Proper Posture

Alignment is essential to efficient prosthetic gait. This is true of the TKA line with prosthetic alignment as it is of our own bodies in relation to the ground. In order for our muscles to work effectively, they must be advantageously positioned to work at their full potential. Tight, short muscles do not have effective pull when contracting. While a Prosthetist can alter prosthetic alignment to adjust for an individual’s loss of range of motion, the prosthetic user cannot fully recruit muscles that are at a biomechanical disadvantage. Maintaining sufficient flexibility of the core and lower extremities are imperative for optimally working muscles, injury prevention and energy efficient prosthetic gait.¹

As mentioned in the last post, unilateral prosthetic users often stand with their unaffected leg positioned under their body close to midline. This provides an increased sense of stability in standing. Over time the improper use of pelvic muscles leads to instability of the pelvis and hip girdle, shortened muscles tendons and an anterior tilt of the pelvis.^1,2. This forward pelvic tilting leads to lumbar lordosis, an accentuated curve of the low back, and decreased use of the abdominal muscles. Many will experience acute straining of weakened muscles when performing lifting or potentially endure chronic low back pain from everyday tasks. Thankfully, there are ways to combat this and one is as simple as laying down every day!

Prone-Lying

Prone-lying Exercise is vital to stretching the hip flexor muscles that run along the front of the pelvis, hip and thigh.³ These often get tight from prolonged sitting and poor posture. Lay on your stomach for 20 minutes each day to loosen these structures (Sound familiar? I bet your inpatient PT taught you this one!).

If you find it is difficult at first from tension in your low back or a pull across the front of your thigh(s), try placing a pillow under your hips before laying prone. As the muscles start to relax and the stretch becomes tolerable, eliminate the pillow. This may take more than one session. As you gain flexibility, think about your posture in standing. Be proud, stand tall and remember to tuck your hips underneath you as you walk.

Upward Facing Dog

Wish to deepen your stretch? Try yoga pose Upward Facing Dog.⁴ This will provide a prolonged stretch of your hip flexor muscles and relieve tension in your back extensors. Start on your stomach with your legs apart in line with your hips and your hands placed beside your lower ribcage. Slowly inhale, extend your legs, and push through your hands and distal lower extremities/prosthetic foot.  Straighten your arms, and draw your chest forward & upwards and your shoulder blades together & downwards. Hold for count of 5 and exhale. Bend elbows, slowly release and rest. Repeat 5-10 times as able. Build up to 30 seconds hold as tolerated breathing slowly throughout the stretch.

Please return for the final installment of this series promoting energy efficient prosthetic gait.