MEET THE PHYSICIANS: DICKSON - DIVELEY ORTHOPAEDICS, PART I

DICKSON - DIVELEY ORTHOPAEDICS
3651 College Boulevard
Leawood, Kansas 66211
and
St. Luke's Medical Campus: Medical Plaza Building 1
4321 Washington Street, Suite 610
Kansas City, Missouri 64111
(913)-319-7600

Please note all information listed below is the most current information on the physicians' clinic websites. Any incorrect information is not the responsibility of Champion Performance and Physical Therapy, but we'd like to get the information corrected immediately. Please contact us with any changes at 913-291-2290. We do not accept submissions of change to any information listed below without a valid NPI number. 

Timothy Badwey, MD

Focus is the ankle and foot, with emphasis on conservative treatments of disease and injury, both surgical and non-surgical, ankle arthroscopy, sports-related injury, and achilles tendon injury. 

Mark Bernhardt, MD

Focus is the spine, cervical through sacral. Dr. Bernhardt specializes in spinal surgery for a wide variety of conditions and injuries, including scoliosis. He also performs many surgical correctional procedures involving fusions and instrumentation.

Stanley Bowling, MD

Focus lies within fracture care and orthopaedic trauma for the entire lower extremity, as well as the shoulder. Dr. Bowling has a blog of his own, providing information ranging from post-injury care to procedures he specializes in, that is accessible through the Dickson-Dively website (as to many of the other surgeons!)

Brian Divelbuss, MD

Focus lies within the upper extremity, with special emphasis on the hand. His specialties, however, remain within the distal portion of the upper extremity, in the hand, wrist, and elbow. Dr. Divelbuss is the current President and CEO of Dickson-Diveley Orthopaedics, and carries a reputation that treatment paired with education most often results in a successful procedure and recovery. 

Constantine L. Fotopoulos, MD

As an interventional physiatrist, his focus lies within minimally-invasive, interventional procedures for the treatment of spinal disorders, although he does treat general orthopaedic pain in the shoulder, knee, and hip pain, as well as the neck and back. Some of his specialties include epidural injections, vertebroplasty, kyphoplasty, and spinal cord stimulation.  Dr. Fotopoulos also has extensive knowledge in hyperbaric and diving-related injuries, as well as past experience with athletic injuries due to professional ties with the Kansas City Explorers tennis team, a former KC Royals Team Physician, and the State of Missouri Mixed Martial Arts Physician. He is fluent in english and greek, and proficient in basics of Italian, Russian, Spanish, and Arabic. 

Robert Gardiner, MD

Focus lies within the hip and knee, as he's been performing hip and knee total joint replacements for over 20 years. Dr. Gardiner does have expertise in treating athletic injuries, as well, as he served as the Team Physician for the KC Blades hockey team from 1992-2001. 

Danny Gurba, MD

Focus lies within the hip and knee, with emphasis on total joint replacement procedures. Dr. Gurba himself reports spending 95% of his clinical and surgical time between the hip and knee. Dickson-Diveley reports that Dr. Gurba has performed over 9,000 hip and knee replacements throughout his career with them. 

James Halloran, MD

Focus lies within diagnosis and treatment of conditions, deficits, and defects of the distal joints in the lower extremity, including the knee, ankle, and foot. Dr. Halloran has completed fellowships in both foot and ankle surgery, as well as sports medicine which has lead to his extensive knowledge of repair and reconstruction possibilities for a wide array of circumstances. This combination lead to his professional ties with the Detroit Pistons (NBA), the Detroit Red Wings (NHL), the Detroit Tigers (MLB), and the Duke University Men's Soccer team, all prior to relocating back to Kansas City.  

For more information, please visit https://www.dd-clinic.com

A newer blog segment called MEET THE PHYSICIANS provides general focus information of some of the best, and most prominent orthopedic clinics in the Kansas City metro area, respectively. From these clinics, a number of their most prominent surgeons refer to us here at CHAMPION Performance and Physical Therapy. 

RUNNING IN THE RAIN

Since Kansas City is one good rain short of drowning, we figured there's no better time than now to post a few tips as far as being smart when running in the rain.

Many avid runners don't find running in harsher weather conditions to be intimidating, and casual walkers, joggers, and runners are more likely to head outside in the rain when the weather warms back up in the spring and summer. Don't get me wrong - a few of us are all about it, too. We just want to make sure we can help you to stay safe and prevent situations or injuries the rain will increase when you hit the road, outdoors.

1. Wear Your Neon!

On the rainier days, neon is especially important for drivers on the road to see you. Visibility is almost as low as when it's dark outside, but car brakes have a higher flaw ratio when conditions are anything less than perfect.  Bright colors will just help to ensure drivers see you in time to make adjustments and accommodations to runners and bikers.

