Along with wheelchairs, nothing conjures up as much anxiety as the idea of having to use new—or long-ago discarded—splints, braces, canes or crutches. Using supportive devices may seem like sending a beacon to the world that we are disabled. After years of functioning without obvious aids, it seems like stepping backwards.
I know how difficult these transitions are. I had polio in one leg at age nine and functioned relatively well for thirty years. All that time I fooled myself into thinking I was a "passer" and worked very hard not to look disabled. I'm convinced now that the stress of trying to fit into the able-bodied world brought on my post-polio symptoms sooner.
By the age of forty-one I had so much pain and instability in my polio knee that going without bracing was no longer an option. About ten years later I starting using a cane and later a forearm crutch, then a scooter for distance walking. As each new piece of equipment became part of my life, my overwhelming emotion was relief, and I wondered why I hadn't done it sooner. My quality of life improved, and I didn't have to prove anything anymore.
Supportive devices and walking aids offer many advantages, such as compensating for muscle weakness, relieving pain, and supporting unstable joints. All this makes a big difference in our energy level and therefore our functional level.
When muscles are too weak to provide support during walking, such as the quadriceps muscle at the front of the knee, ligaments have to provide the support. This can lead to problems like "back-knee" or medial-lateral instability (sideways shifting), and the joint gradually deteriorates. Once a joint is damaged, it will not regain its former functional level, but a long-leg brace can maintain the knee in an acceptable position.
Weak muscles at the front of the ankle can cause a "foot drop" where you cannot bring your toes upward to allow your heel to hit the ground first. To keep from stubbing your toe and possibly falling, your leg has to lift higher than normal with each step. In this case, a short leg brace is an energy-saver and a safety aid.
Weakness in the wrist or thumb muscles can cause you to compensate by moving your arm in ways which quickly fatigue the whole upper extremity, including the elbow and shoulder muscles. Hand splints such as a wrist or thumb support keep these joints in a functional position. If a brace or splint is fabricated properly and fits well, it should never be uncomfortable, throw you off balance, or compromise your function. Now and then commercial off-the-shelf devices are adequate, but it usually works better when the appliance is custom-made especially for your individual problems. Don't hesitate to return, as many times as needed, to the person who made your device if you experience any problems at all. I've known people who were afraid to be critical so they didn't report difficulties and ended up storing the appliance in the closet. If we want our needs to be met, we must learn to be effective complainers.
© 2008 Grace R. Young
Courtesy of Diane Young and Sharon Lark.
Tagged as: assistive devices , braces , falls , mobility , weakness