Evan Strong | Former Patient

Evan Strong , a 22-year-old transtibial amputee, has “the heart of a lion,” says his prosthetist, Mike Norell, CEO, Norell Prosthetics. “Usually, together with the patient, we plan what we’re going to do, but Evan has basically taken it upon himself to continue doing the things he did before.”

Strong was a competitive skateboarder before his accident in 2004. While riding his motorcycle down a two-lane highway, another driver crossed the center line and hit him. After losing his leg, he admits, “I wasn’t quite sure what I was capable of. I just knew that I wanted to recover, and my goal was to bring back at least 10 percent of what I had been capable of before.”

Once he was able to ride a skateboard again, the next step seemed natural. “I knew from that point I was capable of a lot more; then competition became an objective.”

Evan Strong

It wasn’t easy. Strong was on crutches for a solid year after losing his leg. He was fitted for a prosthesis after about eight months, but there were problems. He had significant muscle damage in his quadriceps and below his knee, so it took around six months for his wounds to heal. Because of painful problems with circulation and resulting skin breakdown from wearing the prosthesis, reconstructive surgery was warranted.

“The surgeon wanted to perform an above-knee amputation, but I told him that we needed to try to keep my knee so I could skateboard again. He said, ‘Well, we can try, but your odds aren’t very good.'”

Strong was determined to keep and regain full use of his knee. More than six weeks after the surgery, he was able to try again with a second prosthesis.

“Our largest challenge was his knee-flexion contracture,” said Robyn Pieper, PT, Physical Rehabilitation Center, Wailuku, Hawaii. “Without straightening of his knee, fitting him for a prosthesis would be very difficult. I recall times when Evan’s uncle or father helped to distract his leg [extend it] while I mobilized above and below his knee with as much force as I could.

“Evan tolerated all of this stretching and mobilizing most often with deep breathing. I don’t believe he even took pain medications,” Pieper says.

Once Strong’s knee was straight enough to receive a prosthesis, Pieper had him begin riding a stationary bicycle. “Within three weeks, he had progressed from level one to level ten-he maxed out the bike. Evan’s parents then bought him a road bike, and he began bicycling all over Maui, training for his first bicycle race. Soon after, he successfully competed and began his return to competitive sports.”

Now Strong competes-and wins-­in adaptive skateboarding. His success motivated him to try things he had never attempted before his amputation. He also snowboards, rock climbs, and competes against able-bodied downhill mountain bikers-and wins.

“When your mobility is threatened and then you recover some of it, you are so appreciative,” he explains. “Now I do anything and everything that I can do.”

Strong wears a Norell prosthetic socket, an Ossur VariFlex® ankle, and an Ohio Willow Wood Alpha® liner, and has no additional, specialized components. “I walk, I race downhill mountain bikes, I skateboard, I rock climb, and I snowboard using the same prosthesis. I don’t know if anything else works better, but I’ve made this one work for me.

“I really believe being disabled is a state of mind,” he concludes. “Even if you aren’t capable of doing some things, you can be your own worst enemy and cripple yourself more than you actually are.”

Norell agrees. “It’s all about attitude,” he says. “Even with 80- and 90-year-old patients with diabetes, you can’t predict who’s going to do well until they’re actually on their prosthesis and performing. Some people are just driven, and other people are not. Evan Strong is a very driven person. He’s a performer.”

Working with any active young person presents similar prosthetic challenges, says Norell. “You have to beef up their prostheses; the youngest kids break these things, and if you don’t go with acrylic lamination and carbon graphite everywhere, it’s pretty tricky.

“There are different ways to suspend, as well. You can’t just put them in a leg without supercondylar suspension. You have to lock in the knee as well because you don’t want any kind of pistoning. That would cause trauma because of their high activity level. You’ve got to consider an oversleeve, or try a bony lock, or possibly a suspension sleeve. You’re always going to shuttle lock them on the bottom, too, to prevent pistoning. I try to lock them in on the bottom and lock them in on the top.”

With a less active patient, such steps aren’t necessary, but “with someone like Evan, it’s all about function and nothing about cosmesis,” Norell chuckles. “He might be wearing an Alpha liner that’s three or four months older than it should be and needs to be replaced, but he’s going to tough it out-he’s going to duct tape his socket so he can keep going. That’s Evan.”

 

– Courtesy of OandP Edge Magazine

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