2. Compression Is Best

If you're not wearing running leggings, wear compression shorts underneath your running shorts.  Not only do they help to maintain body temperature, but they're also great to help wet thighs avoid chafing. 

3. Seal Your Electronics ---

Use workout gear with sealed, zipper pockets, to keep your phone or ipod directly out of the rain. However, since most zipper pockets may not completely keep the water out, you can always put your phone in a plastic bag or plastic wrap, or even find yourself a waterproof case. They're more expensive than a typical case, but I'm sure you'll get more use out of it than just running in the rain (dropping phones in the bathroom, in lakes/pools, etc.)

4. CHECK YOUR SHOES!!!

Take a look at the bottom of the running shoes you're planning to wear. If you've had them for a long time, or they've acquired milage from running on treadmills from over the winter, the tread may be worn down to the point that they no longer have any useful amount of traction. This isn't typically a big problem when it's dry outside, but it does add a significant increased risk of injury in the rain. Use some shoes that have more tread on them to avoid slips, falls, or other injuries.

5. Adapt Your Workout

Firstly, don't plan on beating your personal best when it's raining. Harsh weather conditions can considerably decrease your speed - even if you don't realize it. More importantly, increase your stride rate. If you're one to run with longer strides or you have longer legs, try your best to shorten your stride to decrease your time on a slippery surface. 

6. DO. NOT. RUN. WHEN. IT'S. STORMY.

Rain is one thing, storms are completely different. Water is an electric conductor, and the risk of dangers to your health increase when lightning is near. Make sure to check radar to ensure it's only rain coming in your direction, not hail or lightning. 

INTERACTIVE MODULES: CARPAL TUNNEL RELEASE

Another new segment we're starting on Wednesday's for the Blog for the next few weeks is an interactive learning module.  The American Academy of Orthopedic Surgeons posts interactive learning modules to walk you through the process of surgeries from diagnosis to post-operative care.  Keep in mind, it is very general information and every case is different. Some doctors use different approaches than others, and have more conservative rehabilitation protocols. 

Attached below is the link to copy and paste into your URL address box for the Carpal Tunnel Release Interactive Module.

http://orthoinfo.aaos.org/icm/default.cfm?screen=icm002_s01_p1

Enjoy! (And you know where to come for therapy)

MEET THE PHYSICIANS: THE UNIVERSITY OF KANSAS

The University of Kansas
Sports Medicine and Performance Center
10730 Nall Avenue, Suite 200
Overland Park, Kansas 66211

Please note all information listed below is the most current information on the physicians' clinic websites. Any incorrect information is not the responsibility of Champion Performance and Physical Therapy, but we'd like to get the information corrected immediately. Please contact us with any changes at 913-291-2290. We do not accept submissions of change to any information listed below without a valid NPI number. 

Randall Goldstein, DO

Focus lies within sports medicine, both operative and non-operative, specifically pediatric and gymnastics. Dr. Goldstein is one of the most highly renown pediatric, sports medicine physicians in the Kansas City Metro. He also practices at The University of Kansas Hospital Training Complex for Sports Medicine as a team physician for the Kansas City Chiefs and Royals. 

Vincent Key, MD

Focus lies within sports medicine, specifically for adults.  While he is classified as a general orthopaedic surgeon, Dr. Key specializes in arthroscopic procedures involving the shoulders and knees. He also practices at the Renner Road location, as well as The University of Kansas Hospital Training Complex for Sports Medicine.

Scott Mullen, MD

Focus lies within sports medicine, as well as general orthopaedic, arthroscopic surgery of the shoulder, knee, and hip. Dr. Mullen also has a sports medicine focus in gymnastics, along with his colleague, Dr. Goldstein.  According to our patients, his arthroscopic reconstructions have made him one of the best in the city!

Stephen Munns, MD

Focus lies within sports medicine, and although he is board certified as a general orthopaedic surgeon, most often performs both, arthroscopic and reconstructive procedures of the shoulder and knee.  His daughter was a student at our clinic this past Spring of 2016!

Joshua Nelson, MD

Focus lies within general orthopaedic surgery and sports medicine, both arthroscopic and reconstructive. While he performs multiple procedures on both the shoulder and knee, he also performs procedures on the general upper extremity (including the elbow.) While many of Dr. Nelson's patients are adults, he does perform pediatric orthopaedic procedures. He also practices both, at Arrowhead Stadium and The University of Kansas Physicians Medical Office Building on Rainbow Road at the main hospital campus. 

