LETSAir Forces Manual No. 49

BIT’SWMK

Air Forces Manual No. 49Publ ished for

The Air Surgeon, A.A.F. Convalescent Training Divisionin collaboration with the

Institute for Crippled and Disabled, New York, N. Y.by

HEADQUARTERS ARMY AIR FORCESOffice of the Assistant Chief of Air Staff, Training

Training Aids Division

Listen, men...

HEADQUARTERS. ARMY AIR FORCESWashington, D. C., 4 December 1944.

Air Forces Manual No. 49, Let's Walk, (crutch walkinghandbook) is published for the information and guidanceof all concerned.

By command of General ARNOLD:

BARNEY M. GILESI Lieutenant General, United States Army

Deputy Commander, Army Air Forces andChief of Air Staff.

The object of this book is to helpteach you to walk again.

We want every man to leave thishospital under his own power. And itcan be done!

We make no exceptions, regard-less of your injury.

Learning how to walk again willnot be easy. This period in your liferepresents your greatest battle—butyou can win this one, too, if you wish.In it, there will be no shell and flak, noboom and cannon, no guns. For thismission you must supply your ownweapons: determination, patience, anda love of independence! Without these,the best medical aid in the world,which is available to you, will be oflittle value.

In other words, soldier, this fightwill take guts, too.

You who are without both yourGod-given legs can walk out of the hos-pital and take over your former job—-or a better one. You can work anddance and play again. You can takeyour place among friends and neigh-bors and resume your pursuit of happi-ness. Yes, you can marry and raise afamily. No longer need you be confinedto a life in bed or wheel chair. You, too,

can walk—if you will fight for what youwant. What we state is simple truthbacked up by records of many caseslike yours.

The battle will not be easy, mindyou. It will take grit and sweat. To winmeans you cannot surrender in the faceof what may appear to be overwhelm-ing odds. To win means visualizing adefinite goal and then working towardsthat goal in a planned, orderly man-ner. No one but you yourself can de-liver this victory to you. What we pos-sess are knowledge and methods thathave been tried and proved successful,and these are offered for you to takeand use. The results of this one-man'swar will depend on you. We say, "Ifyou want to walk again, you can. Wecan show you how to do it—but youmust do it."

The value you receive from thesepages of illustrations and text dependsupon how well you carry out instruc-tions. Learn to do things the right way—learn to do first things first—andsave yourself many days in the hospital.

Regardless of your past experi-ences, you now face the greatest chal-lenge of your lifetime. You can winagain—it you wish.

IT would be logical ifyou paused now andmumbled: "Sure I want

to walk again. Of courseI want to lead a normallife. But what do I need be-sides will power and desire? Surely theremust be something else."

There are other things. You must keep

your muscles as healthy andas strong as possible. Ifyou're going to walk withcrutches when you first getout of bed, it is necessaryto train the muscles that

will give you walking power. These are pri-marily the finger flexors, triceps, abdom-inals, and quadriceps.

IMPORTANT MUSCLE GROUPS

FINGER FLEXORS"Finger flexors" is merely a two-bit term tor forearm muscles—-important tor grasping and hold-ing the crutch hand grip.

TRICEPSTriceps—sometimes known as the"pushing muscles" — are in theback of the upper arm, runningfrom shoulder to elbow. This pairof muscles is necessary to lift thebody weight. Without strong tri-ceps your arms will be quite use-less.

ABDOMINALSAbdominals form a power unitIn the midsection, power you needto gain proper posture, to main-tain the body frame, and to pre-vent sagging of the pelvis andstomach wall.

QUADRICEPSQuadriceps form the "Big Four"muscle team in front of the thighand are to the legs what tricepsare to the arms.

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5

EXERCISES

PREPARING THE TRICEPSMany of you who have been in bed for a long time

have exercised your biceps—the "pull-up" muscles—byusing the overhead bar. Now you must condition the "push-up" muscles needed for handling crutches. Work on thesewhile you still are in bed. Take it easy at first.

