Walking with forearm crutches is killing my forearms, Video also.

[mr_coffee]

Hello everyone, I need to be walking with forearm crutches alot more but the problem that is keeping me from being more functional with them is my forearms kill me, also my sholders hurt like a motha, but not so much as my forearms! When i remove the fore arm crutches my arms are super red, I have mole skin on the cuffs but that doesn't help. Any ideas?

[Lynne]

Are you "step walking" or swinging through? Sounds as if you have the cuffs squeezed too tight. Are they open on one side or are they a complete circle? Most kinds can be "adjusted" by bending the metal open or closed in order to fit your arm loosely.They shouldn't be real tight. The cuff really is just there to keep the crutch from coming off your arm as you walk if you're stepping. I'm not sure about if you're swinging through. Hope this helps a little. Lynne

[betheny]

The cuff on mine doesn't touch my forearms.

[mr_coffee]

Well its weird, i have brown sequard syndrome, so I step with my right normal, and i swing through with my left leg, its in a KFO. Also, my cuffs are plastic, and they arn't a complete circle.

[MikeC]

I'm not an expert but I'd say if you can't 'widen' the cuffs because they are plastic you need new crutches. Another thing is can you adjust the top part of the crutch (lower it) so that the cuffs hit you arms lower where your arm is skinnier? My crutches are adjustable at the top (with 4 holes) and I've got them on the lowest hole). I can feel the cuffs on my arms but they aren't tight enough to cause them to turn red. The only time I notice them is when I get hot and they are sweaty and I can feel them 'rub' on my arms. Mine are kind of rubber/plasic and I'm sure I could widen them if I needed to. Mike

[Lynne]

What I meant by "swinging through" was that I thought you might have KAFO's and might be lifting your whole body through, swinging forward and landing on both feet at the same time. (This might require tighter cuffs) If you're stepping with each foot your cuffs don't need to be tight at all. Like Betheny, when I used them mine barely touched my arms. Mike's suggestion is a good one. Is there any possibility you're allergic to something on the cuffs? ARE they tight?

[mr_coffee]

Well its weird to explain how i'm walking...here is a video so you can get a feel for what i'm doing:
http://www.mytempdir.com/177121 (http://www.mytempdir.com/177121)

If my cufs arn't tight, my fore arm will pop out and i'll fall on my face! I actually made them tighter for this reason, i put mole skin on them so it would compress my forearm better, but now its way to compressed because u can see a huge red mark on both arms.

[Lynne]

I've looked at your video, but don't have sound in case you were telling me something important to your function or feeling. Are you working with a PT? Did you work with one in order to walk as you do? I may have some suggestions if you're not working with someone now. Since I'm not familiar with your strengths I'm a little hesitant. I'm c6-7 inc. and walked for 14 yrs. with forearm crutches and did some things differently. I don't want to interfere with your therapist, that's for sure!!! Lynne

[Lindox]

mr. coffee,
To be honest. You might want to try underarm..wooden crutches.

In my almost fifty years of crutch use..they are the BEST. And I have experienced every type of crutch made to date.

They are much better for your posture..and also they float well.

If I had only had forearm crutches to use I would have been in a chair YEARS ago I feel.
JMHO.

[mr_coffee]

Lindox, are you talking about the ones that go under ur arm? like someone uses if they break their leg? I have a pair of aluminum ones, same concept as the wooden just different material, i havn't tried them in along time, if this is what your talking about. The problem I remember when i was using them was it was very difficult for me to stand up. What level are you? I don't have great balance, because i still don't have my abs back!

[MikeC]

mr coffee - just finished watching your video and you looked good walking with crutches - much better then me. Who taught you to stand like that? I was told to hold both crutches in one hand, push on my chair with the other and stand up. Then I'd put the crutches on each arm. I'm like you and my balance is bad but it's still the way I stand. Mike

[mr_coffee]

Thanks Mike! no one really told me, it is just what felt easiest for me, and because i don't have much push on my right and none of my left, i can do this alot easier by just using my arm/sholders. Your T-12 right mike? Do you have abs? i thought t-12 does, but who knows, i had a stronger back and abs i would be in good shape, but once i start walking alittle bit, my back gets really loose and gives me this hugee arch which makes it even harder to walk! or stand

[Lindox]

Lindox, are you talking about the ones that go under ur arm? like someone uses if they break their leg? I have a pair of aluminum ones, same concept as the wooden just different material, i havn't tried them in along time, if this is what your talking about. The problem I remember when i was using them was it was very difficult for me to stand up. What level are you? I don't have great balance, because i still don't have my abs back!

mr. coffee,
I'm not a level..I'm a polio.
I started out with ankle knee hip bracing on both legs and a corset back brace attached..this with one arm weakness..and given forearm crutches to boot. Would go a foot or two and fall either backwards or forewards.

