Have you ever watched athletes running in New York City’s annual marathon thinking about how there is no way you could ever have the will or dedication to compete only to see a group of runners with below the hip/knee amputations run across the finish line with ease and grace? There’s not a lot more moving than watching athletes hard work pay off as they achieve their dreams, but there is something extra rousing about watching competitors who have adjusted their lives, and their athleticism, to all the demands necessary in adjusting to life with a prosthetic. 

You can clearly see from the diagram all the nuances that go into analyzing and re-patterning a patient’s gait, or maybe you remember some of this from The Geometry of Running. An experienced therapist must consider stride length, heel strike, swing, weight balances and many other tiny incongruences to fully determine a rehab program for a patient. Rehabbing gait patterns for an amputee preparing for or recently fitted with a prosthetic limb is no different, if not more complicated. 

However, before you start therapy for life with your prosthetic, you’ll need to work through pre-therapy exercises to prepare your limb for the prosthetics and your body (upper limbs, etc.) as well. While you need to re-learn your gait pattern, you’ll first need to build or regain muscle mass and endurance in your upper body to prepare for moving around with an assistance device, like crutches or a wheelchair. Your physical therapist will help you prepare for this as well as for life with your prosthetic. 

Working with prosthetics in lower limb amputees affects gait patterning because the patient does not always have functions that will be equivalent to the hip, ankle, or knee joints, changing the analysis for swing and heel striking, etc.. This will affect all aspects of the physical therapy for the preparation of walking, and eventually running, with a prosthetic.

As you start to work towards repatterining your gait you might want to consider a physical therapy office that has access to a machine like the Noraxon, a high-tech treadmill that uses pressure sensitive technology to offer “quantitative measurements to support qualitative observations”. This is helpful in fully understanding, with absolutely no question, the development of the stride, swing, and gait that you will need to work on with your new prosthetic leg. 

Obviously the road to running in the New York City marathon with your new prosthetic is a long one, but with a dedicated team of therapists and doctors and a lot of determination you’ll be running those 26.2 miles long before I do.

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