From a hands-on-chest position,extend arms forward, sideward,and upward. Try to touch the ceil-ing and the walls.

2 Though you may be in a full-bodycast, push yourself up as far aspossible. Tense upper arms.

3 If you are in a leg cast, push your-self into a sitting position. Tiltbody backward slightly with palmsbeside and behind you. Stiffenarms. Relax. As strength returns,put a box or book under each handto give you some altitude.

4 Exercise the triceps while sittingon side of bed or in wheel chair.Grasp mattress or chair arm firm-ly, stiffen arms, and lift body up-ward as far as possible. (Howz thebreeze uo there?)

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PREPARING THE FINGER FLEXORS

1 Spread fingers wide and practicetightening the fists.

2 Stretch out on your back. Raisearms up and grab top bed rail.Tighten fists and s-q-u-e-e-z-e.Relax. S-q-u-e-e-z-e.

3 A sand box made in the Occupa-tional Therapy room is a handygadget. Tightly grab a handful of"Miami Beach" and then let it fil-ter through your fingers.

4 Create finger power by squeez-ing a tennis or hard rubber ball.It's an old prize fighter's trick andvery helpful. Give each hand equaltime.

5 Strengthen the forearm musclesby doing some mild hand wrest-ling with the fellow in the next bed.But don't get too strong andbreak his arm.

6 Here is more combat. Interlacefingers with the fellow next to you.Now try to straighten his fingersand bend back his wrist.

Seemingly oflittle significancebut really veryimportant is aset of stronghands, for whenusing crutchesyou literally"walk on yourhands."

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PREPARING THE QUADRICEPS

By now you know what to expect of your hands and arms,and how you must condition them. Next start working on theQUADRICEPS, the muscles that put the kick in the conga.It's a simple assignment.

While in lying position, tensethigh muscles of strongest leg.(Tighten 'em up!) Relax! Noticehow knee cap moves? (Seems silly,doesn't it? But it isn't, really.) Re-peat on your weaker pin.

2 After raising your knee, straightenleg as stiffly as possible. Hold ita minute before resuming originalposition.

3 Sit on the side of your bed andraise the leg until it is straight outin front of you. Be certain the kneecap is tight. Relax. Bring leg down.

4 Another way to tone up the quad-riceps: put some sand in a bucket,hang the bucket over your ankle,and lift. Add more sand each day.

Here the leg iscollapsing be-cause of weakquadriceps mak-ing it difficult towalk.

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PREPARING THE ABDOMINALS

It is the abdominal muscle groupthat helps to stiffen the body frameas steel girders support a building.No support, no building. So start

bade to work. We want you to get out of here.

1 If you are in a body cast, raisehead and shoulders off pillow forat least 8 inches.

2 Assume the horizontal position.Set palms on thighs. As you slowlyelevate your trunk, start "walk-ing your fingers" towards yourknees. Keep those legs stiff.

3 On your back again. Clasp handsbehind head. Lift the torso off thesack about ten inches. (Hey!Keep those legs down!) To-morrow it will be easier.

4 Bring both legs up straight andclose together, lower back flat.

5 Turn torso to left and grasp leftbed rail with right hand. Turntorso to the right and grasp rightrail with left hand.

6 The next abdominal exercise hasno artistic accompaniment. Butyou can do it, regardless. Justhiccup. That's right, hiccup.Contract your midsection—drawstomach in — and simulate thesound effects.A hiccup (or hiccough), accordingto Webster, is a "spasmodic in-spiratory movement, consisting ofa sudden contraction of the dia-phragm accompanied withclosure of the glottis, theinrush of air against theclosed glottis producing apeculiar sound." And ourartist says to tell Websterto illustrate that exercisehimself.

Notice the badposture caused bysagging of theabdominals.

