Friday, 24 October 2014

'A leap of faith' - Running Prosthesis Stage 2

Really enjoyed the whole day working with Paul. His positive comments go along way
My appointment to head down to Pace Rehabilitation and their Cheadle clinic to meet with one of my prosthetists down there Paul Richardson, had soon come around. I had arranged with Paul a week earlier to get down to Pace pretty early. This would give us plenty of time to experiment with the next stage of my running prosthesis.
 

I had my alarm on my mobile set for 6:30am, though in the morning discovered I didn't really need it, as I was already wide awake, probably due to the excitement at the prospect of seeing all this new prosthetic kit. I'm sure there are some people out there who just don't get why anyone would be excited at what essentially they would  just see as "a leg". Thing is in the majority of cases as an above knee amputee you need a different leg for each activity you choose to do and without a specific limb you struggle. They are also very expensive and this means quite a few amputees resign their selves to a life of giving up on what they used to do, or want to do, even though they have the potential  in some cases to go on and do even more than they could as an able bodied person.


Sitting back taking it all in
For me becoming an amputee after many years of being disabled with my own leg that had lots of metalwork inside and just wouldn't work due to having a practically fused straight knee and it being very painful, was a huge,exciting and positive way forward. It gave me immense drive.  Instead of thinking of all the things I couldn't do on my one good leg I concentrated on all the new things I would be able to do with my own good leg and my new prosthetic leg, which had the added bonus of being able to bend. I eagerly scoured the internet and looked for the latest pieces of prosthetic technology. It wasn't until I went for my first  everyday prosthesis with the NHS at my local Disability Services Centre and was told "you can't have one of those", that I took my first knock as an amputee. 
 
Obviously as a person who had just elected to have his leg removed and then to be told "you can't just go shopping for the bits you require on-line, then have a prosthetist make it up. Well it just shows how naive I was. The prosthesis I was given was essentially ok. I mean it allowed me to walk and I did learn to ride a bike with it, however I always wanted more. I figured I hadn't spent the best part of over a decade sitting around in limbo trying my up most to save my leg, to then resign myself to "this is now your life, and the odd leisurely stroll or non exhilarating sit in the saddle bike ride". Now don't get me wrong I'm in no way saying there is anything wrong with that. For some people that is a huge achievement in itself and I applaud anyone who basically instead of whining and giving in just gets on with life. You don't have to be doing extreme stuff to be happy, we all have goals and aspirations, the trick is to make them achievable, as when you set the bar to high and you inevitably fail, it leaves you feeling deflated or like a failure. It's all just about not giving up and carrying on with living a life not just leading an existence. Becoming an amputee doesn't have to define you, it is not who you are, it is merely a part of who you are and me well I wanted more. I had to figure out a way to achieve this.

Getting an idea of height and check so
I haven't ran as
I recall since I was around 26. This is when I was employed as a postman and as all my ex-colleagues will tell you I used to have a habit of  running around my delivery. In fact way before Parkour or free running was on the scene I could be found hopping over various walls, jumping gates and trying to find any short cuts in order to get finished quickly. All this with a bag weighing 25 kilo's, or more when gas bills were in town lol.

 



 My sidekick, Ern my dad was coming along to Pace with me, well we are like a team. My dad being my biggest supporter and always there when I need him. After a quick bit of breakfast we set off around 07:00am. Ern was driving, it usually takes us around 3 hours to get to Pace in Cheadle and this time was no different arriving there around 10:00am. Paul soon came to meet us at reception and asked did I mind being observed by a couple of students (One of which was Toby's daughter) "No of course not". I think it's great that youngsters are trying to figure out exactly what they would like to do career wise early on. Much better than back in my day. I didn't have a clue, actually following in my fathers footsteps and wanting to become a mechanic. Weird really as I hate messing around with dirty, oily components now and having ingrained muck on my hands and under my finger nails.

Checking for any nips. Paul often comments on my weird hips
 We were soon in the fitting room and Paul got things under way, revealing my running prosthesis, which Arctic ONE has been so instrumental in me being able to obtain. The limb was complete with a check socket, various adaptors, an Otto Bock sports knee the 3S80 and alloy pylon and then a Ossur Flex Run, running blade which the Challenged Athletes Foundation had issued me a grant and approved me on. 

  
First tentative steps
Good range























Now the hard work starts. Paul demonstrated how the knee worked. The 3S80 has a manual lock which can be engaged, making the knee stable, good for training or when warming up, then at the flick of a small toggle switch can be released to allow full flex-ion and a free swinging knee. To engage or disengage the knee all you do is apply pressure to the toe area in extension and you are able to flick the switch so that the knee becomes free.
 



