Usually the younger you are, the easier it is to adjust to a prosthesis and learn how to
walk. Agility and balance come easier with youth, however most people in reasonably good
shape are able to make this transition to varying degrees, no matter what age.
"I am 62. I don't use any assist if the surface is smooth and
level, but like a cane if I am getting onto uneven ground or going down steps. I
used a cane for the first 4 years, then decided one day that I didn't need it most of the
time and it took only a couple of days for me to feel comfortable without it."
Archie (HP since 1983)
Perhaps one of the most limiting factors in walking is being overweight. Since our sockets
must fit tightly around the hip, abdomen and waist, an excess of fat will make it much
more difficult to get a comfortable socket fit. Carrying excess weight puts stress on the
remaining joints and will make it much more difficult to get around with crutches as well,
even if prosthetic use is not chosen.
Neither is it good to be underweight or too thin, since there should be some degree of
padding between your bones and the socket for comfort. Some of you may have undergone
chemotherapy and radiation therapy resulting in weight loss. Its best to wait until
youve achieved a reasonable, normal weight before being fitted for a socket. Most
importantly, fluctuations in weight are to be avoided once a socket is fitted. Avoid fad
diets, as they will not work over the long haul. Make a commitment to a sensible diet and
a reasonable weight which youll be able to maintain relatively easily.
It takes a great deal of stamina to walk with a hip or hemi prosthetic. A frequently
quoted statistic is that it takes 100-200% more energy to walk with our prosthetics than a
normal person. If you really want to walk, it is mandatory to maintain a good overall
level of physical fitness. Relying partly or even solely on crutch walking also takes a
lot of energy, therefore to regain an active life again you simply must become as fit as
possible. How we do this is discussed in another area of this site, Physical Fitness.
After a major injury, surgery, cancer, chemotherapy or radiation it may take several
months to regain your strength. Dont set yourself up for failure, take your time to
recuperate, and dont push yourself too much too soon. Some of you may have other
medical conditions such as heart, vascular, or lung disease which will impact your fitness
level and energy expenditure. Be sure to check with your Doctor before starting any
fitness routine or trying a prosthesis. It may be wise to so some tests such as a stress
test to assess your tolerance to use of a prosthetic or starting an exercise program.
Our bones provide the structural support to our bodies and are the key to weight bearing,
fitting a prosthesis, and therefore walking. The more bones that remain after surgery the
better, however, we HDs and HPs have proven we CAN and DO WALK, even without
this boney support.
Hip-disarticulations who have been left with their entire pelvis intact generally will
walk easier and better than hemipelvectomies. We hemis support our weight with the
soft tissues that remain. Sometimes only part of the pelvis is removed, called a partial
or semi hemi., which puts you somewhere in the middle. Occasionally more radical surgery
must be done such as removing parts of the vertebrae (back bones), sacrum and coccyx (tail
bone). This will make it more difficult to walk, but not impossible. Lastly, some
HDs have been left with a small portion of the hip joint or femur remaining, not
enough to activate a prosthesis but just enough to make it more difficult to fit a socket.
Sometimes these are called a high AK. In this situation, functionally you are an HD, and
although this makes it more difficult to fit, it is possible, especially with the new
softer socket materials.
Ask your surgeon for copies of your operative report and have a set of post operative
X-rays taken, from mid chest to upper thigh in the standing position, both AP and Lateral
views, showing exactly what boney structures remain. Keep a copy of these and know
yourself what anatomical structures you have left. This information will be very helpful
to your prosthetist when it comes to fitting a socket, and may serve as an indication of
future problems with scoliosis.
Keep your remaining bones, especially the sound leg, as strong as possible by weight
bearing exercises, weight lifting, a sensible low fat, high calcium diet, dont smoke
and watch your alcohol consumption. Post menopausal women should check with their
Gynecologist to discuss and understand the option of hormonal replacement therapy and
assess their personal risk for osteoporosis.
We are all unique and possess certain inborn talents and abilities. Some people are born
with an inherent sense of balance or athletic skills and for those lucky few it is usually
easier to learn to walk with a prosthesis. However, no matter what your physical strengths
are, motivation is perhaps the most important factor of all. Only YOU will decide how you
will function for the rest of your life. Its your decision. It may be harder for
some than others, but never let another individual (even a professional) set limitations
on your abilities or discourage you before you learn the facts. Youll never know
what you can do unless you try. Walking doesnt just happen, no matter how motivated
you are, unless you are willing to invest the time and effort needed to learn any new
skill. It isnt easy and does not happen overnight. Adjusting to walking with a
prosthesis requires time, patience, practice, and commitment. This motivation can only
come from within.
"Don't limit your choices.
Personally, I feel everyone should have a prosthesis when and if you choose...If only for
cosmetic reasons, to attend the occasional wedding or social event, it's worth having a
leg" Colin (HP, occasional prosthetic user)
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