HISTORY of <Rl)KHES

To offset these disabilities, ma »

neighbors, care for his family, or

help him get around, mingle with hts

maybe do a little court.n with thegtraced tQ 2380 B .C. This

was\hm—

°

a gentleman leaning on a shoulder-hig

serious turn of mind and chiseled ou h d’art” unearthed by

victim, using a crystal-capped supports ,

explorers picture fancy rods and bpd up all night dopingP

E«n in the olden days w-e guys who stayed 8^out new ways to do the same o *

n and me dical science moving

ever, was not a * the 5th Century B.C. approached,ahead in history s rap

cow-horn crutches.the Greeks were using a set crutch was the most common

Until the 18th Century the single UP »

hand saw revolutionary

form of walking aid. Withi the in two an arm pit

revisions soon followed. The single P »

d about waist level. Withrest set between them, and a ha" g commonly used prop.only slight modifications this st marketed in recent years.

Innumerable crutch mventionhave bee# and socket to

including one with an a>r-fiUedarm nove l handiwork is a telescopiccounteract friction under the -ngS- Still another is the roiling

adjustable crutch with shock abso g P 6 bits o[ gear are the

crutch” with a rocker set at the base. UX leather seat slung

“saddle” and “mechanical wa£»g *•

of k vers to help move weakbetween the two crutches, the latter y

legs forward. . Ueing with the invention of the

The twin upright crutch tha*. aid yet devised. Your hospitalsaw still remains on£ in that it has adfust.ng

crutch differs from this ancierpbber crutch tips,

systems for length and band grip.locomotion, a method of move-

Realistically, the crutch is a mea hladed ice skates, the Canadianment compatabie to the Dutchman s polished skis. Like ice

trapper’s Sulky you go where you want

“rdrrvaonudCt'todo.

This is strictly G.l. — ~

CRUTCH, ADJUSTABLE,

WOOD, U. S. ARMY

The crutch is a vital means of locomotion,whether your disability is temporary or per-manent. In reality, it is a "walking aid." Hereyou see it—strictly G. I.—in the manneryou first met the Garand or '03, nomen-clature and all.

I. Arm Pit RestUpright

~3. Adjustable Hand Grip*4. Hand Grip Wing Bolt"5. Adjustable Extension Rod-6. Extension Rod Wing Bolts'1. Rubber Crutch Tip

BALANCE AND POSTURE

BALANCE, the first requisite of walking, is the ability tohold one's body in equilibrium primarily by muscle power.It's importance to you cannot be stressed too often.You can lose balance ability and the muscular power neces-sary to maintain the body in the upright position when you

are confined to bed for a long period or when part of the bodyhaving a direct bearing on the balance mechanism is lost.If your ability to balance has been lost through muscle weak-ness or lack of practice, you must practice again and again.If part of your balance has been lost, you must develop this skillanew with crutches, canes, artificial limbs, or braces.With balance mastered, you are ready to start walking.GOOD POSTURE, your next consideration, is the properalignment of the body as taught during basic training—shoul-ders back, head up, chin in, chest up, stomach and buttocksin—the tallest natural position a person can assume.

Proper posture will help you conserve energy and avoid fatigue.And, furthermore, you will look much better when you standand walk correctly.

Head up . . . chin in . . . shoulders back . . . chestup . . . stomach and buttocks in. Stand straightand tall.

Head up . . . chin in . . . shoulders down . . .

stomach and buttocks in . . . toes pointingstraight ahead.

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REESTABLISHING YOUR BALANCE

The reestablishment of your balance is a

high priority mission that must be accom-

plished successfully before you can beginwalking again. Like all successful missions,this one is preceded by diligent preparation.Balance training starts as soon as you getout of bed. You commence at the bed side,continue with a chair as support, and finallygraduate to the parallel bars in the gym.

Hold onto bed and seehow it feels to standagain. Fingertips only,with bed or chair assupport.

One hand and onefoot.

Both hands and onetoot.

Balance with onehand holding chair.

