Well hello again everybody. No we aren't going to talk about honey honestly....."stick" "sticky" honey is sticky, you get where I was going.. đ . Last week I blogged about using crutches in a generally correct sense and mentioned that this week I would cover in more detail about the various walking gaits and progression from non to full weight bearing. Well I did this.......and then deleted the lot đ!
It was probably the most unhelpful and confusing post ever. Trying to describe those particular gaits and progressions and when and how to move the crutches in relation to the stages of your gait cycle, which differs with varying injuries, does not lend itself to written description or accurate interpretation of those description đ.
Demonstration would be a much better medium and I did a little internet search and found endless demonstrations on You Tube. For the aspect of how to use crutches at different stages then, I would recommend a look, you can always message us to seek clarity.
However I mentioned that I would also cover how to get sticks and crutches to the correct height and also the suitability and use of various walking aids, so here we go đ.
First up....crutches: If you are to be truly non weight bearing then you will have been given Axilla Crutches, especially if this is to be for a protracted period. These are the crutches that sit up in your armpits and are used by all self respecting pirates â ď¸!
You don't see then very often (yes, they do still exist) as they are not given out very often Usually because the clinician wants you partial weight bearing...but possibly has not explained this. Parrots and a West country accent are optional extras đ.
So if we want partial weight bearing, where the injured leg has some contact with the ground, even very lightly, you should have been given or moved onto elbow crutches....which are the ones we see all the time. partial weight bering is desirable in most situations as the forces acting through the limb help with the healing process.
But, the BIG question is how do we know they're the right height (when we just borrowed them of a mate)? Well hang your arms by your side, the top of the handle of the crutch should sit level with your Radial Styloid process, Ok,Ok.....thats the lump of bone sticking out of the outside edge of your wrist đ. That's it, it's that simple đ
Moving on then to the use of sticks.
These usually appear in the hands of a relative of the older years, who is feeling unsure about their stability and balance. Sometimes they have been given by a physio, sometimes by the doctor but usually (99 percent of the time?) by a family member trying to be helpful or even acquired by the person themselves, believing it will help.
Now, there is a problem here and hopefully this will be the most useful tip you will ever read!
If there is a stability, balance, falls or confidence issue occurring, get this checked out ASAP. Using a stick if it is not 100 percent necessary can create more problems than it solves đ¤!
When you use a stick for support you now balance the body though three points of support not two (i.e. legs) this re-trains the balance senses to recognise three points of support'. This massively increases the risk of a fall.....when the stick is lifted to clear a kerb or not used for a few seconds around the house, the ability to judge two leg balance has been diminished and the person trips or falls. The three points of support also take some of the weight off of the legs resulting in these becoming weaker, which also increases the chance of fall.
Sticks give a tendency to hunch forward as they are used for 'confidence' in front of the person. This hunching forward moves the centre of gravity of the body ahead of its centre of mass which massively increases the likelihood of falling forward and again messes up the balance senses. But this tendency to hunch forward brings some less obvious but extremely serious issues with too.
Firstly hunching forward compresses the ribs and prevents them from acting to allow full inspiration, this has two major effects. Firstly the inability to fully ventilate the lungs results in increased waste product forming in the lower lobes of the lungs, leaving the person extremely vulnerable to serious chest infections. Secondly the inability to fully oxygenate the blood results in significantly reduced muscle function and therefore reduces the ability to walk and distance or manage stairs. This reduction in the ability to 'exercise' leads to weakening leg muscles, which increase fall risk further and increases the feelings of instability further, shattering confidence levels. This becomes a vicious cycle, in which each problem creates another problem, which makes the original problem worse, until suddenly the person becomes housebound.
The frustrating thing is that it is all so avoidable!
The important thing to realise is that the most common causes of balance, stability, mobility and confidence issues come down to just a few things: Inner ear disturbances (not necessarily infections), visual disturbances including things as simple as type of glasses, interactions or side effect of medications and finally, muscular / joint stiffness and reduced strength.
So where do you go to get these possible causes checked out and solutions offered, before the stick becomes a permeant feature? Funnily enough, right here at The Reinge Clinic.
Falls and Balance is one of the standard, but specialist areas that we train and work in đ. Here at the Reinge Clinic we see many people with falls and balance issues, virtually none of whom need or should ever of been given a stick in the first place. Nearly all of our clients who arrive with a balance / falls /confidence problem are rid of their stick and back to fear free function within just a few monthsđ.