Category Archives: Foot

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PT News June 2022

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PT News PTandMe

This time in PT News we recap what our clinics have been posting throughout June 2022. We are excited to bring you current physical therapy-based posts featuring published articles from PTandMe partnering clinics!

Rotator Cuff Prevents Shoulder Pain

1. How Your Rotator Cuff Prevents Shoulder Pain

Written by Advance Rehabilitation with locations throughout Georgia.

You don’t know what happened. You were just playing catch with your child and you just threw “too hard” and the next day your shoulder hurt. Or maybe you were out cutting tree branches and the next morning you could barely raise your arm. How about you just woke up and had a pain in the shoulder that just did not go away or even got worse the more you used that arm. You decide to see your family physician and you hear the words “Your pain is coming from your rotator cuff.” You think “Great! But what is a rotator cuff and why is it hurting my shoulder?”   Read more

 

Hiking Advice

2. A Physical Therapist’s Hiking Advice

Written by Carolina Physical Therapy & Sports Medicine an outpatient physical therapy practice with locations throughout South Carolina.

My husband and I spend an amazing weekend at Yosemite National Park in California last year. We are not avid hikers, but we could not resist going on multiple hikes when we were there. We decided to go on a very long hike, Upper Yosemite Falls. It is over a 7-mile round trip with over 2500 elevation gain. We did some research before the hike to see what all we need to survive that hike. Read more

 

Low Back Pain Physical Therapy

3. Balance Training to Help Prevent Lateral Ankle Sprains

Written by The Center for Physical Rehabilitation, an outpatient physical therapy group with locations throughout Greater Grand Rapids, MI.

Ankle sprains are one of the most common injuries in the United States with approximately 28,000 occurring per day (Kaminski et al., 2013). Ankle sprains are estimated to make up 45% of all athletic injuries. As an athletic trainer in the secondary school setting, these seem to occur on a weekly basis. Due in part to some quarantine boredom in mid-2020, balance training was a solution found by way of a 16-year-old research study.   Read more

We hope you enjoyed our picks for the PT News June 2022 edition.

Find these locations and others to start feeling better today!

Physical Therapy Appointment

Choosing the Right Athletic Shoe

Choosing the Right Athletic Shoe

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Choosing the Right Athletic Shoe

A good pair of shoes is one of the most essential parts of your workout gear and is critical to your safety. Wearing the wrong shoe can set you up for injuries like plantar fasciitis, shin splints, or even a total wipe-out! If the shoe fits your activity – wear it! So how do you choose the right athletic shoe? Let’s “walk” through the basics!

Choosing the Right Walking Shoe

Walking is one of those activities that can add years to your life -ask any centurion! When you walk to exercise, your heel hits the ground first before rolling gradually to the toe. This means you want a shoe with good shock absorption at the heel, particularly under the ball of the foot. Also, look for a shoe with a rocker bottom or slight rounding at the sole. This will help easily shift your weight from heel to toe.

The shoe should also be:

  • Flexible along the arch area
  • Rigid at the toe area
  • Made with lightweight material
  • Have a good amount of cushioning under the ball of the foot & arch area

Using the right walking shoe will reduce the chances of developing heel pain and burning & tenderness at the ball of the foot, which in many cases leads to plantar fasciitis.

The walking shoes our physical therapists are recommending:

Recommended Walking shoes by Physical Therapists

Walking Shoes Physical Therapists Like

Choosing the Right Running Shoe

If you’re one of those people that likes to get their heart rate up and going out for invigorating runs, there are a few things to keep in mind when finding the right pair of shoes to run in. The best running shoes are lightweight, flexible, have heel control, and overall great shock absorption. What makes a running shoe different than a walking shoe is the thicker heel and the sole is arched, with intricate treads that help propel you forward.

If you need a pair of shoes to run a marathon, the general rule of thumb is that the shorter the race distance, the flatter & lighter shoe you can get away with. Adding any extra unnecessary cushioning and weight to your shoes may affect your running time. For a 5K marathon, a racer may choose a more snug-fitting minimal flat, although a 10K or half marathon will likely require a roomier, more cushioned shoe.