After the small demo on how to work the manual lock Paul also spoke about the various settings within the knee. These range from beginner to someone who is an accomplished athlete. There are a whole range of set-ups and the knee can ultimately be set-up for each individual user as they progress and become better and faster on the unit.

Now to the trying on. I popped off my everyday limb and removed my liner. Paul has discovered I'm now in a much smaller liner as I have shrunk. It's essential to have a good fitting socket as no amount of money invested in good components will benefit the user if he or she is in discomfort or struggles to use their socket due to it not fitting correctly. One of the simple tests Paul carried out was actually to see if my new socket was tight, this involved listening for leaking air andto see if the socket was pistoning. This is where the stump moves up and down in a loose socket expelling air from around the liner. I then had a go at kicking the limb off and finally a good old pull to see if Paul could get it off. Although Paul feels he could do a few tweaks to certain areas, overall he was pretty happy with how the check socket looked and performed.


Boing!
Paul also did various other checks, such as the prosthesis overall height and adjusting the pylon accordingly. With a running limb it has to be measured whilst you are standing on your tip toes on your good leg. This is because as you run the blade loads up, so obviously you loose a little height in the compression of the blade before it returns the energy and helps propel you forward.(I'm talking in layman's terms here I'm no prosthetist.)

 






After a few tweaks to get the socket comfortable Paul demonstrated a few warm up exercises, going through each one as we went. These exercises are not only to warm up, but to get the user confident upon the knee and blade. After all when you put one on for the first time it's a very weird experience.
Using the the Richard Whitehead  technique is quite fun
 As an amputee of just over 7 years and never having ran properly in a prosthesis I will try and explain from my point of view the some of the differences in using a set-up like this compared to an everyday limb.


 
Gaining confidence
When ever I have tried to jog in a normal everyday prosthesis the first thing I have noticed is just how hard the impact of landing on my heel has been. You see you can't land on your toes with a normal limb. My particular knee the Total Knee if I put pressure on my toes the knee goes into flex-ion/bends. It's weird as the knee isn't the reason why you can't run as the Total Knee can be used as a reasonable high activity running knee. It's more to do with the set-up and of course that blade. Using the new running prosthesis although scary is very exciting. On the day I had 2 light falls, on grass. This was mainly due to a lack of concentration on my part as I simply forgot the knee wasn't locked in extension. Whilst running the knee and foot where under me on ever step, which is so bizarre. Not because it's shouldn't be of course but because it's something I couldn't quite figure out in my own head just how. I mean here I am running on my toes, yet each stride my knee and foot is under me. At first ever single stride was a leap of faith. I guess years of using one particular type of knee and being unable to run or jog just plants that seed of doubt. Emotion wise a whole range,fear,excitement,fun and anxious, plus a whole host more all going on at the same time. Learning to run is strange I'm not entirely sure if it's easy or really, really complicated when you over think it. There is just so much going on if you start analysing every aspect of what you are doing. For me I'm the type of guy who when he gets some new piece of electronic tech I immediately dispose of the instructions and just jump in and figure it out myself. I can see the running blade being slightly different and I'm looking forward to not only feeding back my progress to the team at Pace but also to the Lombard Clinic and working on getting a nice fluid technique.


Not pretty, but a huge step in the right direction
Something that I have discovered over the years as an amputee is that you require confidence. Upon my visits to various limb centres and clinics I have met,chatted and watched various people, some have confidence, whilst others don't. This can be for a number of reasons, the fear of falling and hurting yourself,previous injury,no faith in your own ability, or you are just a nervous person. The list goes on. What I tend to see time and again is those people who lack confidence don't do as well, they hold back. I'm not having a go at these people as it can be very demanding learning to walk or use some new piece of kit. It's therefore very, very important to have the right rehab team in place. People who instil confidence and let you learn at your own pace. I hope I don't come across as cocky, but I'm a confident amputee. I always figure it's not to far to fall and I have now had 7 years of practice what with walking and coming off my bike or getting attacked off the odd tree now and again when out on my biking adventures. 
   
Getting a little better
I will honestly admit I felt a little anxious as I was carrying out the various exercises, particularly the side jumping from left to right, as this required landing on my new blade with a free swing knee. It was weird as my mind was telling my body what it wanted it to do, but the bloody thing wouldn't do as I asked, you see that is confidence. Today I appeared to find some of the  simple tasks hard, whilst what should have be more difficult I found easier.