Select an object or markon the wall that is at eyelevel. Watch your pos-ture. This exercise is awonderful tonic for yourbalance mechanism.

Balance with nohand support.

Swing leg backward andforward.

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WALKING WITH CRUTCHES

Walking with crutches Isa skill. The man who thinksotherwise Is due for a fewjolts on a tender spot.

It you recall, your firstattempt to bounce with apogo stick was somewhatawkward. Mounting thefoot bar and grasping thepole correctly were initialproblems. Then you learned

not to lean too far forward or tilt back-ward too much. You practiced untilyour technique was perfect. You dis-covered the correct methods.

So it is with crutches: a rfght wayand a wrong way. As with the pogostick, crutch agility depends on properbalance, posture, and gait, and thecorrect shifting of weight. When thesefactors are understood and put intopractice, you have skill.

To walk with crutches correctly, sothat you can travel from one place toanother with the least effort and thegreatest speed, a technique has to belearned. This technique can be at-tained only by practice of correctmethods.

Body erect. Head up, buttocks in. Setcrutches at angles shown in diagram.Support body weight on hands.

WRONG RIGHT

It is wrong to leantrunk forward, headdown. Don't setcrutches too far apart.Don't bounce but-tocks in the breeze.Avoid weighing downon arm rests.

Before taking any steps, adjust crutchesto proper length—usually two incheslonger than the distance from arm pitto floor. Make measurement while in anerect position. Follow this by learningto stand correctly with your props.

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CRUTCH WALKING DON’TS

Certain practices must beavoided for good crutch walking.Remember these and prevent ac-cidents and ailments.

Don't carry your weight on armpit rests—let the hands and handgrips take care of this. The armpit rest is to balance the upperpart of the crutch under yourarm. Pressure under the arm pitscan cause damage to nerves andmay result in crutch paralysis, themost common of which is wristdrop. Don't hunch shoulders.

2 Don't overpad arm pit rests; thereis no need for this since the restsshould not carry your weight.

3 Don't have crutches too long. Cor-rect length prevents too great aspreading of the props and pre-serves balance. Don't swing thecrutches out—move 'em straightahead.

4 Don't take too long a step. Youmay lose balance and fall.

5 If tips are worn exposing wood,get replacements quickly.

6 Don't turn your feet out. Keepthem straight—and go forward.Don't use crutches or canes with-out rubber tips. You may toppleover.

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1 Don't walk with your game legbent. Muscles become shortenedwhen the leg is flexed for an un-usually long time. Let the leg hangin a normal manner.

2 Using a built-up shoe you can holdthe injured leg straight and off thefloor. This will avoid toe stubbingand enable you to travel in a morenatural manner.

3 The regular type of orthopediccork boot may be provided togive you lift. If you feel ambitious,however, go down to the O. T.Room and build a rocker-bottom"wedgie" for yourself. Height ofthe heel—3 inches . . . 2 l/2-inchceiling for the toe.

4 Don't twist the cast leg out whilewalking.

5 Don't set hand grips too low. Cor-rect adjustment permits hands tocarry your weight. Proper settinghelps you gain proper leverage.

6 Don't neglect your equipment.Check wing bolts. They should betight.

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CRUTCH GAITS

The time has come tor you to start getting aroundon your own. Here are the most common and useful

crutch gaits. The Medical Officer will recommend those mostsuitable for you.

ONE-LEG SWING-THRU (2 pointcontact)—With weight mainly ongood leg, support weight on handgrips. Swing body and both legsthrough crutches. (Don't swingtoo far.) As foot touches ground,bring crutches forward. Do thesemovements as one with a rhythmicfollow-through. Do not hold gameleg flexed behind you. Push downon hand grips and pull BACK.

TWO-LEG SWING-THRU (2point contact)—All in one move-ment again. Crutch tips hit floorsimultaneously. Shift weight for-ward and swing body through. Asfeet come to rest, shift weightforward ... and move ahead oncemore.

