♪ Bob and Brad ♪
♪ The two most famous physical therapists on the internet ♪
(upbeat song fades)
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- I gotta straighten out my tie.
- Yeah. - Today, we're gonna talk
about the safest way to walk
with a walker, including non-weight bearing,
which is a little bit tricky with some people.
- Right, yeah,
there's a little trick to it and we wanna be safe.
There's a few simple little things
that can make a big difference,
'cause you can fall with a walker and get tangled up.
- Oh absolutely.
I've had many people that have, unfortunately.
- Right.
So we've learned, you know-
- We've learned the hard way.
- Right.
So we're gonna show you to keep you a step ahead.
- When one of our patients fall, it's like we're falling.
- Yeah, Mm-hm. - It's bad.
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Bob and Brad.
We are still giving away stuff,
we've been giving away stuff like mad Brad.
- Yeah.
- We're giving away a mattress again, SleepOvation mattress.
- Oh excellent. - Yup.
- This is the third one, right?
- This is the third one and final one of the year.
- Great. - So here we go.
All right, Brad, take it away.
What are we doing? - Okay, walkers.
If you're new to the walker scene or you need a walker,
for whatever reason, whether your balance is off,
maybe you've got a broken femur or ankle,
whatever it may be, just be aware of a few things.
First of all, the height is probably
one of the most important things.
- [Bob] It is. - [Brad] Make sure
it's the proper height.
For example-
- [Bob] Yeah. If it's too high-
- [Brad] Let's let's take this one.
- [Bob] Yeah.
- If I stand here like this and I let my arms hang down,
you can see my wrists are way below the handhold
of the walker, and that's too high.
Now for Bob,
he's much taller than me. - Yeah, we're getting close.
This is about where I'd be.
- Right. - [Bob] Yeah.
- Now this would be right for me.
If I stand here,
you can see the crease of my wrist lines up there.
Now, this isn't an exact science.
- [Bob] No.
- You can be within an inch or so and you're gonna be okay.
Sometimes I say, "Does it feel comfortable to you?"
for my patients.
And they say, "Yeah, it could be up a little higher."
And if they feel better with it...
but when there's a big difference, if it's way up here,
then it's gonna cause problems.
- Well, you can't get the leverage for one thing.
You can't lean on it like you should.
So if I'm like this, my arms are gonna fatigue
and I'm not gonna be able to take the weight off the legs
like I want to.
- Precisely.
So yeah, like this.
I'm standing with my legs straight in there
and I would really get sore arms,
particularly if I was non-weight bearing.
- And also if it's real low, I'm gonna be like this,
and now you're gonna really get that poor posture.
- Right.
- Which is gonna eventually could result in some back pain
or other issues. - Sure.
So get the height right. - Correct.
That's number one.
- Heighth or height?
- Height. - Height.
Get the height. - In my world, it's height.
- There you go.
Well, I'm gonna be an English major,
but I'm I'm still working on that part of my life.
So next thing, stay the proper distance from the walker.
Bob, why don't you grab this one?
And you can show 'em.
- Well, this is really unfortunately
what you see some people doing.
- Yup. - This.
- They get too far away.
- Yeah, and again, that definitely causes them
to lean over more too then.
- Right.
- So you want to keep yourself almost
within the walker itself.
- [Brad] But not too close. - [Bob] Not too close.
- 'Cause if you get too close this way,
then you can have a fall forward.
So there's that happy medium space,
so that when you're step two...
Can you get down to the foot, Liz?
The stepping foot is about halfway
between the legs of the walker.
Okay?
So you're right in there.
Not in here and not back here, as well.
So right there.
- I would say, Brad, too,
going into your next one actually,
our wheelchair of choice, not wheelchair,
our walker of choice generally is one
with the wheels on the front.
- Right, precisely.
I mean, a lot of people, patients, will tell me,
well they're worried about having wheels
'cause they feel like it's gonna roll away on 'em.
- Mm-hm, mm-hm.
- If you have wheels just on the front and not on the back,
it gives you a little bit of gliding,
but it doesn't wheel away out from you.
- [Brad] Right.
- [Bob] There's enough resistance from the back.
- [Brad] Right.
- [Bob] And usually, we got the tennis balls on there
quite often, that we put on there to help 'em glide.
- Now those are on there for a number of reasons.
If you don't have 'em, sometimes they squeak,
sometimes they scratch the floor,
which gets people upset,
and they're just smooth and they work really nice
and it's really cheap.
- And they eventually wear out
and you have to replace them. - Right.
- But if you buy the gliders, the plastic gliders,
I've seen those get scratched up
and then they scratch up the floor.
- Right and they're the gliders or the skis.
On carpet, they're good.
- They're they're really good on carpets.
- Right, right.
So we wanna stay back online here.
So the next thing is, if your weight bearing as tolerated,
well let's just say, you need it just for balance.
