How do I strengthen my arms to prepare for a stint on crutches?

April 1, 2007 2:38 PM

How do I strengthen my arms to prepare for my fat ass being on crutches for several weeks?

After about ten months of trying to fix my screwed up ankle via physical therapy, my orthopedist has decided he wants to do some fairly complicated surgery (reconstruct a couple of tendons here, lengthen a leg muscle there, plus a couple things he added after I stopped listening). I'm currently getting a second opinion, but the bottom line is that if the surgery goes through, I'm stuck on crutches for 4-6 weeks.

A big complicating factor in all this is that I'm overweight. And not just "I need to lose a few pounds" overweight but like about 80 pounds over where I should be. Last time I was on crutches (for about a week after I initially hurt the ankle), I had no muscle tone in my arms, and I thought they were going to fall off after the first three days. Let me tell you, there is no bigger wake-up call to how fat you are than when you have to lift your entire body weight with your unmuscled arms every time you want to take a step.

The good news in all this is that I can't get the surgery until the second week of May at the absolute earliest. I'm trying like hell through diet and exercise to take off at least a little of the weight before the surgery goes down, but since there ain't no way in hell I'm losing 80lbs in a month and a half, I really need to strengthen my arms as much as possible.

I belong to a gym with a fair bit of nautilus equipment, but I'm looking for some direction in terms of what I need to be doing. I know dips are about as close to the actual movement I'll be doing as I can get, but what other muscle groups (and which machines) should I be focusing on?

There's also some free weights so if there's stuff I can be doing with those that'd be helpful, I'm certainly open to suggestions, I'm just more comfortable with the ability of the nautilus machines to force me to do the exercises right. Any help or suggestions anyone could give would be greatly appreciated.

posted by loudguitars to health (18 comments total)

A good exercise to strengthen all the muscles you will be using while on the crutches would be to practice walking with the crutches. Start slow and walk with them for more time each day.
posted by yohko at 3:20 PM on April 1, 2007

Push-ups should be a good general arm-strengthener, even if you have to start by doing them on your knees. So long as you keep your back straight and hips off the ground, you can't really do them wrong.

Here's a quickly googled-up list of stuff for your triceps, which should help you keep your arms straight when under strain. The "One-Armed Dumbell Kickback" type motion should be easy to do correctly.

If you have a pair of crutches, or can get them early, practicing with them early should also strengthen your arms before you have to rely on them.
posted by CKmtl at 3:22 PM on April 1, 2007

When I was on crutches, my chest felt completely exhausted, so it might be good to work on strengthening your pectoral muscles too. Push-ups are a good idea because they work both your triceps and chest.
posted by Jeanne at 3:53 PM on April 1, 2007

Lose weight, strengthen arms ... all good things.

But, let's face it, you're not really going to make much of a dent in six weeks.

I'd suggest you start test-driving the wide variety of crutches and walking casts to ensure you're using the best possible equipment in the best possible way, and practice with them. You can also spend time preparing the house for your period of relative immobility -- how you will shower, use the toilet, eat, drink, get dressed, etc.

Answer these questions now, and 50 percent of the problems might just go away, and then you'll be making the best use of what arm strength and mobility you will have.
posted by frogan at 4:26 PM on April 1, 2007

Here's what I'd suggest:

Do some push-ups. If push-ups against the ground are too difficult for you, you can do them against something that's at mid-chest height or even waist height.

Try doing some planks. Lie on the ground like you're going to do a pushup, but rest on your forearms. Hold for as long as you can. 30 seconds to start is good. Those will help your shoulders, your triceps, and your back muscles - all stuff you'll want to be stronger on the crutches.

Tricep dips are often, but they are really, really hard. Do they have one of those machines that helps you with assistance? You could use that to do some pull ups, chin ups and tricep dips without nearly killing yourself.

Definitely work your pecs also. You could just try one of the standard pec fly machines, but I personally think the best exercise you can do is to lie with your back on one of those large exercise balls, and grab two dumbells (not too heavy, but not too light!). Lie so that the small of your back is touching the ball, and then hold the dumbells outward in a christ pose. Then slowly bring your hands together, as though you were one of those toy monkeys clapping a pair of cymbals.

My trainer has me do this exercise called clocks that are AWESOME for practical muscle building. Take a bosu ball (one of those half exercise balls designed for balance exercises) -- and place it ball side down on the floor. Get into plank position, gripping either side of the ball. Then rotate the ball 5 times in each direction. This is really hard, but you will feel it everywhere in your upper body.

Also, as others have pointed out, do practice on the crutches as well.

Finally, just doing any weight training, in addition to diet and exercise, will up your metabolism. So keep at it!
posted by pazazygeek at 4:28 PM on April 1, 2007

Depending on how active you need to be -- a more realistic suggestion would be to look into renting a lightweight, foldable wheelchair.
posted by peace_love_hope at 4:38 PM on April 1, 2007

(Was on crutches for nearly 3 years straight after various ankle surgeries-filter:) When you're on crutches your weight should be borne by your entire upper body, not just your arms. You're not supposed to rest your armpits on the tops of the crutches; you're supposed to place the tops of the crutches about 3 inches below your armpits and squeeze them between your rib cage and upper arm. It takes some practice, because basically you have to get used to the notion of lifting yourself using your arms/neck/shoulders/back/chest, and then doing a sort of butterfly-kick where you hurl your bad leg and its side of your body forward using your stomach muscles. But if you crutch this way, it will take a lot of stress off your arms and distribute it across your entire upper body (as well as lower your risk of pinching or injuring the nerves that run through your armpits).

