Running Advice


Running advice for people with leg amputation Usually people who have limb loss or limb absence of one or both legs, who have a stump that can tolerate pressure from a prosthetic socket, and who walk without a walking aid can learn to run with a prosthetic leg (or legs). Running is a movement action that just means you move fast enough for both feet to be off the ground at once. Officially, there is no such thing as “jogging” and so if you jog you are just running at a slower speed!

Why run? Running is useful if you want to catch a bus or catch up with your small children or grandchildren. It is useful if you want to take part in some sports like badminton or tennis. Running as a hobby or a sport in itself is evidently more demanding.

If you want to take up a sport that doesn’t involve running on a prosthetic leg but involves speed, you could choose to use crutches (for example football) or wheels (for example wheelchair basketball).

Want to learn to run? The first time you learned to run as a child you would have just had a go. You will have fallen over and dusted yourself off and tried again. Adult runners who have had a leg amputation are more likely to be more cautious about trying to run because of a fear of falling. This is only natural, but you can do some things to help build up your confidence to give you the best chance of being able to run. Simple things will help – like making sure you know how to get up off the ground if you fall (ask your physio if you are unsure). Remember that as a child you learned to walk before you learned to run and walking exercise is a great way to start, especially if you have been a couch potato lately!

Your health and fitness

You may have had a leg amputation, but are well and have no other health problems, or you may have come to have an amputation because of health related lifestyle choices that over the years have led to poor circulation and ultimately to amputation. If you have been inactive for a while then it will take time for you to build up your fitness levels

We recommend that if you are planning to increase your activity levels then the following questions may help you identify whether you should check with your doctor first.

Physical Activity Readiness Questionnaire (PAR-Q)

Exercise is a form of physical activity which can be fun and healthy and very safe for most people. Common sense is your best guide when you answer these questions.

Please read the questions carefully and answer each one honestly.

Questions

1. Have you sought medical advice for a heart condition? 2. Do you experience chest pains? 3. Do you have a bone or joint problem? 4. Do you have low or high blood pressure? 5. Are you pregnant? 6. Do you have diabetes? 7. Do you have asthma? 8. Are you over 60 years of age? 9. Have you had an injury in the last 6 months? 10. Do you know of any reason why you should not increase your physical activity?

If you can answer YES to ANY of the questions then you should first talk to your doctor before increasing your activity levels.

You may be able to participate in running even if some of your involvement is restricted. Talk with your doctor about the kinds of activities you may be involved in that would involve running.

Your stump and your socket

At normal walking speed, the forces that transmit through our legs when we strike the ground are equivalent to three times our body weight. When we run these forces are magnified in proportion to our speed. In order for someone with a leg amputation to be able to run, their socket should be well fitting so that it can effectively transfer force to and from the amputation stump.

The socket fit is the most important part of the prosthetic leg. Special prosthetic components are not needed for someone to begin to learn to run, but a well-fitting socket is important. Rather like a comfortable running shoe, the socket should be closely fitting and yet comfortable.

If your socket fit depends on stump socks, then make sure you use your “best” socks for running and keep an extra sock in your pocket so you could put it on if your stump shrinks during your exercise period. A loose socket will cause blisters (just like a loose running shoe causes blisters on your heel). Use a stump compression sock when you are not wearing your leg because this will prevent swelling and let you put your leg back on again.

If you would like to improve your socket fit, then talk to your prosthetist. Also ask your prosthetist about suspension – you may need additional socket suspension for when you are running.

Your environment

Confidence is a big part of enabling you to run. Think about where you would start to practice running and possibly the best person to talk to for advice is your rehabilitation consultant, your prosthetic physiotherapist and/or your prosthetist. It may be possible for you to visit the physio gym or a local sports centre where you could have your first running steps supervised indoors with specialists on hand to advise you.

Co-ordination, control and balance

Running is essentially controlled falling over! Your lean forward, fall forward and quickly put a foot ahead of you to stop you falling on your nose. Knowing where your prosthetic foot is in space without looking at your feet is called “proprioception” and despite you having no foot of your own, your brain can unconsciously work out where your prosthetic foot is to accurately place your foot under you so it is “there” when you need it to be. The more you repeat a movement pattern, the better your brain and body gets at doing that movement.

Trans-tibial amputation: If you have had an amputation below the knee, all the movement sensors in your knee still exist and so it is easier to learn to run.

Trans-femoral amputation: If you have had an amputation above the knee it is harder to control where the foot is in space because you can’t always tell if your knee is straight when your foot hits the ground. The settings of your knee might slow the rate of swing through of your prosthetic knee down and so the foot won’t be there for you when you need it. We recommend that you talk to your prosthetist about running so your knee settings are right and that you enlist the help of your physio to learn a running technique (or attend a running master class).

To help you with your chances of running, work on other non-running exercises that improve your fitness, your core muscle strength and your balance.

Our running information is being updated after our running master Class on 20 March 2011. In the meantime, some useful information is available in the information booklets produced for the SPEEAD project (see our PROJECTS webpage)