Joseph Noland, MD

Focus lies within sports medicine non-operative care, with specialities in musculoskeletal pain, adolescent medical disorders, and preventative medicine. Dr. Noland practices primarily at the Renner Road location, both as a specialist and primary care, family physician. 

J. Paul Schroeppel, MD

Focus lies within general orthopaedic, sports medicine surgeries, with specialties in both the upper and lower extremity, pediatric and adult procedures.  His common surgical procedures include arthroscopic and reconstructive methods on the shoulder, elbow, hip, and knee. Dr. Schroeppel also practices out at Arrowhead Stadium, at The University of Kansas Hospital Training Complex. 

David Smith, MD

Focus lies within sports medicine, non-operative, orthopaedic care.  Dr. Smith is a family practitioner, with emphases in concussions in athletes, as well as health, wellness, and preventative medicine.  Dr. Smith also practices out at Arrowhead Stadium at the Training Complex.  

Lucas Thompson, MD

Focus lies within medical and non-operative orthopaedic sports medicine. Dr. Thompson conducts stress testing and impact concussion testing with athletes.  His only practice location is at The University of Kansas Hospital Training Complex at Arrowhead Stadium. 

Bruce Toby, MD

Focus lies within the upper extremity, specifically microsurgeries. Microsurgery is a surgical subspecialty requiring a microscope. Dr. Toby's procedures include operations ranging from the general orthopaedic upper extremity (hand and elbow), to microvascular, to peripheral nerve surgical procedures. He currently only practices at The University of Kansas Physicians Medical Office on the main hospital campus. 

For more information, please visit http://sportsmedicine.kumed.com/our-providers

A newer blog segment titled MEET THE PHYSICIANS provides general focus information of some of the best, and most outstanding orthopedic clinics in the Kansas City metro area, respectively. From these clinics, a number of their most prominent surgeons refer to us here at CHAMPION Performance and Physical Therapy. 

IS YOUR INSURANCE IN - NETWORK?

Rolling off that post last Thursday regarding the differences between copays, deductibles, and co-insurance, we go to the next aspect of it that affects certain patients at Champion Performance and Physical Therapy directly: whether we are in-network with your insurance, or out.

In-Network essentially means this clinic (or any doctor's office) has signed a contract with your insurance.  We abide by their rules as far as scheduling and charging for your visit, and they allow patients to utilize their in-network benefit coverage to see us here. Whether or not we are in-network with your insurance is generally determined by whether or not we have the demand for in-network benefits.  If we have enough patients with a certain insurance we are out-of-network with, we'll look into become a so-called "member" of that insurance, or becoming an in-network clinic. 

The reason it's appealing to use in-network is because it is almost always cheaper for the consumer, or in this case, the patient. The deductible for in-network plans are lower, as are out-of-pocket maximums, etc.; both for individual and family plans.

Insurances allow patients to utilize their out-of-network coverage as freely as they do their in-network coverage, but because the deductibles/co-insurances/out-of-pocket maximums are so much higher, it makes more sense for the patients to attempt to locate an in-network provider, instead.

Out-of-Network is more likely to occur with some insurances that may be private, less common, or small, compared to the big-name, widely-renown groups such as Blue Cross or United HealthCare.  A part of membership for providers may require either extensive paperwork, or monthly fees from the provider; which can also lead them to remain out-of-network, despite the demand from their patient demographics. 

How do you know if you have in-network or out-of-network coverage, at all?

You'll call that same customer service line on your insurance card. Many plans include out-of-network coverage, but some do not. Those plans will have lower premiums, and the deductibles can vary from far below average to way above average. 

Keep in mind: having only out-of-network coverage at a specific clinic does not necessarily mean they do not accept your insurance. 

Some clinics, including us, accept certain forms of out-of-network coverage. While we can't speak for other clinics, we, here at Champion Performance and Physical Therapy, will do what's called "match your in-network benefits." 

What this essentially means is, while we are not in-network with your insurance, we will do you a favor and go based on your in-network benefits, instead of your out-of-network.

For example: your in-network deductible is $1000, but your out-of-network deductible is $2000. We will abide by your $1000 deductible, as opposed to the latter. The same goes for co-insurance and co-pay. 

Why do we do this, you ask? 

In some cases, it may be a smarter business decision in the long run with certain plans or insurances. We may not have the demand for that insurance to become in-network, or the plan itself would not benefit the patient or the provider as much as it would in-network. However, our belief in the relief physical therapy here at Champion provides, means we want to open our doors to as many individuals as possible - basically we do it because we don't want your insurance to get in the way of a healthy rehabilitation with us. We urge you to contact our clinic location at 913.291.2290 - and we'll do our best to walk you through this process as you start therapy with us, as well as ensure that you're getting the best "bang for your buck!"

