Sports and Recreation for Those with Lower Limb Amputation or ...
Sports and Recreation for Those with Lower Limb Amputation or ...
Sports and Recreation for Those with Lower Limb Amputation or ...
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Snovvrnobi!ing is an activity in<br />
which most individuals <strong>with</strong> amputation<br />
can participate . The sp<strong>or</strong>t<br />
is especially appealing since it offers<br />
access to remote areas that<br />
may not be otherwise accessible.<br />
While few modifications are<br />
generally necessary <strong>f<strong>or</strong></strong> the person<br />
<strong>with</strong> amputation toadapt toanow`<br />
nnobiUng,a buddy system is recommended.<br />
Also, most individuals<br />
<strong>with</strong> below-knee amputation<br />
prefer a snowmobile <strong>with</strong> a relatively<br />
elevated seat. If the seat is<br />
too low, the knees have to be bent<br />
m<strong>or</strong>e than 90 degrees, which can<br />
cause discom<strong>f<strong>or</strong></strong>t in the popliteal<br />
area (Fig. 45).<br />
The task of keeping one's prosthetic<br />
foot on the footrest can be<br />
difficult. (The ideal ,footrest provides<br />
good supp<strong>or</strong>t, but does not<br />
limit leg movement.) Many people<br />
<strong>with</strong> amputation choose to custom<br />
make their own footrest<br />
against which they brace their<br />
prosthesis.<br />
Many individuals <strong>with</strong> amputation<br />
have achieved notable success<br />
in snowmobiling . One such<br />
example is Bill Jirkoiwic of Neenah,<br />
Wisconsin . Against all odds,<br />
including severe paralysis, harsh<br />
Fig . 45 . The snowmobiler <strong>with</strong> amputation<br />
needs to find a snowmobile <strong>with</strong> the c<strong>or</strong>rect<br />
seat height to allow <strong>f<strong>or</strong></strong> a com<strong>f<strong>or</strong></strong>table<br />
angle of knee flexion, especially <strong>f<strong>or</strong></strong> long<br />
trips .<br />
weather conditions of 20 below<br />
zero, <strong>and</strong> an 11-year old snowmobile<br />
indisropair, Jirkoivviuoonnp!e1-<br />
od a 428-mile journey from Neenah<br />
to Eagle River, Wisconsin in<br />
time to catch part of the January<br />
1984 W<strong>or</strong>ld Championship Snowmobile<br />
Racing Derby. Although<br />
this unusual individual made the<br />
trip solo, the imp<strong>or</strong>tance ofunovvrnnb)!ing<br />
<strong>with</strong> anonnpanion need<br />
not be detailed.<br />
F<strong>or</strong> additional in<strong>f<strong>or</strong></strong>mation on<br />
anovvnnmbi!ing,nontant:<br />
New Englan'd H<strong>and</strong>icapped<br />
<strong>Sp<strong>or</strong>ts</strong>men's Association<br />
c/o Earl Plummer, Pres.<br />
26 McFarlin Road<br />
Clems<strong>f<strong>or</strong></strong>d, MA 01824<br />
(S17)35G-3240<br />
• Seattle H<strong>and</strong>icapped <strong>Sp<strong>or</strong>ts</strong><br />
<strong>and</strong> <strong>Recreation</strong> Association<br />
(NHSRAChapte/)<br />
c/o Del Melchow<br />
17017 Tenth Avenue, N .E.<br />
Seattle, WA 98155<br />
(2U8)382-2449<br />
Veterans Administration<br />
Medical Center<br />
Prosthetic Treatment Center<br />
c/o Ellis Hensley<br />
1660 South Columbian Way<br />
Seattle, WA 98108<br />
(206) 262-1010<br />
Extension 435<br />
Vinl<strong>and</strong> National Center<br />
c/o Joan Saari<br />
3675 lhduhapi Road<br />
L<strong>or</strong>etto, MN 55357<br />
(612) 479-3555<br />
^Winter Park <strong>Sp<strong>or</strong>ts</strong> <strong>and</strong><br />
Learning Center<br />
c/o Hal (]'Leary<br />
9O. Box 36<br />
Winter Park, CO 80482<br />
(303) 726-5514, Extension 179<br />
(See also the <strong>Sp<strong>or</strong>ts</strong> Organizations<br />
42<br />
Snow skiing <strong>f<strong>or</strong></strong> those <strong>with</strong> amputation<br />
made inroads in Austria<br />
<strong>and</strong> Germany in the late 1940a.<br />
Subsequently, the Swiss introduced<br />
crutch skiing . It was not<br />
until the 1960s, however, that avid<br />
interest was seen in the United<br />
States . By 13G7 ' thoNational <strong>Amputation</strong><br />
Ski Association was<br />
<strong>f<strong>or</strong></strong>med, <strong>and</strong> today skiing is taught<br />
to those <strong>with</strong> amputation in <strong>or</strong>ganized<br />
classes throughout the United<br />
States. In fact, the ski enthusiast<br />
<strong>with</strong> amputation can sometimes<br />
learn to ski intermediate <strong>and</strong> expert<br />
slopes in less time than his <strong>or</strong><br />
her able-bodied friends.<br />
While the individual <strong>with</strong> unilateral<br />
below-knee amputation can<br />
ski <strong>with</strong> <strong>or</strong> <strong>with</strong>out a prosthesis,<br />
the person <strong>with</strong> bi!at*nal belowknee<br />
amputation usually skis four<br />
track, using two prostheses, two<br />
skis, <strong>and</strong> outriggers . <strong>Those</strong> <strong>with</strong><br />
above-knee amputation generally<br />
ski three-track (Figs . 46a <strong>and</strong> 46b).<br />
Below-Knee Skiing<br />
Prosthesis<br />
To achieve skiing proficiency, it<br />
is imp<strong>or</strong>tant that the skier's center<br />
of gravity be located ahead of the<br />
bn!l of the foot <strong>f<strong>or</strong></strong> proper balance,<br />
ease in turning, <strong>and</strong> adjustment of<br />
speed . While individuals <strong>with</strong> two<br />
sound legs maintain balance by<br />
increased ankle d<strong>or</strong>siflexion <strong>and</strong><br />
a <strong>f<strong>or</strong></strong>ward lean, which most ski<br />
boots are designed to encourage,<br />
the skier <strong>with</strong> amputation may require<br />
certain adaptation.<br />
A conventional prosthesis can<br />
be adapted by placing a 2 .54 centimeter<br />
(one inch) wedge under the<br />
heel of the ski boot to achieve the<br />
desired <strong>f<strong>or</strong></strong>ward cant. The resultant<br />
increase in socket flexion,<br />
however, may raise the socket's<br />
posteri<strong>or</strong> brim in relation to the<br />
patellar tendon bar, thus causing<br />
excessive <strong>and</strong> painful pressure on<br />
the hamstring tendons.<br />
One way to relieve excess pressure<br />
on the hamstring tendons is
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