If I had time to prepare for more crutchin', I'd work on my shoulders and trunk muscles (i.e. chest, back, and stomach) so these larger muscles would be ready to take the load off my arms.

Another idea: you've been to physical therapy, have you talked to any of the trainers there? They'll probably have some good advice for preparing for life on crutches.
posted by holyrood at 4:43 PM on April 1, 2007

In my experience, it's the wrists that take the biggest pounding when on crutches (I've had three stints on crutches). That's where all the load seemed to be concentrated. So I'd focus on wrist curls and anything else that strengthens the forearms.

Very important not to overdo it. You don't want to get an overuse injury right before you become dependent on crutches.

Another gadget I've seen for people recovering from an injury is a very narrow cart that allows you to put one leg up, bent at the knee. Imagine a monster-truck version of a kid's scooter. You might look into that. Should be perfect for someone with a bum ankle.
posted by adamrice at 4:45 PM on April 1, 2007

What about a knee walker, like this? You put one knee on the padded rest and scoot along. It keeps the weight off your foot, but doesn't require any upper arm strength. I saw a guy using one of these in the airport this weekend, and it looked quite comfortable.
posted by MsMolly at 4:46 PM on April 1, 2007

MsMolly put a name (and picture) to exactly what I was trying to describe.
posted by adamrice at 4:50 PM on April 1, 2007

get crutches like these Instead of the Victorian era ones that go under your armpits. Those ones suck, I don't know why they even make them anymore.
posted by fshgrl at 4:54 PM on April 1, 2007

OK, that didn't work. Like these. They are called "forearm crutches".

Not only do they save your wrists but experiments tell us that one is far less likely to fall down one's stairs using them.
posted by fshgrl at 4:56 PM on April 1, 2007

The problem with anything involving wheels arises with my apartment: I live on the second floor of a building with no elevator, so I need something that will let me get up and down the stairs with (relative) ease. I've had suggestions to just move out of the apartment while I'm on the crutches but even before having to pay my share of the surgery, that's not a financially viable suggestion.

Given that, I think the forearm crutches are a good suggestion, I'll talk to my doctor about seeing if I can get my insurance to cover them.

As for the actual strengthening stuff, I'll certainly give a shot to the pushups and such, I've been doing crunches for a few months now with one of those ez-abroller things so my ab muscles are somewhat stronger. The dip machine I've been using is a seated dip, so that at least takes some of the stress level down.

They've got a weight-assisted dip but you're supposed to make it around your actual weight, and sadly the heaviest it goes is about 20 pounds lighter than my current weight. I've been doing a lot of chest and back stuff too, remembering the soreness I had in my chest after a few days of using the crutches.
posted by loudguitars at 5:39 PM on April 1, 2007

I deeply sympathize as someone who is about as overweight as you are and has been forced to use crutches for the next few weeks. I'm about a week into it, and all I can say is that your muscles will adjust after a few days. It will be incredibly tiring, but you will get by. And, when it is all over, you'll look in the mirror and see how your pecs, lats, and triceps have developed. Even though I really, really did not want surgery, it has been good for my overall health - I've lost weight (from pain and from being dependent on others to cook for me), and I've built some much needed upper body strength. My post-op leg is wasting away to nothing, but we'll deal with that later :-).
posted by sherlockt at 6:10 PM on April 1, 2007

Forearm crutches are pretty tough as well, I spent three days using them with a sprained ankle and had blisters on my hands. Get something to pad the handles, or maybe work on toughening your hands. (I have soft hands though)
posted by jacalata at 6:24 PM on April 1, 2007

There's also this hands-free crutch: iWALKFree

(Essentially a platform that you rest you knee on with a "peg-leg" beneath)

I've never used one, or even seen one in use, but it always looked like something that would be useful if I had an ankle or foot injury.
posted by ShooBoo at 7:37 PM on April 1, 2007

I just have to say that both the Knee Walker and the iWalkFree are awesome, and I totally wish I had come to AskMe when I was laid up with an ankle injury a while back.

I am very klutzy and had trouble with crutches, so I only used them for a few days. After that my arms started to get used to it, but I probably could've used some push-ups and tricep exercises to get ready. After that, I used a lace-up ankle brace with a rigid shoe, which was ever so sexy, and a cane. Will you need to be on crutches the entire time?
posted by bedhead at 9:09 PM on April 1, 2007

Wow, that iWalkFree thing looks awesome. My only concern is its load limit, but hell, I've gotta look into that, it looks like it'd be a LOT easier than crutches.

4-6 weeks was the length of time I was given as "non weight-bearing", which for all intents and purposes means crutches or some other method of putting zero weight on the ankle.
posted by loudguitars at 8:57 PM on April 1, 2007