- Sure.
- But you just need something there,
obviously you're not gonna have a walker
without wheels on it, for that situation.
Here we got a nice walker.
You can have fun
with your walkers. - [Bob] There you go, yeah.
- Decorate 'em up a little bit.
- [Bob] Got little fishies on there.
- [Brad] There ya go.
But if you just need some support
and you can walk relatively normal gate,
you just keep it there and you're just gonna walk.
You sometimes we need to practice the turn.
Sometimes I get some people that just need little hint,
lift it up a little bit.
But this kind of a thing is not really what we want.
- The thing about is, the reason the wheels are also good,
is because if you have a walker without wheels,
every time you pick it up
you're at that risk for losing your balance.
- Sure.
- So I go up here, I could lose my balance.
When the wheels are on the ground
and you're going like this,
you've got the support all the time.
- There's one instance where I do like without wheels
and we'll get into that
in a little bit. - Yeah.
- So that's the situation,
if you're just using it for walking.
Now, the next thing.
If you have a fractured ankle or sprained ankle, knee, hip,
or whatever it may be, and you can put weight on that leg,
the doctor says weight bearing is tolerated,
so if you put some weight on it's okay,
but if you put all your weight on there it hurts
or it's painful.
So then you have to get a certain sequence.
And this is the mantra that I always use.
This is what I learned when I first started,
is I would tell the patient,
"Just say to yourself, walker, sore leg, good leg."
- Right - Walker, sore leg, good leg.
Walker- - That that's what I often do
with people too.
- In other words, the walker goes first.
If my right leg is my sore leg, walker, sore leg,
then you can step through with the good leg.
Walker, sore leg- - [Bob] And as you can see
what happens then,
he's taking weight on his arms
when the sore leg is being in the walker,
so you're taking some of the weight off.
- [Brad] Exactly.
- So it works out quite good. - [Brad] So again,
- [Both] Walker.
- [Bob] Sore leg, good leg.
Walker, sore leg, good leg.
I used to do walker, bad leg, good leg,
but it's really not a bad leg, it's just sore.
- [Brad] Right, if you got a leg, it's good.
You know? - [Bob] Yeah that's right.
- [Brad] Some people don't have a leg.
- [Bob] That's right. - And that's the situation
to be aware. - [Bob] That's right.
- And then the last thing is the non-weight bearing.
You have a fracture, whatever it may be,
and you cannot put any weight on that foot.
And that's when sometimes I'll go with the wheels
or without, it depends on the individual.
Depending on how much they're walking,
how far they're going.
- But some people, psychologically
they just feel if those wheels are on there
it's gonna get away, so then I'll go to this.
If they feel better, then I'll do it.
And it's usually you're not taking big steps,
it's small step,
and then you're gonna hold a foot back here
or hold it out in front,
depends what's more comfortable with the person.
And then we just do a hop, small hop,
and don't hop into here and get into that situation.
- [Bob] I have to be honest, Brad,
with a lot of especially my elderly patients,
I'll have 'em do very limited walking
if they are down to one leg. - Yeah.
- 'Cause quite often what happens,
they start developing problems on that good leg then.
- Sure. - They get plantar fasciitis.
- Right, right.
- So if they're pretty strong and you can see
they can really take weight on their arms,
they could go like this, fine,
but if they're weak and they're really hopping.
- Yep. - Yeah.
They could end up with a fracture even on that leg
if they're osteoporotic.
- Right.
So yeah, it is an individual thing.
I've got a patient right now and she has no hip.
They took the ball right out
and they're gonna leave it out for about six months.
- For an infection, I bet.
- Yup.
But she's a little younger
and she's doing pretty good like this.
And she's gonna get around, go back home
and live like that for a few months
until they get the hip back in.
- Yeah, it's a really individual thing.
You have to determine what their capabilities are.
- There ya go. - But if you've got
an elderly person that's a little questionable...
- Yeah, be on the safe side.
And the other thing is
if there's no weight bearing that is tolerated,
or partial weight bearing, I never, ever, let them-
- Use the four wheel one.
- Right, that is when the four wheel one is,
I never advise that.
- [Bob] This is one that can slip away from you.
- [Brad] Right. - When you got four wheels.
They are good for outdoors.
I like 'em because they got the big wheels.
- Yes.
- But these things,
you better have a little bit better balance
when you're using a four-wheeler 'cause it can go.
And it's like a shopping cart, it can go
in different directions. - Right, right.
Yeah, yeah.
Yeah, and they got hand breaks,
you have to learn how to use those,
if you want to sit down on it.
All of those, it's a whole different story
than this type of walker.
So we actually have some videos
just on the four-wheel walker,
but for what we're talking about today,
if you wanna be safe, we're not gonna use that.
- All right. - Be careful Liz!
Don't let it hit ya.
- All right, thanks for watching folks.