If you prefer running through the unpaved trail with beautiful scenery but with uneven terrain, look for trail running shoes. This type of shoe offers even greater stability and support by having a more aggressive tread to help grip the ground and get better traction. Check out our Pre-Run Dynamic Stretching Routine to keep all the moving parts of your feet and legs running smoothly.

The running shoes our physical therapists are recommending:

Running Shoes Recommended by Physical Therapists

Running Shoes Physical Therapists Recommend

Choosing the Right Cross-Training Shoe

Sometimes you just need a good pair of shoes to help you do a little bit of everything. Maybe your workout routine consists of walking, jogging, playing a game of basketball, and then hitting the yoga mat −cross-training shoes would be perfect for you. Also, if you want a pair of shoes that’ll get you through the day after you run some errands, reorganize your closet, and do some gardening −go with the cross-training shoes!

Cross-training shoes combine the running shoe’s flexibility at the forefoot and the walking shoe’s shock absorption. A good cross-training shoe has good traction, a thick and durable stable sole, cushioning for extra stability, and a solid upper to give you ankle support.

Once you’ve found your perfect training shoe, a general rule of thumb, is to replace them every 80 to 100 workout hours. A simple visual test can be your guide as well. If you notice excessive creasing or wear on the areas of the shoe that absorb the most load (the heel and ball of the foot), it’s time to toss them out. Damaged safety footwear can increase your risk of injury, so it is important to know when it’s time for a replacement.

More Shoe Tips to Consider

  • Your feet swell throughout the day so it’s best to try shoes on around midday when your feet are the largest
  • Running shoes can also cause pain before they look worn. This is because they lose the capacity to absorb shock. The guideline to replace running shoes is every 350 to 500 miles. Running shoes older than one-year-old may also cause pain because of changes in the sole with exposure to humidity or heat.
  • Avoid narrow shoes that pinch your feet and look for shoes with a wide toe box, leaving ample room for your toes.
  • If your feet tend to perspire, select shoes that are made from moisture-wicking or leather material.
  • There should be some arch support in the shoe or the insert inside the shoe. Many shoes can be made to fit better simply by removing the factory insert and having a physical therapist order a custom-fitting orthotic. Ask your physical therapist about this!

physical therapy near me

Who knew there was so much to choosing the right shoes! If your feet feel uncomfortable or are in pain, ignoring this is a sure way to develop lingering issues in your feet, legs, hips, and lower back. Minimize your risk of foot or ankle problems and talk to a physical therapist to get the most out of your next activity or workout.

Resources: 

How to Pick the Right Running Shoe (Runner’s World)

10 Points of Proper Shoe Fit (FootCare MD)

 

 

PT News PTandMe

PT News December 2021

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PT News PTandMe

This time in PT News we recap what our clinics have been posting throughout December 2021. We are excited to bring you current physical therapy-based posts featuring published articles from PTandMe partnering clinics!

Core Strength Improve Balance

1. Injury Prevention and Durability: The Significance of the “Core”

Written by Mishock Physical Therapy with multiple locations throughout  Montgomery, Berks, and Chester Counties.

In the US, 30 million children, and teens participate in organized sports with more than 4 million injuries each year. The majority of these injuries occur as sprains and strains of the upper and lower extremity. (Hopkinsmedicine.org) Many of these injuries are preventable with proper exercise training, which ultimately reduces health care costs and minimizes lost playing time keeping the athlete on the field or court.  Read more

 

Boxing Physical Therapy

2. Boxing: Making an Impact in Physical Therapy

Written by Intermountain Physical Therapy, an outpatient physical therapy practice with locations in Caldwell, Nampa, and Meridian, ID

Boxing is a full-body fitness and rehabilitation strategy that, in addition to general fitness, can be applied to a variety of conditions seen and treated by Physical Therapists and Physical Therapy Assistants.  Boxing has health applications for both neurologic and pathologic conditions, with significant research focusing on four common conditions addressed by physical therapy. Read more

 

3. The McKenzie Method

Written by ARC Physical Therapy+, an outpatient physical therapy group with locations throughout Greater Kansas City. 

