condition.
Just a few reminders before you start stretching: Perform the exercises below slowly to avoid injuring your muscles. Do not bounce back and forth when stretching, and ease your body into these exercises. Stretch at least once a day either before going to bed or first thing in the morning.
• Alternative (Advanced) Prone Stretch
a. Lie on your stomach.
b. Roll up a towel and place it under your residual limb.
c. Lie in this position for 20 minutes.
d. Increase the size of your towel roll to further stretch your hip flexor muscle.
• Hamstring Stretch with Unaffected Leg—Lying
a. Lie on your back. Then bring your unaffected leg toward your chest.
b. Put your arm around your thigh and hug the leg closer to your chest. Hold this position for 20 seconds.
c. Keep your leg straight to effectively stretch the back of your thigh.
• Hamstring Stretch with Unaffected Leg—Sitting
a. Sit on a flat surface, and ensure that your back is straight.
b. Lay your unaffected leg straight in front of you.
c. Reach your hand toward your foot and lean forward until you feel a stretch in the back of your upper leg.
• Calf Stretch with Unaffected Leg
a. Sit on your bed or a mat on the floor. Keep your back straight and your unaffected leg straight in front of you.
b. Loop a towel just below your toes. For this step, you can choose to use either a towel or a small pillow under your heel.
c. Hold the ends of the towel, and make sure that your knee is straight.
d. Pull on the towel until you feel a stretch in the back of your lower leg.
• Shoulder Push Up
a. Roll onto your stomach with your legs straight behind you.
b. Rest on your elbows, but make sure that your elbows aligned with your shoulders.
c. Raise up on your elbows, keeping your hips on the floor, as you arch your back. Do this until you feel a stretch on your lower back and abdomen.
• Quad Hip Flexor Stretch with Residual Limb
a. Lie on your back.
b. Lift your unaffected leg up to your chest. Hold the position with your arms.
c. Get someone else to assist you and have them push your amputated limb down to the bed. Hold this position for a count of 20.
d. Relax and repeat.
You don’t need to dread winter. As long as you prepare for it, you can avoid many common season-related issues and even—dare we say it—enjoy the season.
What about you? What do you do to prepare your household and yourself for winter? Share it with us in the comments section below.