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Title: Cycling/Disabled - Tips on bycycle riding for lower limb amputees Specialized section of Amputee Web Site. Provides invaluable tips for the lower limb amputee considering the use of a bicycle for any reason.
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On Yer Bike  Amputee WEB Site Welcome Amputee Forum What Amputee's Say About this Site General Information Prosthetic Components Phantom Sensation and Pain Amps on the Web Sport and Recreation World Issues [updated] Special Events Videos Books and Magazines Credits and Awards Updates Advertising Rates Amputee Related Sites Amputee WEB Site Amputee Newswire Amputee Mailing List Hosted WEB Pages Site Map Personal Pages  Return to Amputee- Online.com © 1995-2003 GB Communications On Yer Bike Tips on Cycling for lower limb amputees  Wayne Epp - Calgary, Alberta  Commuting by bike is not out of the question for amputees See Ian's Autofree Blog  Average clearance for Mountain bikes  Average clearance for Road bike  Ian Gregson ready to roll See Ian's Autofree Blog    Photo by Norm Lourenco  Cycling is well regarded as an alternative form of excercise for lower limb amputees due to its ability to utilise all lower limbs regardless of residual limb length. Whether you are on a mountain bike on a lightweight road bike there are a few considerations to be contemplated before riding a bike. If you have riden prior to your amputation you already have the motor skills needed to ride post amputation, all you have to do is gain the confidence and possibly adapt the bike in minor ways to your prosthesis or lack of prosthesis for higher levels of amputation. If you have never riden before welcome to the world of bike riding, hope the following helps you on your way. To use a prosthesis or not: Actually the use of a prosthesis for bike riding really depends on your level of amputation. I recomend that all lower limb amps except for exceptional short AK's and hemi's DO use a prosthesis. Although it maybe difficult and your sound side does all the work, in fact excercising the prosthetic side in beneficial to the development of muscle in the residual limb. The only lower limb amputees that would not benefit from using a prosthetic limb are those who do not have enough physical strength in their residual limb to physically push the pedal. However, this is not to say mid-thigh AK's should not contemplate riding without a prosthesis, but it should an alternative after all else fails with using a prosthesis. Of course those AK's who do not use a prosthesis for daily activity will no doubt prefer to ride without a prosthesis. Balance: & Confidence As you have now discovered as a new or recent amputee many of your former motor skills need a little revision, such a re-establishing your balance for swimming and other physical actiivities. Cycling is no different, your balance on the bike will be different than when you had two full limbs and the higher the level of amputation the more difference you will find. Essentially, setting yourself up on your bike is the same as when you set up the bike prior to limb loss. a. Frame Size: Make sure the frame size is correct for your height. You may feel a little more comfortable on a frame slightly smaller than what is recomended for your height, that is OK. Frame size is measured from the centre of the bottom bracket (the nut that holds on the pedal) to the top of the seat tube(where the frame ends and the seat begins). The best way to find the right height is to stand flat footed over the frame. The clearance from the crotch to the frame should be about 2cm- 4cm or .5 to 1inch for a road bike and 6-10cm for moutain bikes. Keep in mind that peoples proportions are different as are bike frames, the distance from the seat to the handlebars is also a consideration. Typically a six foot man should fit well onto a 24-25 inch frame. Since womens proportions are somehwhat different, experimentation with frame sizes should be a consideration. Most experts recomend that women do not use an "open" style frame and do consider purchasing seats/saddles specifically designed for women. b. Seat height: This varies on your height, the level of amputation and the type of shoes you wear! As a general rule BK amps that have good strength in the residual limb should adjust seat height so that you can reach the ground with the toes of your good foot. If you do use your prosthetic side for stationary balance you need to adjust the height of the seat so that the majority of the foot is on the ground when sitting on the seat; this also applies to double bk's and symes. Since there is no flexion or dorsi flexion in your ankle(s) and a lampost or stop sign is not always convenient, you will need your seat slighty lower than if you used your non-prosthetic side for stationary balance. Everyone must consider seat height as a major effect on your ability to ride and ride well. You should have 5-8 degrees of flexion in