“The most compelling part of the McKenzie Method is that it allows the patient to take a more active role in managing their pain,” Megan Westman, DPT, Certified MDT, explains. “It provides the patient’s tools to prevent further pain as well as improve centralization and reduction of symptoms in between each PT visit.”…  Read more

We hope you enjoyed our picks for the PT News December 2021 edition.

Find these locations and others to start feeling better today!

physical therapy near me

PT News PTandMe

PT News November 2021

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PT News PTandMe

This time in PT News we recap what our clinics have been posting throughout November 2021. We are excited to bring you current physical therapy-based posts featuring published articles from PTandMe partnering clinics!

Healthy Snacks While Traveling

1. 15 Healthy Travel Snacks

Written by The Jackson Clinics with multiple locations in Northern, VA.

Packing healthy travel snacks may sound like a silly thing to do. After all, there are plenty of food options at just about every rest area or airport. However, there are many reasons to consider packing at least a few healthy travel snacks on your next trip.  Read more

 

Frozen Shoulder Physical Therapy

2. Don’t Miss Out on Free Physical Therapy

Written by Momentum Physical Therapy, an outpatient physical therapy practice with locations throughout Greater San Antonio, TX. 

Have you met your annual insurance deductible? If you have, it’s a great time to come in to see your physical therapist! any people find that they can access physical therapy at low or no cost after their deductible has been met. Most deductibles reset on January 1st, so NOW is the time to take advantage of your access to physical therapy. Not sure if your deductible has been met? Read more

 

Choose the right shoe

3. If the Shoe Fits

Written by Physical Therapy Plus, an outpatient physical therapy group with 3 locations in New Jersey

All too often the topic of footwear comes up in our clinic, even if the person isn’t there for a foot problem. The shoes you choose to spend your day in will greatly impact all areas of your body including your knees, hips, and spine. Your foot is the first part of your body to absorb the impact of the ground. That being said, it’s best to arm it with the right surface to stabilize against the force of the ground reaction…  Read more

We hope you enjoyed our picks for the PT News November 2021 edition.

Find these locations and others to start feeling better today!

physical therapy near me

Plantar-Fascioisis

Is your Plantar Fasciitis Really Plantar Fasciosis?

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Plantar-Fascioisis

There is a pain in your feet that has been bothering you for quite a while now.

You brush it off and put on your shoes in the morning to go to work. By the end of the day your feet are throbbing, and you realize there is a problem. Your feet handle the task of getting you from one place to another every single day, and sometimes you can experience pain when the thick band of tissue on the bottom of your foot becomes inflamed. This is called Plantar Fasciitis-or is it Plantar Fasciosis?

Plantar Fasciitis

Plantar fasciitis, pronounced PLAN-tur fas-e-I-tis (in case you were wondering), is one of the most common causes of foot pain. This is when pain and inflammation of the thick band of tissue on the bottom of your foot, called the plantar fascia, that connects the heel bone to the toes and creates the arch of the foot. When the plantar fascia becomes inflamed, it is called plantar fasciitis. This may be causing that stabbing pain you’ve been feeling in the morning, or when you stand up after sitting for a long period of time. Once your foot warms up, the pain of plantar fasciitis normally decreases, it may return after long periods of standing or after getting up from a seated position. This inflammation can be caused by trauma such as a fall or jumping from a height resulting in a once-off tear in the plantar fascia, or it can be the result of repetitive strain and micro-tearing from overuse or other causes. Common treatments for this condition are cortisone injections and pain medications.

