With the ever increasing awareness of disabled sport, and the high media profiles of amputee athletes such as Oscar Pistorius, prosthetists and prosthetic component manufacturers have never been under more pressure to ‘’produce the goods.’’
Some sports that amputees participate in do not require prosthesis, for example, swimming. But, these amputees will still benefit from prosthesis for daily activities and training in the gym, should they progress to that level.
Previous articles in this magazine have covered socket interface systems (liners) and the importance of a good fit. All that is left for me is to emphasize the importance of a comfortable socket.
As with any piece of sports equipment, such as a tennis racket, golf club or a canoe, there are types for all levels of competency from beginner to expert/professional. The same can be said for prosthetic components. Knees, feet and suspension systems all come with various features at various prices.
Besides the usual brand names in prosthetics, prosthetists are often called upon to make a unique prosthesis or adaptation for a specific sport need.
Requests that come to mind are rowing adaptations for arm amputees, leg prostheses with adaptations for scuba diving and underwater hockey, as well as some for micro light and aeroplane flying.
For many amputee sportsmen and women, their prosthesis is a vital piece of equipment which enables them to participate. The challenge to prosthetists, amputees and their funders is to find the balance between over-prescribing, and ending up in a situation which would equate to a prosthesis only being used to a fraction of its potential.
Alternatively, under-prescribing could result in a prosthesis that is of no help to the user, and besides the lower cost, is a waste of money. This may cause users to lose faith in their own ability and their ‘equipment’, to the point of not participating in any sport at all. In some cases, a compromise may call for a prosthesis that has a dual purpose. That is, it will be functional for every day use as well as some sporting activity.
We have all heard someone say “If only I had X, I could also be like so and so”. The fact is, even the most expensive running shoes will not make you run like Bruce Fordyce. But a good entry-level pair will at least give me the opportunity to start jogging, and this I believe, is the most important factor.
Everyone, at least, deserves the opportunity to start some type of sport or recreational activity. Who knows how many potential elite athletes are out there just waiting for the opportunity to start?
The best prosthetic components are not always the most expensive. The prosthetist should consult with the patient about what is required during that particular sport or activity. Some of the more common competitive sports that amputees participate in are athletics (both track and field), golf, bowls, cycling and all court related sports.
Each of these sports demands its own unique requirement from the prosthesis. For example, an above-knee amputee that cycles long distances would require a prosthesis that allows a great range of movement - a knee joint that is free moving and does not create any resistance. And a foot that is very stiff to transfer force directly to the pedals.
In a sport such as golf, stability during the swing is of great benefit, and if coupled with some rotation ability, all the better. A sprinter’s priority would be forward propulsion with an explosive energy release, as found in the carbon fibre sprinting feet.
In 2006, a bilateral (both legs) above knee amputee Richard Whitehead from the UK ran the Two Oceans Ultra Marathon in 6H13. This would not have been possible had it not been for the type of running feet that were available to him. He will be back in South Africa this year to run the Comrades Marathon, so look out for this amazing athlete and give him your support along the route.
The biggest factor of whether amputees participate in sport or not is an individual’s desire to do so. The available equipment will help them progress to a higher level and achieve greater goals, but first must come the desire and commitment. That, along with a comfortable socket, is the first step to participation in sport with prostheses.