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Limping, Bandages, and a Crutch
Written by Chloe on Sunday, October 19, 2008
Recently, the emotional strain of appearing able bodied at work got too much for me. I started limping. The next week I bandaged my left leg in such a way that I had no choice but to limp. The next week I added a right forearm crutch.
The Limp
My partner and I got back from our recent trip on a Sunday. The next day I went to work; no leg braces, no wheelchair. It seems I can handle this pretty well after a week of wheelchair/leg braces. There is an afterglow. After returning home from work, I immediately sat in my wheelchair for the evening as usual. Too late! The crash was hitting.
The next day I went on one of my killer hikes. Paradoxically this seems to help my mood, just like a wheelchair does. The hike was sufficiently strenuous to cause some pain in my left thigh, and an associated limp. The pain, and the limp, lasted for another two days, while I was at work. By Friday the limp was gone, and the pain was almost gone. I decided to limp at work anyway to see if it would help me to handle BIID. There didn’t seem to be much benefit.
The Bandages
The next Sunday, I decided to bandage my left leg so that I would have no choice about limping at work. This bandaging is something that I have been doing for the last forty years in order to manage my BIID. I think I am quite skilled at it by now.
I have tried many different techniques, so I thought I would describe what I did in case there are people out there who haven’t tried this who might benefit from it. There is no "correct" way. People have different shaped legs, different skin sensitivities, different needs. The idea is to prevent knee flexion to a sufficient extent that one is unable to walk without a limp. This technique can be more convenient than a rigid knee splint, since it allows sufficient flexion to be able to sit without too much difficulty.
I use elastic adhesive bandages in three inch, four inch, and six inch widths. By using adhesive bandages it can be easier to prevent flexion. Also, one can just leave them on for several weeks without worrying about them falling off, taking them off for showers, etc. By using elastic bandages you get a "spring" effect such that there is a force tending to extend the knee, while still allowing some flexion. If you are hairy, you probably will want to shave first. I have very little body hair, so it’s not a problem.
All the bandaging is done with the knee in full extension. First I use three strips of the three inch bandage. The first strip goes vertically in front of the knee, with sufficient length above and below the knee to get a good grip. If you are unfamiliar with this you will find that you should stretch it more than you think you should. At first it might seem that you are unable to bend your knee at all. The next two strips are diagonals in front of the knee, similarly stretched. If you really want to go for minimal flexion, the strips in front of the knee can be non-elastic. Since the three strips are in significant tension, they can slip on the skin over time. In order to prevent this I use three inch circumferential anchor strips above and below the knee. Next comes a six inch circumferential wrap directly around the knee. Again, you will probably want this tighter than you think you do.
Finally, an entire length of four inch tape is applied as a spiral bandage from mid calf to mid thigh. In order to prevent skin breakdown it is best to start and finish with complete circumferential turns under relatively low tension. The spiral itself can be under higher tension. If your foot turns blue, you used too much tension. Overlap the tape on each turn by about two thirds. I used an additional length of four inch tape to go from mid thigh to the very top of the thigh. This is optional; it doesn’t do much to prevent knee flexion. This should also start and finish with circumferential wraps, with a higher tension spiral in between. I have found that skin breakdown at the top of the thigh is minimised by including an inch or two of the buttock.
After a week I decided to remove the upper thigh bandage, since I was getting some skin breakdown in the groin. After ten days I added an additional three strips in front of the the knee, and an additional four inch spiral. Without this extra taping the tension will gradually diminish, along with the limp. I usually take off these adhesive bandages after about three weeks. It works best when the bandage is soaked, as after a shower. After drying your leg, rub in a bunch of lotion or oil. I use sweet almond oil. Give plenty of skin care for the next week. I allow the leg an equal amount of time without adhesive bandages so that the skin can recover fully, before applying again.
In terms of handling BIID, the bandaging is a little better than just the limp. This used to work for me pretty well, but my BIID is more intense now.
I should mention that my wheelchair has independent elevating legrests, so it’s no problem if one knee can not be in significant flexion.
The Crutch
For a while I have been using a forearm crutch to get from my house to the car, even if I am not going to be using the wheelchair or leg braces out that day. The neighbours perceive me to be disabled. Consequently I always have a crutch in the car wherever I am going. It had been bugging me to leave the crutch in the car when I get out.