Plantar Fasciosis

Chronic inflammation of the plantar fascia can cause plantar fasciitis which will evolve into plantar fasciosis (pronounced PLAN-tur fas-e-O-sis), if not treated. While fasciitis is an inflammatory process, fasciosis is non-inflammatory. Here is what this means: After the injury to your foot, the inflammation begins and tries to repair itself, but since we all need to use our feet every day, the plantar fascia is repeatedly stretched causing more tears all the while trying to repair itself. After time goes on and the injury is left untreated, there is a point where the tissue that is attempting to repair itself begins to break down leading to deterioration and scar tissue. At this point, the inflammation is gone so treatments for plantar fasciitis no longer work for plantar fasciosis. So how do you treat this pain?

Inappropriate footwear is the No. 1 cause of plantar fasciosis. Footwear that has a narrow or tapered toe box holds your big toe in an unnatural position. This happens by pushing your big toe towards your second toe, and if the front of the shoe is lifted, which is called the “toe spring” of the shoe (common in most athletic shoes). This will then pull on the foot muscle causing restriction to the blood flow to the main artery that carries blood to the bottom of your foot causing pain, inflammation, and tissue degeneration.

Here are some prevention and support tips:

  • Avoid high-heels. Wearing these fashion-approved shoes shortens the calf muscle placing even more stress on your arch and heel.
  • Avoid shoes with tapered toes. Your toes lose the ability to provide support for the rest of your foot when squashed together!
  • Always choose shoes with shock-absorbing soles and space inside for well-cushioned insoles. You can buy them and insert them into any pair of shoes.
  • Choose shoes that keep your feet in their natural position, with neither a high toe spring nor a high heel.

Don’t walk away from the pain and have a physical therapist take a look to help you sort out what type of injury you have. Those trustworthy feet of yours deserve it!

physical therapy near me

 

References:

https://bimptnyc.com/plantar-fasciosis-or-plantar-fasciitis/
https://www.aaronharriscmt.com/plantar-fasciitis-vs-plantar-fasciosis/

how to choose the right safety shoes

How To Choose the Right Safety Shoes (Infographic)

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how to choose the right safety shoes

In the market for a new pair of safety shoes? Read this guide to find out everything you need to know about how to choose the right safety shoes for your needs.

Why Wear Safety Shoes?

If you work in a hazardous work environment, then it’s important to protect yourself against injury. In fact, 7% of wounds caused by workplace accidents are foot injuries. Yet, data from the National Safety Council reveals that many workers tend to overlook their feet with only one out of four victims of job-related foot injury wearing any type of safety shoes or boots.

Risks to Feet in the Workplace

There are two main types of foot injury that may occur as a result of a workplace accident:

  1. Slips and falls
  2. Trauma e.g. burns, cuts, punctures and impact

Depending on your workplace, your feet may face a range of different hazards. For example, electricians may be at risk of electric shock or those who work in a foundry may need protection against extreme heat. As such, the type of footwear required will depend on the particular risks associated with your working environment.

Choosing Safety Shoes

Like most shoes, you will need to pay attention to fit, comfort and support. Additionally, you will also want to look at the shoe material and the type of protection offered. Before shopping, always consult your employer for specifications and check if there are any specific safety features that you will need.

Learn More About Safety Shoes

This infographic from Walsh Brothers Shoes looks at the most common foot injuries in the workplace and outlines some of the most common risks to our feet in the workplace. It also goes on to offer advice on how to choose a pair of safety shoes that will give your feet the protection they need at work.

Scroll down to the infographic below to find out more.

how to chose the right safety shoe

 

 

physical therapy for plantar fasciitis pain

Physical Therapy For Plantar Fasciitis Pain

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plantar fasciitis physical therapy; physical therapy for plantar fasciitis

Does your foot or heel hurt with the first step in the morning? Does your foot hurt when you get up from sitting or driving for long periods of time? If the answer is yes, you may have plantar fasciitis. Plantar fasciitis is the most common type of foot pain. Plantar fasciitis is the irritation or inflammation of the plantar fascia. The plantar fascia is a thick dense connective tissue that attaches to the heel and ball of the foot. A related problem is a heel spur which is extra bone that may grow from the heel bone. This is in response to the plantar fascia being tight or inflamed, thus pulling on the heel bone.

