Monday, July 22, 2024

RESPONSES: downhill skiing

Schafer, Kristin

Hello Listers. Thank you all for your range of responses. They are very helpful and I will follow up on some of your suggestions and pass this information along to my patient as well.

Once again, you are invaluable!
Kristin

ORIGINAL POST:

Hello Listers.

An early-40’s female patient of mine has approached me looking for information on beginning downhill skiing. She has a long, fleshy transfemoral residuum. She wears an Ossur seal-in liner suction socket, C-leg and Triton foot. She says she has skied in the past (about 8 years ago, long before her amputation), and that she was good at it. She walks with no gait aids for most distances and uses a cane for longer distances. She has gone hiking, snow shoeing and attends the gym regularly.

I have made only two transtibial ski prostheses in my career, but never a transfemoral ski limb. What considerations should I be aware of? What components do people recommend? Is this even a good idea, given the risk of falling and further injury? I see on the Canadian Para-Alpine site, some people choose to not wear the prosthesis at all. Is this for those that want speed? Do any skiers where AK ski limbs?

Is there anyone you are aware of who participates in the sport recreationally who would be available to talk with both my patient and myself?

Thanks to all.

RESPONSES:

1. Look into the Bartlet Tendon knee and ProCarve knee and foot. Ideal for skiing.

2. Check these guys out.

http://www.biodaptinc.com/

The founder is an above knee amputee himself and competes in the X-games still.

They also have a bunch of youtube videos on the MOTO Knee itself.

Insurance doesn’t like to cover it though, but probably the best option out there in my opinion.

3. I’m actually an above-knee amputee and I ski without my prosthesis. I don’t know of any amputees that would choose to wear it other than for reasons of Vanity and appearance. Functionally it will not benefit the amputee for skiing. I would recommend that she wear a socket just as protection on her limb. She can use out-riggers which are basically Canadian crutches with little ski tips. They used to be available through pel but I’m sure you can find them online.

4. As a AK amputee I have been fortunate enough to ski with one leg and with a prosthesis on skies. I would be happy to chat. I have copied Richard Chan, a AK ski instructor, Richard Chan, a snow boarder in Vancouver. Who might be willing to chat.

5. If she is interested in skiing I would just recommend mono skiing and out riggers. I have volunteered with an amputee ski group for teenagers and any AK we put in a mono ski. Most would just wear their liners and socks under ski pants, never had any serious injuries related to falling on their limbs but if it’s a concern you could always do like a short sub ischial something for protection.

6. Look for Bob Emerson. Prosthetist, former Paralympic skier. He is like a bird on the slopes and would be a great resource. He just uses 1 ski.

7. Ottobock has a foot/knee combo for skiing called the ProCarve that looks awesome.
https://www.youtube.com/watch?v=e-WIeWTMPIk I’ve never used it for a patient, but I’ve just seen the promotional material and video. We also have a patient who is new to us, but at his previous facility they made his skiing prosthesis with the Bartlet Tendon Knee which he likes a lot.

8. Have you considered the ProCarve by Otto Bock? https://professionals.ottobock.ca/zb2b4ob/us01/en/USD/Prosthetics/Lower-Limb-Prosthetics/Fitness-Prosthetics/c/6788

9. I volunteer to help amputees ski with a group called TAASC in Ohio. where is she? there are a number of programs available with numerous amputee skiers to talk to. the rule of thumb is most above knee amputees ski without there prosthesis and use 2 outriggers. Dave Begg is an instructor at Silver Creek adaptive ski program in West Virginia and an AK himself. it may be worth a phone call to him. silver creek is attached to Snowshoe ski resort.

10. You should contact Steve Wall at Otto Bock Canada…he heads up the C-Fab department. He is a TF amputee, skier (I think he was on the national para team at some point?) and is always happy to talk about his experiences. Hope this helps!

11. We have a vet who skiis on an X3 knee. He did it 3 mos post op. Granted, he is super fit and some vets can take on anything. I’d checkout the Ottobock ski knee and foot. X3 has a ski mode, so the ski knee isn’t required for this vet, but I think the ski knee and foot is preferable. That said, your Pt would need to afford it.

12. Has she considered ski biking instead? Several AK and BK amputees in the Seattle area are avid ski bikers. Generally they don’t need any special prosthetic design. There’s lots of info online “ski biking for amputees” I have one myself and it’s a blast.

13. We had a 30 year old male, who was an expert skier who lost his leg above the knee in a skiing accident. He was and excellent ambulator with a C-leg. After two years post healing, we tried him skiing with us, end result is that even with his past experience and excellent strength, it was decided that he would be better off skiing with a ski on his sound leg only and use pole out riggers.

14. I know there’s a company that makes a knee specifically for downhill skiing. I don’t remember the name but they’ve got ads in all the different O&P publications. I’m sure a quick Google search will turn them up. Freedom innovations makes a foot designed to lock directly into ski bindings.

15. I forwarded this to my patient who just got back from snow skiing (two months ago). She wears a c-leg with seal-in as well. C-leg 4 has a snow skiing mode.

16. I am an above knee amputee and a past skier who did mostly 3 track skiing. In my opinion it would be easier this way. Some use one ski and poles if they are very strong. I never considered using my prosthesis as I don’t believe it would be comfortable or very easy controlling the ski. I have a client who is a through-knee amputee that uses an XT9 knee unit. There is another unit by a guy called monster Mike – bioadapt unit. These would work if your client had good control of her prosthesis and it is nice to walk around in the chalet rather than with outriggers or crutches. I unbolt my prosthesis to ski and then ‘bolt’ it back on to walk in the Chalet.

Kristin Schafer, B.Sc. (Kin.), C.P. (c)
Rehabilitation Engineering
Health Sciences North- Horizon Sante-Nord
41 Ramsey Lake Rd.
Sudbury, ON
P3E 5J1
(705) 523-7100 x3176
Health Sciences North’s vision is to be globally recognized for patient-centred innovation.
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