I decided to crutch into work. This gets a LOT more (unwanted) attention than a limp. Only one person had asked me about the limp. I have used the crutch at work for one week as of this writing, and I have lost count of the number of explanations I’ve given. I don’t deviate from my actual injury: SCI and some resulting paralysis of the left quadriceps. Even though I tell the truth, it still feels like a deception because I have no physical need for the crutch.
It seemed like I might as well use the crutch for everything else too, since I already have it in the car. So now I am crutching into all the stores on the way home, where I used to appear as able bodied. It seems to me that I get treated somewhat the same as in the wheelchair. I am now in the "disabled" category.
The Downside
I have a pretty nasty limp. I put a lot of weight on the crutch in order to make my left leg minimally weight bearing. This is putting a significant amount of stress on the right side of my body. I am starting to get pains in my right shoulder, right hip, and right ankle.
I am already pretty tired of explaining my crutch. I don’t want to explain this. It gets old very quickly. I know full well that there are going to be a lot more people who will ask. I just want to get on with things and not have people make a fuss. They are both caring and curious, but my patience is declining. Maybe I’ll just say that I don’t want to talk about it.
The Upside
This combination of limping, bandages, and a crutch definitely feels better than doing "nothing". It does not manage my BIID as well as a wheelchair does. However, it does seem like a reasonable compromise for the time being. I still get to use the wheelchair and/or leg braces for things other than work. My BIID feelings are currently extremely intense, but I think I have finally reached a new plateau in the way I am dealing with it.
Tags: Bandages, BIID, Crutch, Disabled, Knee Splint, Leg Braces, Limp, Pain, Paralysis, SCI, Wheelchair
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8 Comments
“This is putting a significant amount of stress on the right side of my body. I am starting to get pains in my right shoulder, right hip, and right ankle.”
Get another crutch for the other side.
I use crutches on and off because I have early onset osteoarthritis which tends to flare up in the winter and a couple of days using only one will provoke the same problems with me.
If I actually behave myself and take both crutches the stress is lot less lopsided and I don’t get weird pains.
And physios are always shouting at me about using a single crutch as well.
Thanks K. Two crutches does indeed alleviate the pain, even with the left leg being zero weight bearing. However, my problem is that I haven’t figured out how to carry stuff like that. The biggest issue would be at the cafeteria, carrying my lunch tray to a table. I would much prefer to be using two crutches. Suggestions please anybody!!
For now I have been allowing more weight on my left leg. That also alleviates the pain. I don’t like it though since I am trying to represent myself as having significant paralysis in the left thigh.
4 On 24 October, 2008, Sean said:
Suggestion? Easy. Ask for help. That’s how others do it :)
Urgh. I hate asking for help. Besides, I work in a psychiatric hospital and most of the people in the lunch line are barely able to take care of themselves.
I have been working with a physician colleague of mine for the last couple of days. This afternoon we sat down for a chat about my back, my leg, and my crutch.
He says I have been using the crutch on the wrong side. I said it feels “wrong” to use it on the left side. He said most people feel like that, but I’ll get used to it and it will cause less stress on various body parts. I’ll try this.
He was not at all surprised about increasing paralysis of the left quadriceps, given what he already knew about my injury. I am happy to get confirmation that what I am representing is indeed medically plausible.
He was a little surprised not to see more atrophy. I was wearing jeans today. Guess I need to cover up the lack of atrophy with a skirt.
It can be quite a trip to look at what one was writing a year ago. It’s been a year since I presented at work as able bodied. I took things as I usually do; starting with a limp, and gradually working my way up to a wheelchair; all within my comfort zone.
A year ago I said that my BIID feelings were extremely intense. I would no longer use those words. It’s not that it’s actually any less intense; but the current (wheelchair) treatment is quite effective.
It all happened faster than I was expecting. I think Sean knew though.
The journey has been less difficult than I thought it was going to be. But; it’s not over yet…
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1 On 22 October, 2008, Chloe said:
Gordo, yes I had been thinking about you since our situations seemed somewhat analogous. I’m looking forward to hearing about your wheeling at school.
Maybe I should try caning. It sounds fun ;)