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The PRE-STROLL (2 point con-tact)—If medical Officer permitsyou to put injured toot to theground for balance, move this legforward, toes lining up with rub-ber tips. Swing weight and goodleg through. Bring crutches for-ward.

To swing your body through thecrutches, it is necessary to under-stand the smooth power gener-ated when you push down onthe hand grips and pull back.Unless you execute this correctprocedure, you will be "jumping"through the props—an incorrectand most tiring activity.

The STROLL (3 point contact)—Place weak leg between props.Carry weight forward with mostweight fixed on crutches. Stepthrough with strong leg. Advancecrutches and weak leg simul-taneously.

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PREPARATION FOR WALKING

You have received the best medical care possible. Youhave been fitted with the best artificial limb for your needs.Your object now is to perfect your walking by learning how tomanipulate the limb with a normal gait—to learn the everydayprocedures necessary for work and play. Since you can't im-prove on nature, the obvious thing to do is to imitate the wayyou walk on your good leg.

In order for you to go up and down stairs, climb, drive acar, dance, sit down and arise with ease and the least conspic-uousness, your artificial limb must move as part of your body.Once the muscles controlling the stump are strong, these activ-ities will be easy.A below-knee amputee with strong quadriceps should walk with-out any further problems, and without any noticeable gait.

These exercises are "MUSTS" to build up the muscles.

Before dressing in the morning,exercise your quadriceps. With-out swinging the knee, slowly raisethe stump to bed level. Tense theknee cap. Relax. Resume originalposition.

2 Toughen the stump via this novelgadget. (Make your own with atriangular block of wood, a spring,and a noose of leather or strongcloth.) Raise leg against the re-sisting spring. Slowly—up, down... up, down.

3 The buttocks and adductors mustbe tough, too. Bring stump closeto good leg and lift. Keep goodleg down. As you lift stump, tensethe buttocks.

4 S-q-u-e-e-z-e pillow between legs.Paint pictures of Hitler and Tojoon each side and kick their teethin.

WITH AN ARTIFICIAL LIMB

Orthopedic gym workouts forquadriceps should include tablepulley routine.

2 The wall pulley is a fine conditionerfor the buttocks. Note how thehead should be brought back asthe stump goes rearwards.

3 Turn back to pulley and bringstump forward and upward. Thisis for your hip flexors.

4 A little wrestling and tumbling arehelpful.

5 Reach up and back with arms forstall bars and work with artificialleg.

6 As though ordinary G. I. sit-upswere not enough to contend with,here's a new "one-point" variationto create powerful abdominals.From a reclining position, hike uptrunk and legs simultaneously. Bal-ance on the buttocks—and reachfor your shoelace.

7 Heads up! This is strictly from thechorus line. Turn the heel out . . .

then the toes . . . and dance yourway down the corridor. A few ofyou doing this together to a slowfox trot isn't a bad idea.

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BALANCE AND POSTURE

The next essentials are BALANCE and POSTURE. Properbalance on the limb is the foundation for each step you willtake. Balance has to be practiced until it becomes automatic.Learn to balance properly on each leg; don't neglect the goodone. To balance properly meatis to have proper posture as well.Correct posture, which must be maintained, is the same as thatdescribed under crutch-walking—the G. I. way again. Walkingin front of a mirror will be very helpful. A natural gait is thelast essential. Above ail, avoid bad walking habits. They aredifficult to break once begun. It is so much easier to learn theRIGHT way FIRST.

Here is the wrong way to balance.You're off the beam.

0This is the right way to bal-ance. Body erect. Stump hangsstraight.

3 Balance between bars. Extend legbackward and forward.

4 Balance on plank with good leg. . . then learn the same thingstanding only on artificial limb.

5 In the ballet, this is called theArabesque. Ballet or not, it's ex-cellent advanced balance training.

6 The Pelvic Roll. Squeeze buttockstogether, draw in abdominals, androll pelvis under and forward—-like the burleycue gal doing thebumps.