That after quite a few months on parallel bars.
Then got my first pair of underarm crutches..and yes most likely also due to more strength returning to my one arm..really got going. The forearm crutches seem to cause you to bend to far forward thus balance is compromised. Your shoulders can be used to realign yourself if you go off balance where with forearm crutches you tend to overcompensate to one direction or the other. At least I do.

I think it is a unique thing really which works best for who. One thing I did notice was those kids that did use forearm crutches ALWAYS had more severe scoliois then those that used underarm crutches..this may be also due to the fact they usually only had one leg involvement don't know..but sure was evident in the population in the hospital I was always in. Of course also we all came from different cities and towns and had different orthos too.

Whichever you do use..it will take TIME and alot of practice to get really say used to using them on a daily basis. And able to do normal type things while using them with a messed up lower body. Best of luck.

[mr_coffee]

thank u for the info!

[Lynne]

mr coffee, I do notice that you have your wrists (hands, grips) turned inward when you walk. This is putting a lot of pressure on your forearms (also your shoulders). These crutches are meant to be used with the grips facing forward. You probably feel that holding them forward will cause your arms to come out of the crutches. You might try this: Shorten the total length of each crutch so that your elbow is just slightly bent when the crutch is 6"-8" or so to the side of the top front of your shoe when standing (hand on grip, your wrist is touching you) Also lower the cuff so it is maybe 2" below your elbow. It also appears you could benefit from smaller steps. You appear to be reaching far ahead of yourself with too long crutches and large steps. You get there faster, but perhaps with less control and more pain. The far reaching may be causing the cuffs to slip off. With the four point gait you're using you should be able to do this well with shorter steps. When you place the right crutch forward move the left foot even with it, left crutch forward, right foot even with it. (stepping only a little more than a foot length at first......you can lengthen later) Of course this is just my opinion. I hope this helps. I was also taught, like Mike, to get up pushing off with both crutches in one hand, one hand on armrest. Easier on shoulders. You have so much potential here. You could really be helped by a couple of visits with a PT. Sorry this got so long! Lynne

[mr_coffee]

Thanks for the advice Lynne, i think that will help, it feels like my crutches are doing too much work and my legs arn't doing enough...
You have so much potential here. You could really be helped by a couple of visits with a PT. I actually do see a PT, 3 times a week, and on the off days I work with it myself. The PT is the one who set up the length of the crutches, and how i should walk, etc, doesn't seem like she is doing a very good job! The reason I take such long strides is because the side with my KFO, i can't lift up that leg, all i can do with it, is swing it through, and if i don't use the crutch to help it along, i can only move it foward alittle bit, you think if i put a lift in my right shoe it would work?> that way i wouldn't have to use the crutch to elevate my left foot so it doesn't drag on the ground.

[Snowman]

mr coffee

Just watched your video...

I would say that your crutches are set too long/tall, you definately are leaning too far forward and planting your crutch too far in front. This then causes your upper body/arms to take the brunt of your weight. If you can try to shorten your crutches, face the handles forward, stand in a more upright posture, and take shorter steps...you may not have the core strength for this so don't be disappointed if you can't. What is the function of the leg with the KFO? Non-existant or....?

[mr_coffee]

That sounds like an excellent idea, because my legs never get tired when I walk, its my upper body that gets tired and it has to be because of what you and others have said about the forearm crutches being too long. My leg with the KFO can't move if i'm sitting in the chair, but when I walk, and move my right foot my left foot will move, its very odd...Anything I do with my right, my left can mimic it, but like if i bend my right, my left won't bend, i'm saying when my leg is straight. But my main problem with the KFO leg is keeping it from dragging on the ground, When i walk, i use the crutch to lift the left KFO leg just high enough to swing through. Also my leg with the KFO has some hamstring, but no quads

[MikeC]

Thanks to Lynne, Snowman and Lindox for posting - gave me a few things to think about. I was going to tell Mr. Coffee to twist his crutches with the handgrips forward but wanted to try it his way first. You all are right; it puts a lot more pressure on my shoulders when I tried his way.

Mr Coffee, I do have abs but I don't have very good hips and no calves/ankles. So, my balance problem is mainly in keeping my hips under me and staying straight - not leaning forward as others have discussed.

Mike

[betheny]

Still haven't seen the video, will have to mess with it a bit I guess.