either limb at full extension. This can pose a problem for some AK prostheses. Some knee units that use a "dampening" effect to stop "clunking" at full extension whilst walking may cause the prosthetic limb to rise of the pedal as the limb approaches maximum extension whilst seated. Knee units such as CaTech and Mauch can be adjusted to give more of a free swing, generally the less resistancethe better when bike riding. If the seat is too high either limb will feel like it being pulled down onto the pedal as full extension is reached. If the seat is too low both limbs will feel like they are not extending enough and may even hit you in the chest as you reach full extension. Some bk and ak prosthetic limb designs involve various degrees of motion especially at full flexion. Knee units such as Mauch and CaTech do have a limited range and can actually can cause considerable damage to the knee unit if this range is surpassed. If you have what feels like the right seat height and your prosthesis does not seem to go through the full range of motion, it is time for a decison. Will a prosthetic adjustment for cycling detract from your walking? If cycling is your preferred method of transportation than it will be worth it. Get your prosthetist to make some minor adjustments, if you can take the bike with you and have your prosthetist look at the problem directly. c. How to keep prosthetic limbs from falling off the pedals: Probably the most difficult aspect of riding with a prosthesis especially for AK's. There are several methods of overcoming this problem. i. Use of conventional methods: regular toe clips, straps or riding shoes are all possibilities for more serious riders. However before such devices are used several prosthetic issues have to be considered. Foot Aligment toe in-toe out: Most prosthetic feet are set for walking, most are set slightly toe-out. However, this often proves detrimental for the amputee bike rider and bike pedals prefer feet to be set straight ahead with toes on the pedal. Toe clips and riding shoes will only allow the foot to attach to the pedal at the ball of the foot, this is not always conveneint, especially for short street riding. ii. The use of a serrated metal pedal together with the serrated sole of a decent running shoe will give considerable traction for a prosthetic foot with limitations. Bumps and potholes will still cause the prosthetic foot to fall off the pedal, be forever vidulent in looking at the foot making sure it does not fall off the pedal. However, if you ever fall to your prosthetic side you have more of a chance of getting the prosthetic limb out and locked if an ak to stop you from a potentially nasty fall. Toe in and out is less of consideration using this method as you can place the foot at any point along the pedal.  Safety: Is always a factor in any level of bike riding. A helmet(lid) is rapidly become law in many states and provinces in North America. A good pair of fingerless gloves with some heavy duty padding on the heel of the hand is your second most important safety device, especially when heavy duty moutain riding. Sunglasses are also an issue even if it isn't sunny. Sunglasses keep the rain, wind and the bugs out of your eyes, there's nothing worse than getting a wasp in your eye at 40 mph! I've even had rocks bounce off my sunglasses! Even a pair under $10 will do the job, the bigger style the better coverage of your eyes. Safety is especially a factor when re-learning how to ride. Don't let your confidence hinge on a few mishaps at the beginning. The best surface to learn to ride of is short grass, preferably with a sligh decline slope. Check out you route beforehand, look for objects that are hidden and could cause you to either oversteer or lose you balance. Local parks with well cut grass are perfect for learning to ride. Of course once you learn to ride, the next lesson is how to stop. Make sure you know the back brake from the font. Front breaks are far more effctive at stopping you and your bike than the back brakes. However, front breaks can often lead to your bike stopping with you continuing over the handlebars. Practce using the brakes in a stationary position, apply pressure to the back break first and then the front. Too much pressure will lock your wheels (especially on dirt) and they have not devised an anti-locking brake system for bikes yet. For further reading on amputee bike riding from the prosthetists point of view check out the following article by Brian Mackie. Book Recomendations: The Bike Book by Haynes: Whilst Haynes have been producing top quality books for cars, their bike book is an excellent guide to the modern bicycle. Ranges from saftey, buying a new or used bike, setting them up and re-building all parts. The books page layout is excellent, lots of accurate photos (rather than handrawn sketches) and easy to follow, unpretencious instructions. The Haynes Bike Book should be available at your local library or from any decent bike