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USING THE NEW LIMB

The basis for controlling an ar-tificial limb is a healthy, strongstump. It is this power unit thatpermits you to lock the kneeand avoid "knee-shooting"—and"knee-shooting" means falling onyour face. If you goofed-off onthe previous stump exercises, nowis the time to make amends.Come on, men, let's walk.

Stump thrust welback in socket"Lock" knee.

Step out. Stumpflexed, limb ex-tended.

Stump thrustback, heel "dig-ging" in.

Weight forward,stump back, knee"locked."

WRONG RIGHT

1 This is the abduction walk—a roll-ing gait—and it's wrong. Abduc-tion is a tough habit to overcome,too. Don't raise hip and shoulderfor this swings your leg out. Addi-tional exercising of the adductorswill help prevent abduction.

2 This is correct. This is normal. Theleg does not swing out. It movesstraight ahead. Hips and shouldersare level. Don't rely too much oncanes. You don't need them.

3 Going up stairs, place your goodleg on the first step. Follow upwith the ’artificial limb. Continuewith good leg to the second step.

4 Going down stairs, reverse theprocedure. Place artificial limb onlower step. Bring body weight for-ward to keep limb extended. Movegood leg down.

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HINTS

Sitting down and arising froma chair are special techniques. Donot choose a low chair—it's toughto get up from and accentuatesyour artificial limb. One too highwill cause your limb to hang un-naturally. If a chair of properheight is not available, sit forwardso the new foot rests on the floor.

When approaching a chair try toavoid "shuffling" from one footto the other. Time your approachso the good leg is nearest thechair. A RIGHT amputee pivotsto the RIGHT. LEFT amputeepivots to the LEFT.

Dark shoe in diagramrepresents the artificial limb.

2 Arising from a chair without no-ticeable effort can be done easily.If the chair can be moved, moveit out from under you as you riseto stand. If the chair cannot bemoved, plant your feet evenly,press down with your hand onartificial limb socket—and stand

3 Practice walking on rough terrain.If you react quickly, you shouldnot fall. When elevators do notstop level or thresholds are toohigh, learn to step out and overwith good leg first. If you feelyourself falling, take a quick, shorthop with your good leg. Practic-ing this hop will prove helpful.

RECREATION

Many forms of physical rec-reation also will serve to build upthe several muscle groups thatmake for good balance, goodposture . . . and good walking.

Rope climbing . . . develops theadductors.

2 Golf . . . sharpens the balancemechanisms. But take care—kneeshooting can occur at the end ofyour swing.

3 Walking the Plank . . . smoothesoff some rough edges In your bal-ance and posture pictures.

4 Hop Scotch . . . for the good leg.Another balance primer.

5 Throwing Darts . . . adds furtherknowledge to knee-shooting con-trol.

6 Musical Chairs . . . tones up yourreaction to everyday things youmust do in a different way thanbefore. Like getting up fromchairs quickly . . . and sitting downbefore the other guy.

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BILATERAL AMPUTEE

With the bilateral amputee—the man who must use two arti-ficial limbs—the problems of balance and posture are moredifficult than for the single amputee.

1 Using the bed as support, learnto stand correctly—head up in adignified manner, buttocks rolledunder. Frequent practise meanseasier and better walking.

2 Acquire posture and balance bystanding on one limb while liftingthe other slightly.

3 Parallel bars and mirror form atop-notch device. Hold on to bars—but don't lean on them. Standerect. Roll those buttocks under.Head up, mister, and watch your-self in the glass. Shift weight overright limb—and step out with theleft leg. As the left leg comesdown, thrust the stump back in thesocket and "dig" the heel into thefloor. Shift weight over left sideand step out with the right leg.Learning to thrust the stump backis invaluable technique that willprevent knee-shooting.