Mr. Coffee's gait sounds a whole lot like mine. I'm intrigued by the idea of the lift in the shoe of the good leg because I drag one, too. I also take big steps because the dragging is so hard. My bad leg has no hamstring, hardly any hip flexor, no calf, foot or ankle operational but the quad and glut does fire pretty well. My good leg has it all, probably 75% original strength. My legs get tired more than my upper body tho.

Let me know how that lift works out if you try it, Mr. C. Also the underarm crutches. I use 1 forearm crutch, mainly for balance when I'm on the bad foot, but sometimes to lean on or catch myself when I spaz.

I hate the crutch because carrying anything is so risky. It takes full concentration to stay upright. There's a new guy from OK here on CC. I first met him at a meeting. I was carrying a plate of food, caught my toe because I wasn't looking at it, pitched forward, caught myself about 6 inches from his lap.

Because he's a gentleman he said he enjoyed the experience. But he steers clear of me now when I'm carrying food. :D

Edit: Why the KAFO instead of AFO I wonder? I never used a KAFO, started out w/ 2 AFO's. Now just 1 on the weak side. Can you lock your knee on your weak side, Mr. C?

[Snowman]

I would be concerned with using a lift in one shoe since that would basically make one leg longer than the other. This would then cause you to lean to the side without the lift...causing all sorts of new posture and balance issues. Not to mention the structural stress it would put on your pelvis and back...

Betheny

From Mr c's previous post I do not believe he can lock his knee as he said he has no quad function.

[Sim]

I'm coming late to the conversation, and can't seem to view the videos you posted ("The file was removed. Reason: Hosting period expired") I'm not sure I can add a whole lot to some of what has been said, but from the sounds of it, if you can make any adjustments to the crutches you have, that might be your best (and cheapest) option. While your arms will probably get easily tired as you first learn to walk with crutches (you're using your muscles in a different way than your body is used to), after a while, this should be less of a problem with properly adjusted crutches. I'm not sure where you're at as far as this goes.

As far as the underarm crutches, these tend to take more energy to use than forearm crutches and can cause problems with long term use. I suggest sticking to the FA crutches for now, as you are learning. I say this because I think UA crutches can cause one to learn bad habits in a way that FA crutches don't, and don't give you the full benefit of using your body the way you need to if you want to learn to walk again. It may just be me, but though I do use UA crutches on occasion, I find that my posture is actually better with FA crutches rather than UA crutches, as I tend to get lazy and stoop with the UA crutches.

Good luck, and hope this might help.

Sim

[mr_coffee]

thanks everyone, I took your advice and I made the crutches smaller, I can tell such a difference, it feels like my leg is doing so much more work and i love it.. Also my posture is better and it forces my steps to be smaller! I wouldn't have ever known if it wasn't for you guys! my therapist was impressed also, so she says thanks!! About the lift, Snowman, if it makes it easier for me to walk should i do it? but i see your point on everythig you said. Also here is the video again, it should still work!
http://www.mytempdir.com/177121

[Snowman]

I would say no to the lift if you were my client. It may help you walk better in the short term, but it is only going to make things worse in the long run...

Not trying to bash your PT, but she should have realized your crutches were too long.

[betheny]

I agree with Snowman. Re the lift: You're too newly injured to compromise your gait that way, Mr. C. And I was also going to caution you about your PT. They mean well but so few are experienced with sci. I've had more bad ones than good by now. Listen to your gut. You're really smart to post that video and ask here.

[mr_coffee]

Thanks everyone, but yes I realize my PT has no idea about SCI, infact she is not even a real PT, she is a PTA. So at therapy I basically tell her new things we should try, and i get that from posting here. There is no other rehab even remoltey close to me that has PT's that know what the f is going on. It sucks in a big way.

[mr_coffee]

I was wondering if anyone knew any weight baring exercises i can do with my left leg? An idea what I told the PT was to brace my left leg with just a knee imbolaizer, its just a leg brace that will allow very little knee extension but still will allow some. Then I use ace bandage wrap to wrap up my left foot to keep it from dropping, so when i put weight on my left leg, it will really make my ankle work. THe problem is though, i can't do it with my crutches, I have to use a walker, is this bad? Or is this helpful? Right after i'm done walking like that it really stimulates my left leg and i can move my toes.

[Snowman]

As long as it isn't messing up your gait seems like a good idea...especially since it is stimulating your bad leg and allowing you to move your toes. Even if it is messing your gait up a little bit, as long as your not doing it all the time, it should be of benefit.