shop that sells books. Also check out the following pages for amputee bike tips and safety: Amputee Cycling Association MTB Amputee The following is taken from the St Johns Amputee Listserv and answers some commonly asked questions about bike riding for lower limb amps Hello amp-friends: Do any leg amputees out there go cycling? I recently acquired an exercise bike (all part of my new years resolution to get fit, giving up smoking etc. My, my, aren't I squeaky clean.....). I use it just with my one leg at the moment, with a toe strap so I pull up as well as push down, I haven't tried it with a prosthesis because I can't wear one at the moment. I remember seeing a film clip a while ago about a really good woman amp cyclist, who just used her one leg also. She went up and down mountains and all sorts. I would like to be able to cycle to the shops, to visit friends etc instead of having to get the car out every time, but what do you do when you stop? Strap crutches on the bike? Has anyone ridden with their prosthesis? (I am AK). How much of a problem is balance? GENERAL Jackie and any other potential cyclists: Cycling is a great recreational activity that is far less stressful than running and it gets you there faster. The amputee cyclists that I have met are in two camps. One being high AK's tend to go for no prosthesis, a good toe clip/strap on the good side and away they go. Keeping in mind it takes practice to get the good foot in and out of the toe clip quick enough so you don't end on the deck. Balance wise you will always be prone to tipping on your good leg side. Its a lot of work at first but it becomes easier very quickly. I would recomend some padding on the stump side just in case of a tip over to that side. The other lower AK's and BK's use their prosthesis for bike riding. Main problem keeping the prostheic foot on the pedal. This can be accomplished in several ways depending on the type of bike and the type of terrain you are on. Using a toe clip on the prosthetic side can be a little dangerous as you tend to tip over to the prosthetic side more than if you used no prosthesis at all. I use a toe clip on my good side, but leave the prosthetic side free. This is ok on smooth roads and trails but not very good for rough terrain. For rough terrain a more stable anchor is needed as the prosthetic foot tends to bounce off too much. I use moutain bike pedals, these are pedals with serrated edges, these seem to grim the sole of the shoe on the prosthetic side more effectively. In combination with a running shoe with a serrated sole the prosthetic foot stays on 90 per cent of the time on the road. I rode a moutain bike for a few days in Sept 94 in the St. Helens area NW England and in Uppsala Sweden. Everyone looked at me as if I was crazy for wearing a bycling helmet. I cannot ride without one these days, much like a seat belt in a car. Here in Canada it is now law to wear a bike helmet (well maybe just in BC). Always worth while getting a bike helmet too. Lots of bright clothes and reflective surfaces also help to get you seen. You may look like an idiot but at least nonchalant drivers can see you and I'd rather look like an idiot than a dead cool dude. KIDS My bilateral BK son can ride his bike with prostheses and no modifications for his legs or feet. It took a while for him to learn to start and stop without falling, especially hard when you cannot feel the pedals, but he did it. Now he can ride anywhere. His biggest problem with a bike is his right hand with only two digits that do not bend. The bike needs to have one-handed brake controls! TANDEMS There's a third camp - tandems. Shortly after Janet (who, you'll recall, is an HD) and I met, she borrowed her boss's lightweight 10-speed tandem. We likedit so much (having taken it, among other places, to Aspen) that she bought herself one. This was the best way we found for really covering ground; the fact that she only has one lung (nasty stuff, that metastatic sarcoma) makes it difficult for her to maintain steady aerobic exercise. Later, she did buy a single bike, which she rides with no prosthesis (as is the case with the tandem) and a toe clip. If anyone would like to find out more, email me (wdorsey@science.gmu.edu) or Janet (Janet_Dorsey@postoff.senate.gov). Return to Sport Rec Page  this page was last updated3/3/07  |
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Specialized | section | of | Amputee | Web | Site. | Provides | invaluable | tips | for | the | lower | limb | amputee | considering | the | use | of | a | bicycle | for | any | reason. |
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http://amputee-online.com/amputee/onyerbike.html
Tips on bycycle riding for lower limb amputees 2008 November
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Specialized section of Amputee Web Site. Provides invaluable tips for the lower limb amputee considering the use of a bicycle for any reason.
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