4 The double amputee's tendency isto keep his hips way back andchest out, a tendency to be pre-vented.

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CRUTCH GAITS

PRIMARY WALK Your first crutch gait is the PRIMARY WALK (3 point con-tact) . . . Bring weight to left leg and left crutch as you stepout with right foot. Move right crutch ahead of right footand shift weight over right leg. Step out with left limb. Moveleft crutch ahead of left foot. Repeat.

PACE WALK Next is the PACE WALK (2 point contact) . . . Right leg andright crutch move out together. Shift weight to right. Continuewith left leg and left crutch moving simultaneously. Repeat.

ALTERNATE CRUTCH WALK The ALTERNATE CRUTCH WALK seems tricky at first butit becomes simple and smooth after practice. Advance leftcrutch and right leg together. Shift weight. Follow throughwith right crutch and left leg. Repeat.

Become proficient with crutches and soon you may be able todiscard them for canes. The CRUTCH-CANE WALK will helpthis come about. Set crutches outside arms with arm pit restsagainst shoulders. Put hands through uprights to grasp handgrips. From this position, practice the foregoing gaits.Short crutches may be prescribed before you graduate to canes.Topped by a ring through which the hand is slipped, the shortcrutch is about three-fifths the size of a regular staff.

PARALYSISCaused by Spinal Cord Injuries

If you have paralysis caused by injury to the spinal cord,the chances are very good that you can walk again. It will bea rough job learning, no doubt about it. But it can be done—-if you provide the fortitude.

Spinal injuries between the upper and lower extremitiesusually mean walking with crutches and braces. The big factorsin such cases are strong arms and shoulders, so concentrate onthese items by doing the following exercises. You will workoff all excess fat at the same time.

With fracture board under mat-tress, learn to balance yourself ina sitting position.

2 Press hands on diaphragm and giveout with some noise that soundslike "HUH, HUH".

3 The Medical Officer approving,roll from your back onto yourbelly. Develop power for this movefrom your arms and shoulders. Dothis on gym mat, too.

4 In the wheel chair, lift body offseat by stiffening arms.

5 Move over to the horizontal barin the doorway and learn to puli up.

6 Correct tripod stance betweenbars.

Push yourself up between bars androck your legs.

8 Shift weight, but keep Ihe bodystraight.

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CRUTCH GAITS

With the problem of staying up with an evenrudder overcome, it is time for you to learn towalk. There are three movements, all started from

a tripod stance, the Medical Officer may pre-scribe for you: The Shuffle, The Swing-Thru andthe Primary Walk.

THE SHUFFLE (4 point contact)With crutches slightly forward, sweep legs tocrutch line. Shift weight over crutches, advancecrutches, sweep legs forward.

NOW is as good a time as any to remind youabout one of the more important points in crutchwalking technique: press down on hand grips, andat the same time pull back on the grips as thebody weight moves forward.

THE SWING-THRU (2 point contact)Try to perfect this so it evolves into a single,rhythmic movement. Crutch tips hit floor simul-taneously. Shift weight forward over crutches.Swing body through. As feet come to rest, shiftweight forward—bring up crutches, and moveon. (Be careful not to swing too far forward orbalance will be lost.)

THE PRIMARY WALK (3 point contact)Press down on right handle, putting weight overleft leg and crutch. Right leg forward. Rightcrutch forward. Press down on left handle. Bring

weight to right side. Move left leg and crutchforward to come on line with right prop and limb.Watch your posture. Stand erect. Head up.

CRUTCH WALKING EXERCISES

You should be quite a master with the polished stems bythis time. Your muscles have been reconditioned and tuned forduty. The basic elements of crutch-walking have been divulged,studied and practiced. Soon you will be ready to leave.

But before you depart, become expert in a few tricks ofthe trade—a few fancy steps, so to speak, that will furtherhelp you go where you want to go to do what you want to do.

j With back to wall, bring bothcrutches forward .

.. then back.

