Amputee Bicycling: Great for Body and Mind

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By Bruce Hibbett

Many new amputees are under the mistaken impression that the loss of their limb means the loss of mobility and a sedentary lifestyle. However, statistics show that most amputees are able to return to a level of activity they had before the amputation surgery. Many walk, hike, bowl, golf - and some even run or jog. Being active is good for the body and mind and helps develop and maintain the muscles of the residual limb so the socket fits more securely.

One of the more popular forms of exercise for amputees is bicycling. Riding a bike is easy on the ankle and knee joints, increases muscle strength, and the aerobic aspect of bicycling is good for the heart. Bicycling provides a way for amputees to develop balance and coordination and is an excellent way to increase range of motion in the hips and knees. And hey, its fun to feel the wind in your face as you race down the road just like when you were a kid.

Okay, so you think bicycling is something you want to try, but youre not sure how to get started. First, check with your doctor. As we age, it is more and more important to get those dreaded but necessary checkups to make sure there are no medical problems, especially with the heart, joints, and circulatory system. Next, check with your prosthetist and make sure your prosthesis is designed for the repetitive pedaling motions. Most prostheses today are made of high-tech metals and are built to take all kinds of punishment, but its best to know if any adjustments are necessary to the foot for bicycling.

So, everything checks out health-wise, and you're confident in your prosthesis, but you're still not sure if bicycling is for you? One easy way to start is to try out a stationary bike and see how it feels. Stationary bikes are plentiful at any health club, and I have even seen some in prosthetic shops. Get on the bike, ride at a moderate pace for five minutes, and see how it feels.

Tips for Safety, Success

Once you feel comfortable on a stationary bike, you are ready for the real thing. Here are some tips based on my experiences as an amputee bicyclist:

Bicycles - Sports equipment can be costly, and bicycling is no exception. However, many low-cost bikes are on the market (I have a friend who rode her bike, purchased from a discount store, across the country with no major breakdowns). These bikes may not have all the bells and whistles, but they are very functional and will provide the amputee with years of good riding.

Bicycle Seats - There are many bike seats on the market, and, unless you are a hardcore rider, the seat that comes with the bike will probably do nicely. As for seat height, the seat should be adjusted so that your feet feel comfortable on the pedals and your knees do not hyperextend as you ride. Leaving a bit of flexion in the knees will help reduce strain and allow you more power on the upstroke.

Clothing - There is a lot of flashy bike clothing available, but to start I would recommend comfortable shorts and shirt. If you ride in long pants, make sure to secure the pant leg near the ankle with a rubber band so the loose pant fabric wont become caught in the chain. And of course, dont forget the all-important bike helmet, which can be purchased at most discount stores or bike shops.

Pedals - One problem most amputees encounter is the placement of the prosthetic foot on the pedals. When I first started riding after my amputation, my prosthetic foot tended to slip off the pedal, making riding very frustrating. One option is to secure the prosthetic foot to the pedal. A low-cost method is the toe clip, which consists of a cage that partially surrounds the top of the pedal, securing the foot. As you ride, you simply slip the front part of the shoe into the clip, and the foot is secured to the pedal.

A do-it-yourself method is the use of Velcro® (its good for just about everything). In this method, a strip of Velcro is secured to the pedal, and the bicyclist wraps another strip around his foot. When the foot makes contact with the pedal, the Velcro strips adhere to one another.

A more expensive method is to purchase special pedals with matching biking shoes that actually clip into the pedal.

One word of caution when using clips: it takes some time to get used to clipping in (and more importantly, clipping out when stopping), so practice in a safe area until you get the hang of it.

You may also check with your prosthetist to see if your foot can be adjusted. Most feet are aligned so that the foot is slightly toed out, which is the proper alignment for walking. If you feel brave and your prosthetist recommends it, you can get your own Allen wrenches and adjust the foot to "toe in" so the foot moves more efficiently while pedaling. Just make sure to mark the position of your foot prior to the adjustment so you can make readjustments after you ride.

Bike trails - Regarding places to ride, some states have bicycling paths marked on state highways. And most parks have bicycling trails designed for all levels of biking. In addition, many states are converting old railroad lines to bike trails ("rails to trails"). The advantages here include gentle grades, and the trails are restricted to walkers and bicyclists. My home state of Missouri has an excellent rails-to-trails system called the Katy Trail that extends across most of the state. I have been on the Katy Trail many times, and it is a great way to enjoy a leisure ride and see lots of varied scenery.

Becoming an amputee does not mean the loss of an active lifestyle. You can return to the activities you enjoyed prior to your limb loss as long as you practice moderation and monitor any health issues.

Helpful Websites

For more information on amputee bicycling, here are some of the websites I have found useful:

  • http://www.mtb-amputee.com  - This site is more for those into mountain biking but it contains a lot of useful tips for amputees;
  • http://www.amputee-online.com/amputee/onyerbike.html - A good site overall that contains a lot of information on positioning, seat height, etc; and
  • http://www.onelegtim.com/bicycle.html  - Another good site by a retired police officer with many tips, particularly for above-knee amputees.So stop procrastinating, get out on that bike, and enjoy this great activity. Its healthy, easy on the joints, and it feels good to be out enjoying life from a bicycle seat. 

Bruce Hibbett, a BK amputee, lives in Missouri and is employed as a physical therapist assistant. He was one of three amputee riders in the 2003 Amputees Across America transcontinental bicycle ride.