Inflammation and microtears occur more commonly in sports that involve running, long-distance walking, dancing, tennis, basketball, and in non-athletes who spend long periods of time walking on unyielding surfaces. Patients with pes planus and heel pronation have an increased likelihood of developing plantar fasciitis because of the increased tension on the plantar fascia caused by these anatomic features. A tight gastrocnemius can result in heel pronation thereby making plantar fasciitis more likely. Cavus feet with relative rigidity also place more stress on the plantar fascia. The plantar fascia also tends to become more rigid with age making it less effective as a shock absorber and more likely to develop microtears.

Common Causes of Plantar Fasciitis:

  • Too Rapid of an Increase in Exercise Program.
  • Change in Lifestyle (Active to more Sedentary) Causing Sudden Weight Gain or Sedentary to Active.
  • Muscle Tightness and/or Weakness.
  • Poor Biomechanics (movement) at the Foot and Ankle.
  • Inadequate Cushioning in Shoes or Inadequate Shoes.
  • Occupation with prolonged weight bearing on Hard Surfaces.

Plantar Fasciitis Symptoms:

People with plantar fasciitis complain of searing pain at the point of the fascias insertion into the calcaneus. This pain is at its worst with the first few steps upon arising in the morning or after a sustained period of being off their feet. The plantar fascia origin is often extremely tender to palpation. Pain is also increased after long periods of walking, climbing stairs or doing toe raises.

Finding Plantar Fasciitis Relief with Physical Therapy:

Physical Therapy for Plantar Fasciitis

Physical therapy evaluation generally reveals an antalgic gait pattern especially when first beginning to walk. Often foot is pronated, gastrocnemius is shortened and there is severe pain with palpation of the inferior, medial heel. Most people can experience relief in just a few sessions. However, the longer the pain remains untreated, the longer it will take to heal. It can even become so chronic in some cases other non-conservative treatments are deemed necessary. If you are experiencing symptoms similar to the ones listed earlier you may have plantar fasciitis. If you are diagnosed with plantar fasciitis physical therapy can help you resolve your pain.

Physical therapists take the time to educate each plantar fasciitis patient on how to prevent a recurrence of pain. They provide preventative stretching programs that can be done at home, instruct on what to look for when purchasing new shoes, and if necessary, help patients adapt their current lifestyle to prevent re-injury.

physical therapy near me

For relief at home before your evaluation try these!

plantar fasciitis stretch
Frozen Can Roll
Take a frozen food can and roll your foot forwards and back.

plantar fasciitis exercise

Towel Grab
Grab and pick up a towel or dishcloth using only your toes.

 

 

More Articles about Plantar Fasciitis Physical Therapy:

Plantar Fasciitis   Plantar-Fascioisis

Big Toe Problems in Runners

Big Issues with the Big Toe

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Big Toe Problems in Runners

Many runners don’t realize what an important role the big toe plays in stabilizing the foot both during push-off and when the foot hits the ground. There’s a reason the big toe is also called the great toe: if it lacks strength, the foot can collapse. And if it is unable to move fluidly, unwanted motion will occur at the next link up the chain…the foot. And that’s not good. Let’s find out how big toe problems in runners can be addressed with physical therapy.

Quick vocabulary time-out: a joint can be hypermobile (too mobile) or hypomobile (not mobile enough). So how do we manual therapists know if a joint is moving too much or not enough? We look for 60-90 degrees of extension. If you can bend your big toe up so far that your toenail almost hits the top of your foot, that’s too much mobility! But if your big toe doesn’t bend at all or can’t budge up to 60 degrees, then you’ve got too little mobility.

Let’s look at hypermobility first. I see more instances of hypermobility in women than men, especially if the woman sits with her toe in extension, dances ballet now or in adolescence, or frequently wears high heels. Hypermobility can lead to a lengthening and weakening of the tendon or muscle, and can lead to issues like turf toe, plantar fasciitis, posterior tibilais tendinitis, anterior knee pain, and even chronic hip issues.

