Responses to Query about Transtibial Amputee and Return to Ice Skating

Responses to Query about Transtibial Amputee and Return to Ice Skating

9/22/2003

To the list,
    Thanks for the response on my query regarding a return to skating for a TT amputee. I have listed the query as well as the responses below. Coincidentally, almost immediately after sending my query, I opened the O&P almanac to the article about the Amputee Hockey Team. I immediately sent the url of the team's website to my patient.

Original Query:
> I have a recent unilateral TT amputee has returned to normal, unassisted ambulation as rapidly as any individual I have ever worked with. He is a very active 60-year-old gentleman who was a collegiate hockey player and would like to return to ice skating (although probably not to hockey as he believes his wife's reaction to that might be fatal). I would be interested in any input from members of the list who have worked with clients who skate or who are amputee skaters themselves. If there are any tips or tricks that might make his return to skating easier, please pass them a long. My client has no other medical complications and is in excellent physical condition.

Responses

Harry, here in Minnesota many amputees skate using one of the articulated foot/ankle combinations. College Park or one of the others similar to it works without changing alignment. This also works for roller blades and roller skates as well. Good luck.


I work with two individuals who are on the US amputee hockey team. One is
captain of his College Hockey team ( Don't tell your patient's wife if you
don't want). The other is a bilateral BK, who plays goalie. I will see if
I can get their email addresses for you. As stiff a foot as possible in
coronal plane seems to work well.


I'm a physiotherapist who has worked with several people with
transtibial amputations return to skating, both figure skating and
hockey. Here's my method in re-introducing this leisure activity
1. working on single limb balance long before they ever put their
skates back on, particularly balancing on increasingly narrow edges to
simulate the edge of a skate blade. Someone with good balance on the
amputated side can balance with a level pelvis and minimal arm work for
greater than 1 minute.
2. The first time at the rink was a useful communication time for both
the physio and prosthetist, since the heel to toe support required
adjustments at the ankle or a change of foot. None of my patients
needed a special foot for skating.
3. Most of my patients leave their prosthesis in the skate - its a
bitch taking it in and out, so a second backup leg comes in handy to
double as the skate leg. The hockey player used an off the shelf knee
brace for further medial lateral knee support and suspension.
3. Once out on the ice, my clients started with gliding exercises
around the boards, holding onto the boards, working on the
gliding(stance phase) and the pushing on the amputated side.
4. Any part of skating that requires an outside edge on the amputated
side (particularly turns) is a challenge for balance. So work on turns
towards the sound limb side first.
5. Add in backwards skating
6. Figure out whether stopping is a problem - snow plowing is not
possible.
7. Anterior distal tibial pain is a likely symptom
Hope that helps


I have a 48 year old TT amputee client who has returned to playing
competitive hockey, speedskating and inline skating. He just inline skated
a marathon this weekend, finishing the 26.2 miles in 2 hours 7 minutes! He
is a member of the American Amputee Hockey association. He wears a TEC VASS
suction socket with gel cushion insert and Flex Foot Vari Flex foot. He has
an CTI Edge knee orthosis that he uses during skating to help stabilize. I
custom made an ankle for the inline skate. He wears a regular hockey skate
boot over his Variflex.
I can get you more information if you need.