  
Over the playing fields
After a good bit warm up Paul could see that I was obviously getting along with my new prosthesis and felt the next step was to go for a little practice outside of Pace. So we all headed outdoors and I began some simple warm-ups. Paul had taught me how to do a sort of Richard Whitehead bounce. I found this quite enjoyable as it really gave me a feel for the stored energy in the blade upon each bounce. From there we went on to cover high knees. Unlike an ordinary able bodied runner and above knee has to use their hip to flick the prosthesis out and then draw back at the hip to get their knee and foot back under them. It's a difficult technique to learn. Paul described it as imaging a MMA fighter and the process of drawing the knee up at speed, with good body posture,slightly leaning back. Next we moved onto the small piece of grass directly in front of Pace's building,a few walks up and down, paying attention to flicking the knee and foot. It was at this point I was just dying to have a proper go and I kind of knew Paul was too. So after I turned around I just decided to try and have a few strides in some sort of an attempt at running, or shall we say jogging. It sure wasn't pretty, but wow it sure felt good. Even though the grass was soft and not exactly flat I managed quite a few small back and forth's, each time gaining in confidence. I was well pleased especially when Paul congratulated me saying I had achieved more than what he thought we would have today as Carolyn  the physiotherapist wasn't around on the day to help give me some pointers. So Paul and I had done it. I had taken my first few running steps in over 20 years.
  
Paul running alongside checking out the swing
  Of course we couldn't just stop there. Paul was just as excited as I was and suggested breaking for lunch, then heading over to some local playing fields afterwards, along with his wife who is a trained clinician and they could then both see how I preformed on a larger area, offer tips and advice and Paul could do a few minor tweaks as required.

Popping my everyday limb back on was so weird it felt like I was walking in treacle, the movement so slow and requiring quite a bit of effort. Ern and I headed over to the sandwich shop and we sat inside to have a nice couple of sandwiches and a hot cuppa. I'm not sure what Ern chose but I had a bacon and sausage sandwich. This was to prove to be a bit of an error on my part, because wow did I feel a bit sickly once we got over to the field in the afternoon. You have to remember though I'm quite fit due to my cycling, running is a whole different ball game. I was surprisingly less tired than I thought I would be, this just shows the return of the knee/blade combo, but that sandwich kind of stopped me sprinting the whole way around the football field, well that's my excuse.

Never mind I got in a good few practice runs, running up and down the line of the football field. I even managed to increase my pace at one point to a fair old trot and had Paul beaming. After a few jogs I set up my Go Pro on a goal post and took some footage. It's good to be able to see where I need to work on. It's very early days, but I can already see I need to be more relaxed in my shoulders and arms, really extend and flick that knee and just work on my overall technique.


I am very happy with how the day went and what really made the day for me was the high praise I received from Paul my prosthetist. It's an absolutely fantastic feeling to work with someone who is so passionate about their job and doing the very best they can to enable you to do stuff in your life which makes such a huge difference. Sometimes the simplest  positive comments can be priceless and to me that's the sign of a good clinician.

I was allowed to bring my new running prosthesis home on the condition I'm careful, warm up correctly and don't over do it. this will enable me to get a feel for the new limb, offer feedback for any adjustments, either socket wise or in the speed of the knee. It will also allow me to work on my technique.




My follow up appointment with Paul has already been booked on the 5th November and I will be receiving some expert advice from Tracy Millar at the Lombard Physiotherapy Clinic over in West Moor Newcastle. It's ideal that Pace have found fellow clinicians in our area that they can work alongside and I'm very much looking forward to working with everyone as I know they not only offer me support from a professional side, but also as a friend.

As I end I will say as I sit here this morning writing up my blog I have discovered I have muscles that must not have been used in a while as I am sooooo stiff. It's a good pain though a one I have worked real hard for, it's also one that will fade quickly as I become stronger.

Finally none of this would have been possible without the support of everyone at Arctic ONE. I owe you guys so much and hope I can really go on to promote and create more awareness of your amazing work. I want to assist in giving more people just like myself the opportunity to get out there and take part in what is important to them and welcome them to our family.

My CAF approval letter for my Blade in hand, along with my Arctic ONE funded running prosthesis. All put together and supplied by Pace Rehabilitation
To The Challenged Athletes Foundation. I was very fortunate and honoured to be among one of the 1,469 challenged athletes who received a grant this year. Your support will help me go on to use my new found ability and in turn support other people, leading through example and doing what I can to assist others in finding a way forward through sport.
And of course to everyone at Pace Rehabilitation. You were where it all started for me and you share in all my achievements and success.

Thank you

4 comments:

  1. Awesome totally awesome.

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  2. Thanks Jessie. I have also been following your progress and you too are doing awesome. I'm pleased you found us over on the Facebook group and that you have a place to share your continued progress. Keep up the good work...

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  3. Awesome. Keep it up and enjoy the new leg.

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