2 Stay against wall. Left crutchto the left . .. back to original po-sition. Right prop to the right .

..

back.3 Leg swinging between crutches.

4 The Side Swing will get you downnarrow church or movie aisles.Shift crutches and weight to right.Steady yourself. Push down onhand grips. Lift feet off groundand swing legs towards rightcrutch. To move left, reverse pro-cedure.

” Wanna make a tight turn like aPiper Cub? Use the Swivel Hop.From tripod stance move crutchessimultaneously in direction ofturn, keeping tips equidistant. Pushdown on hand grips, stiffen arms,lift body, and make like a ball tur-ret. Swing body around. Liftcrutches . . . push down . . . stiffenarms . . . lift body .

. . swing.u From tripod position, swing

crutches back . . . then forward.1 The One-Crutch Stance: lean

body up to left crutch, fingers setsnugly against hip joint. Beardown on left hand grip and—-presto!—the right arm and handare free to turn the knob, lock thedoor ... or tip your hat to thepretty blonde.

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AND TRICKS OF THE TRADE

\ One of the easiest ways to get ona curb: turn your back to the curband swing one leg up on it. Pressdown on both crutches. Swing upthe other leg. Bring up one crutchat a time. Join the other pedes-trians.

2 To get down from a curb, set thecrutches off the sidewalk, bringone leg down, then the other—-and start across the street.

3 There's a definite way your buddycan help you onto crutches. Withhis legs astride yours, his armsthrough the prop frames, he holdsyou under the armpits. You takehold of his shoulders. He movesback two steps bringing you up-right, and you take over thecrutches to assume a tripod posi-tion.

4 To sit down—turn, grasp the chairarm, place one crutch against sideof chair . . . regrip other crutch,and slowly let yourself into chair.

C There is a simple skill involved inleaving a chair, and here it is toryou to put in motion: lock bracesand do a quarter turn in your seat.Grasp left chair arm with righthand. With left palm flat on seat,push up. As body rises . .

.

...turn to face the chair. Straight-en up. Take one crutch . . .

. . . get it into position. Get theother one—and take off.

29

YOUR OWN RECORD

NAME RANK ASN

CAUSE OFDISABILITY DATE PLACE

HOSPITALIZATION

Name and Location of Hospital:

Date Admitted Date Discharged

Name and Location of Hospital: _

Date Admitted Date Discharged

Name and Location of Convalescent Center:

Date Admitted Date Discharged

DISABILITY WHEN ADMITTED TO CONVALESCENT CENTER

PROGRESS RECORD

Received prosthesis (or braces) on

First stood on crutches ; on artificial limb(s)

31

ACHIEVEMENTS

BALANCING

List weekly progress of balancingon weak or artificial leg.

Date M inutes Seconds

SPEED WALKING

How long does it take you to travel40 feet? List the score each week.

Date Time

ENDURANCE WALKING

How far can you walk withoutstopping? Write it down.

Date Steps Yards

SPECIAL EVENTS

When did you first ...

Get in and out of chairs?

Walk up and down stairs?

Open and close doors?

Go swimming?

Play golf?

Drive a car?

Dance?

*l(i. (£o*tcCei4.C<Ht . • •

This ends "Let's Walk", Army Air ForcesManual No. 49, prepared after many long, tedi-ous hours of work by the many persons involved.Of course, all admit this has been a minor effortcompared to the one you must make to walkagain.

"Let's Walk" really is an illustrated state-ment of strategy and tactics that have won in-numerable hospital campaigns like yours. Un-bounded confidence prevails that you can gainmuch by taking advantage of what is containedbetween these covers. This confidence is basedon the opinion that you are ready to work—evenfight—tor what you want. But the lessons ofmedical and therapeutic experiences set downwill be valueless without your toil, withoutyour determination, without your patience—andcourage.

You can win.You will win—because our kind of people

settle tor nothing less than victory.Let's Walk!

New Era Litho. N. Y. 10M—2-45