So what do we do? For a hypermobile joint, we have to stabilize the big toe using strengthening exercises. Research shows that the following exercises help stabilize the foot/arch:

The Isometric Vele Lean (think of the “Michael Jackson lean”)

  • Find a neutral foot position. (A flat foot position will have little to no space between the floor and your middle arch. A high/rigid foot position allows you to fit two fingers between the floor and your middle arch. What you want is a neutral position in which the arch of your foot is just an index finger high off the ground.)
  • Lean about ten inches forward (similar to the position you see skiers use when they jump off a slope to get distance), hold 10 seconds, and then return to the neutral foot position.
  • Perform 10 reps, provided you do not feel pain.

Backwards Walk (sticking with the MJ theme, you could consider this a slow and controlled Moon Walk)

  • Again, find a neutral arch.
  • Walk backwards heel to toe (“retro tandem gait” in manual therapist speak), maintaining that neutral arch.
  • Continue for two minutes, stopping if you feel fatigue or pain.

Let’s not forget that the toe, foot, and leg are like a chain, so we have to address all weak links, not just the hypermobility. For example, if a toe is hypermobile, the next joint up is often stiff. Or the knee might be painful. A manual therapist can help determine the cause (lack of quad strength? hip or foot weakness?) as well as the solution.

OK, now to address hypomobility, in which the great toe does not allow enough movement. Runners with hypomobile toes tend to compensate in one of two ways: they either over pronate, which can result in a bunion or a collapsed foot, or they can keep their feet supinated in order to avoid rolling off their big toes. As with hypermobility, it’s important to find the cause of the cause: what is the reason for the hypomobile big toe, which is the reason for such irritants as turf toe, plantar fasciitis, lateral foot pain, and even lateral ankle pain? And up the chain? Yes, even knee and hip pain can result from a big toe that can’t move freely enough.

While a manual therapist can help address your overly stiff big toe, you can also gain mobility with exercise at home. To determine if your great toe is too stiff, actively lift the toe while in a weight-bearing stance. You should be able to lift the toe high enough to allow you to slide a finger under it. If you can’t lift your big toe that high, try the following to get your hypomobile great toe moving:

  • Kneel down and lift the hypomobile big toe by placing it on a folded towel in front of you.
  • Holding the foot neutral, try a lunge or calf raise. If you feel pain, decrease the height of the big toe.
  • Perform ten reps.
  • Progress to more lifts the following day, provided you are not too sore.

The exercise above will certainly help loosen a big toe with low mobility. But if you aren’t able to get the big toe off the ground at all, then you may need to proceed with caution. Before attempting the lunge/calf raise exercise, simply try to hold a prolonged low-load stretch for seven minutes or longer. Be careful, as overly aggressive stretching can be harmful. I would rather you progress slowly, day by day, to make sure you keep you from pain. (Please seek a manual therapy fellow to prescribe the correct intensity and duration of activity if you DO have pain.)

Now, please don’t read the above and immediately diagnose yourself as having a problem with your great toes; many runners will never experience big toe stability or mobility issues. This is just one tool in a manual therapist’s toolbox. Just because you now have this hammer, it doesn’t mean you have a nail that needs hammering!

Written by: Brad Perry, PT, MS, SMTC, FAAOMPT
Owner @ Kingwood, Lake Houston, Spring-Klein, Cleveland, & Northern Oaks Sports Medicine Physical Therapy
Kinesiologist, USA Triathlon, USATF Certified Coach, & Slowtwitch Certified Running Coach
www.kingwoodotpt.com

Achilles Tendinitis

Treatment Options for Achilles Tendinitis

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The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run and jump.  Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis, a condition associated with overuse and degeneration. Achilles Tendinitis causes pain along the back of the leg near the heel. If you suffer from Achilles Tendinitis – try these pain relief methods.

