How often do you pay attention to your posture? Probably not so much. Humans are creatures of habit, and if our current routine doesn’t require a posture refresh, we’ll never get around to it. In fact, if our lifestyle requires us to sit down for long periods of time, slumping becomes second nature. But if you’re a prosthesis wearer, you may want to check your form as it can greatly affect your body and your health.
Prosthetists, physical therapists (PT), and gait gurus are currently advocating for walking "naturally" by "loading" your heel when it hits the ground, followed by your toe before lift-off. This is after years of research have finally shown the basis of natural form, or what’s considered as proper prosthetic gait. However, changing one’s ways just because a new study says so might take some time. This is especially true for amputees who have gotten used to their walking habits.
Right now, you're probably aware about your shoulder dropping too much or that you lean over your prosthesis. Maybe a family member or a friend has pointed it out and advised you to see your prosthetist. If this is the case, book that appointment ASAP. Perhaps it’s time for you to get a gait makeover.
Prosthetic Gait MakeoverIt might sound trivial, but it’s not. The clinical term is ‘gait training’, which means learning to walk or run properly. Meanwhile, ‘retraining’ is relearning how to walk or run again.
Your prosthetist can better determine if you need one or the other. Relearning may be necessary if your prosthetist finds a red flag that may predispose you to injury or reduce your walking performance.
Right now, you may think that you don’t need a gait makeover. Your sound-side knee is not injured or your lower back is fine, but fixing red flags now and working through a gait makeover is best. Remember that poor gait patterns are often associated with wasteful movements and rotations that don't lead to efficient forward propulsion.
For this purpose, consulting your PT and prosthetist is recommended. You can also easily download gait assessment apps on your smartphone such as Coach's Eye, which helps identify posture red flags and gives you homework to assist your form. If you don’t want to pay for an app, there are a lot of free options like PnO Data Live and Stridalyszer, both of which help you locate and change these dangerous patterns.
To start your gait assessment, ask someone to take a video of you, then play it back in slow motion. Pay attention to your prosthetic side, knee, and shoulders.
To further help you determine if it’s time for a gait makeover, here are 4 things you need to watch out for when reviewing your video:
1. Where your foot contacts the ground with respect to your pelvisYour heel should be parallel to the ground. If you draw a line from your heel at first contact straight up, it should fall within the inside of your hip joint and just outside of your belly button.
Pull your leg in closer to your body when your heel first meets the ground if the former isn't happening. Increase your cadence and steps per minute. Seek help from your prosthetist to inset your foot slightly or change your ankle level's angle.
2. How far your knee (prosthetic side) thrusts outward
When you're in single limb support phase of gait and you're struggling to see this "outward thrust", that's a good sign. Detecting any thrust can be prevented by walking with a smaller support base or asking your prosthetist to readjust your prosthetic foot.
3. Arms swinging in front of your body and crossing your midlineThe driver of movement can either be your arms if your upper body is weak, or your legs can be the culprit on the opposite side. In either case, make sure that your arms are swinging with limited motion across your body.
4. If you look relaxed and confident
This has to do with your posture. Remember to walk tall with your abs engaged and your shoulders down and back. Keep your chin up and pulled in, feeling relaxed but confident at the same time.
Text or email your videos to your prosthetist or PT for a professional evaluation, as a trained eye can see red flags quickly. They can also give recommendations through FaceTime or via Skype.
A gait makeover is all about you and your unique way of moving. Gait analysis is all about looking at your entire body as a holistic organism—a single amazing unit. Don't be afraid to address poor movement patterns. It’s always best to catch them as early as possible and work on fixing it immediately.
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