[Fwd: [OANDP-L] Cramping in Trans Tibial Client res. limb]

[Fwd: [OANDP-L] Cramping in Trans Tibial Client res. limb]

Award Prosthetics

6/7/2006

First let me thank all of you, who took the time to send me your
thoughts. While reading your replies, I realized that there were a
couple of details I should have added to the synopsis, which I will now
put down and see if you have any other thoughts.

When this gentleman came to us he was using a prosthesis made by his
previous prosthetist about 4 or 5 years ago. Part of the reason he came
to us for a new limb was that he had started to experience the
cramping. He had started swimming about 3 months prior to coming to us
and we felt that there had been some hypertrophy that changed the socket
fit and resulted in the cramping. One point to note is that there is no
history of cramping prior to this with this client and it is only
occuring in the residual limb and not the sound limb. So we recast him
and he continued to have the same problems with cramping whenever he
walked any distance. We re-cast him and increased the socket by 5ply to
give him fluctuation room when he was exercising in order to reduce the
cramping. This did help to reduce it but not remove it.

We did try the Seal-In liner with this client and he felt that he much
preferred the pin suspension system that he had used successfully for
many years without cramping.

As for the foot having a relation to the cramping - hard to say, but not
likely as the cramping occurs regardless of the foot he is using. He is
currently using the Freedom Innovations Renegade which he prefers to his
original Mod III.

I have another client(staff member) who has had the same problem but
for her it was due to large weight gain and to resolve the cramping we
recast her and when she still had the cramping we increased that socket
by stretching it over her cast with a 3ply sock and that seems to have
resolved it for the most part. The only time she has had the cramping
since then is when her residual limb has edema and the socket feel a bit
snugger.

I hope this helps to shed a bit more light on the situation and I would
greatly appreciate any other input you may have. I am working on
compiling the responses received thus far and hope to have them posted
within the next couple days.

Thanks again for sharing your experiences with me.

Tony van der Waarde, CP(c)
Certified Prosthetist



-------- Original Message --------
Subject: [OANDP-L] Cramping in Trans Tibial Client res. limb
Date: Tue, 30 May 2006 17:01:37 -0700
From: Award Prosthetics < <Email Address Redacted> >
Reply-To: <Email Address Redacted>
Organization: Award Prosthetics
To: <Email Address Redacted>



I have a male trans tibial client, age 35, weight 220lbs, med-high
activity level with a muscular residual limb - he underwent a traumatic
amputation in 1991. Recently he has been having problems with cramping
in the entire calf ares, mainly gastrocnemius muscle. He swims 3-4
times weekly and wants to start running. He also does limited biking,
hiking, golfing and other outdoor activities (lawn mowing, etc).

He is currently on a TSB socket design with OSSUR Original pin locking
liner and Modular III flex foot - which he has worn for the past 5
years. We have refit him with a TSB Stabilo pin locking liner &
Renegade foot. I have tried 3 different types of sockets; including
vacuum casting with lowering and raising the popliteal shelf and
proximal AP dimensions.
Would a 'Framed' socket with flexible insert and obturators in the
distal-mid posterior area work? Added obturators for the pre-tibial
area are also being considered.........

The cramping can come on anytime, even after moderate activities.
Medical testing to determine the cause have been non-conclusive. Any
help would be appreciated.

If you require any further information in order to provide any solutions
or suggestions please feel free to contact me or my assistant (Tracy).

Kind regards,

Tony van der Waarde, CP(c)
Certified Prosthetist

<Email Address Redacted>
www.awardprosthetics.com

P: 604-298-0236
F: 604-298-0254

solutions or suggestions please feel free to contact me or my assistant
(Tracy).<br>
<br>
Kind regards,<br>
<br>
Tony van der Waarde, CP(c)<br>
Certified Prosthetist<br>
<br>
<Email Address Redacted> <br>
www.awardprosthetics.com<br>
<br>
P: 604-298-0236<br>
F: 604-298-0254<br>
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