REST: Cut back your training by decreasing your mileage and intensity. Also avoid hills and speedwork. You may substitute running with swimming, running in water and biking to reduce the irritation.

ICE: Apply ice to the affected area for 10 to 20 minutes with at least one hour between applications. Do not apply ice directly to your skin – a pillowcase or dish towel works well as a protective barrier. Frozen peas or reusable gel packs are flexible and conform well to the injured area.

PROPER FOOTWEAR/ORTHOTICS: This situation can be corrected with arch supports or custom orthotics. Orthotics allow your foot to maintain correct position throughout the gait. Avoid walking barefoot and wearing flat shoes. If your pain is severe, your doctor may recommend a walking boot or to cast you for a short time. This gives the tendon a chance to rest before any therapy is begun.

NON-STEROIDAL ANTI-INFLAMMATORY MEDICATION: Drugs such as ibuprofen and naproxen reduce pain and swelling. They do not, however, reduce thickening.

PHYSICAL THERAPY: Achilles tendinitis can be painful, chronic condition if left untreated. Consult your physician to discuss physical therapy options. Licensed physical therapists coordinate with your physician to provide individualized care and treatment options for your specific needs.

CORTISONE INJECTIONS: Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections into the Achilles tendon are rarely recommended because they can cause the tendon to rupture (tear).

lower limb amputation

Lower Limb Amputations

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LowerLimbAmputations_FBsize

The goal for every patient with a lower limb amputation is to walk normally again.
A patient with a lower limb amputation faces many challenges when it comes to walking safely in a variety of walking surfaces and without exerting excessive energy. Generally, the higher the amputation level, the more we can expect to see gait deviations or difficulty walking. This is because with each segment of the anatomy is lost to amputation, more muscle, sensory receptors and leverage are also lost. A Physical Therapy treatment program can be designed to assist a patient return to a “normal” walking pattern in terms of posture, step length, stability, balance, rate of speed, and limb positioning.

GAIT TRAINING
Almost all patients with a lower limb amputation will benefit from physical therapy and gait training at some point in their recovery to help them return to a more normal walking pattern. Pre-amputation exercises will assist the patient in arm and leg strengthening to help them prepare for using a walker during gait training with their prosthesis. After amputation surgery a prosthetist will work with the patient to fabricate and align a prosthesis to assure that it will optimize the patients walking pattern.

WHAT TO EXPECT DURING PHYSICAL THERAPY

  • The physical therapist will typically work with the patient 3 days per week

  • The physical therapist and prosthetest will remain in close communication with gait training is occurring since any changes in the prosthesis will affect the gait pattern

  • Initially physical therapy is focused on standing and walking with enough stability to ensure safety (this initial gait training is performed in parallel bars with the assistance of the physical therapist holding the patient with a gait belt for additional safety)

  • Initial gait training is supplemented with strength and flexibility exercises for the legs and trunk muscles since strong trunk and leg muscles make it easier to progress the patient’s gait training

  • The physical therapist will also work with the patient to improve balance and coordination to help the patient develop a more normal step length and walking speed

Physical therapists use many different techniques during gait training sessions

leg amputee

LEARNING HOW TO WALK AGAIN
Specialized Treatment Techniques

  • SPLINTER SKILLS: Technique where the walking pattern is broken down into a sequence of events that are practiced individually before putting them all together to build the walking pattern
  • WHOLE WALKING: Technique in which the entire gait pattern is performed all at one time without thinking about the individual components of walking therefore relying on the body’s natural tendency to find the most stable and energy efficient way to walk

BUILDING CONFIDENCE
Once the patient feels confident and the physical therapist believes that it is safe, a walker can be used instead of the parallel bars. When using a walker, the focus will change to helping the patient walk on uneven surfaces such as outdoors and walking around obstacles or stepping up and down stairs.

Even patients who have walked with a prosthesis for years can benefit from gait training for a “tune up” of their walking skills or to learn a new skill such as side stepping, tandem walking or even running.