Cycling with a Leg Prosthesis

(Authored article by Dr. Ravi Chandra Kelkar, Consultant- Orthopaedics, Columbia Asia Hospital, Hebbal)

 

Famous para Olympian Aditya Mehta, today is an inspiration to many. After losing one leg in a road accident, Aditya never lost hope. Today, the renowned cyclist has won many medals internationally and has even attempted mountain biking to motivate similarly abled people like him

 

Cycling is considered as one of the best physical activity for the differently abled and offers good cardiovascular workout while placing minimal stress on the residual limbs. There are special adaptations available to make cycling a safe and pleasurable experience for leg amputees

 

Varun (name changed) used to love cycling and used it as his workout every morning. However, when he met with a bike accident 2 months, back, he had lost all hope of continuing his cycling. His bones were fractured and crushed when he came to the hospital and were beyond salvage. The first step that is normally taken in cases like this is to salvage the vascularity, reattach the blood vessels, ligaments and bones. But since Varun’s condition was pretty serious we had to unfortunately amputate the leg. As a part of the post operative counseling we advised Varun to get back on the saddle with the help of a prosthetic

 

For any person who has gone through amputation, it is important to let the legs heal for at least 2-3 weeks. They are then put on trial prosthesis on the limb with supports. This helps the patient get used to the prosthesis. After the patient feels more comfortable, the final prosthesis is fixed. There are different attachments available for people who like to cycle and get the prosthesis customized according to their needs

 

Getting used to the prosthesis

It is important that you get used to prosthesis. After you are comfortable with the temporary prosthesis, the main prosthesis is set up. Talk to your prosthetist for any customization that you would require. In the beginning, it is important to take it slow. Cycle for short distances for 5 minutes for a few days. Once you start getting used to it, you can gradually increase. For people who are into competitive cycling, it is important to take this as any other competitive sport, it is important to properly train yourselves before going for a cyclothon, or long rides. Also, always carry a spare prosthesis on the long ride.

 

Setting up your bike

The most common problem that cyclists face is the prosthetic foot slipping off of the pedal.  Clip-on or cage type pedals can be a good solution in these cases. For safety, when starting out, it’s best to use a flat pedal without clip-ons on the sound side for single leg amputees as you adjust to clipping in with your prosthesis. Make sure that you adjust the setting to the easiest position, where it gives the least amount of strain to your legs.

 

 

 

Setting up your prosthesis

Start with setting up your prosthesis on a stationery bike or a trainer to make sure you get used to the process. One of the most common problems cyclists face, is that the heel of the prosthetic foot hits on the crank arm. In this case, consult you prosthetist to help you with adjustments or any customization required. For above the knee sockets, it sometimes works to have your prosthetist cut down the height of an older socket to improve comfort on the seat. Certain prosthetic knees allow a free-swing setting which makes pedaling more efficient.  It’s important to know how to change this setting when getting on and off of the bike.

 

First ride

After you’ve set up your bike and prosthesis, you need to learn how to get on and get off the bike. Having someone around you for the first time is a good idea. That person can also help get the prosthetic foot secured to the pedal if you’re having any difficulty. Getting off requires setting your sound side (or stronger side for bilateral’s) down first.  Unclipping the foot requires a twisting motion for clip-on pedals.  It is sometimes easier to unclip your prosthesis if you lean your bike over a bit after putting your sound side foot on the ground.

 

Riding a bike with or without prosthesis may take some work up front to get everything work properly.  Once set up properly, it can lead to miles and miles of fun.  However it is extremely important to understand the whole process and get used to the prosthesis before taking up any activity.

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