Please note: we accept almost all plans from most major insurances, including: Aetna, Blue Cross Blue Shield, Medicare, UnitedHealthCare, Humana, and more.  Call for more information regarding whether or not we accept your insurance, or specific plan. 

INTERACTIVE MODULES: KNEE REPLACEMENTS

Another new segment we're starting on Wednesday's for the Blog for the next few weeks is an interactive learning module.  The American Academy of Orthopedic Surgeons posts interactive learning modules to walk you through the process of surgeries from diagnosis to post-operative care.  Keep in mind, it is very general information and every case is different. Some doctors use different approaches than others, and have more conservative rehabilitation protocols. 

Attached below is the link to copy and paste into your URL address box for the Knee Replacement Interactive Module.

http://www.orthoinfo.org/icm/default.cfm?screen=icm005_s01_p1

Enjoy! (And you know where to come for therapy)

MEET THE PHYSICIANS: KANSAS CITY BONE AND JOINT

Kansas City Bone and Joint
A Division of Signature Medical Group of KC, PA
10701 Nall Avenue, Suite 200
Overland Park, Kansas 66211

& check out their website listed at the bottom of this blog post for the address to their newest location in Lee's Summit

Please note all information listed below is the most current information on the physicians' clinic websites. Any incorrect information is not the responsibility of Champion Performance and Physical Therapy, but we'd like to get the information corrected immediately. Please contact us with any changes via phone at 913-291-2290 or via email at admin@kcchampionperformance.com. We do not accept submissions of change to any information listed below without a valid NPI number. 

Robert Bruce, MD

Focus lies within sports medicine, and arthroscopy of the shoulder and knee, as well as total knee replacements and anterior-approach total hip replacements. Dr. Bruce is affiliated with St. Thomas Aquinas High School, Shawnee Mission East High School, and Shawnee Mission South High School. Dr. Bruce was also the orthopaedic surgeon associated with the Kansas City Ballet from 1996 - 2007. 

Thomas Samuelson, MD

Focus lies within sports medicine, specifically shoulders and knees. Dr. Samuelson has history with athletic teams across Kansas City; including Baker University, UMKC, Kansas City Comets, and Kansas City Attack soccer teams. He is currently the team physician for Rockhurst High School. Dr. Samuelson has performed shoulder and knee surgeries on one of our own Champion Performance and Physical Therapy family members!

Gerald McNamara, MD

Focus lies within sports medicine, as well as general orthopaedic surgery. While he does specialize in the lower extremity, including the hips and knees, he also does upper extremity, as well. Dr. McNamara performed shoulder/collar bone surgery on our very own Hope Hillyard!

Atul Patel, MD, MHSA

Focus lies within musculoskeletal medicine and rehabilitation, as well as neuropathic medicine, with subspecialties in spasticity and movement disorders, such as Parkinson's disease and MS. Dr. Patel is also board certified in other aspects of injury or disease, including spinal cord medicine and brain injury medicine. 

Jeffrey Salin, DO

Focus lies within the lower extremity, specifically the hip and knees. Dr. Salin is another member of Kansas City Bone and Joint who performs the minimally-invasive anterior-approach total hip replacement, and is always looking into more efficient, successful techniques and devices via an endless database of literature to keep his practice on the cutting edge of musculoskeletal science. Dr. Salin also had the opportunity to practice under Dr. Lombardi prior to joining Kansas City Bone and Joint in 2007. 

J Clinton Walker, MD

Focus lies within sports medicine, as well as the upper extremity, with subspecialties in the hand and elbow.  While Dr. Walker has patients all across the board, age-wise, he does hold a special interest in those athletically-related cases, as he was a collegiate baseball player, himself!

Suzanne Elton, MD

Focus lies within the upper extremity, with subspecialties in the hand, wrist, and elbow. Dr. Elton's clinical specialties include microsurgery; or the practice of complex surgeries within a small space requiring the use of a microscope. Her surgical specialties include, but are not limited to: endoscopic carpel tunnel surgery, arthritis of the hand and wrist, and the treatment of tennis elbow. 

For more information, please visit www.kcbj.com

A newer blog segment called MEET THE PHYSICIANS provides general "focus" information of some of the best, and most prominent orthopaedic clinics in the Kansas City metro area, respectively.  From these clinics, a number of their most widely-renown surgeons refer to us here at CHAMPION Performance and Physical Therapy. 

INTERACTIVE MODULES: HIP REPLACEMENTS

Another new segment we're starting on Wednesday's for the Blog for the next few weeks is an interactive learning module.  The American Academy of Orthopedic Surgeons posts interactive learning modules to walk you through the process of surgeries from diagnosis to post-operative care.  Keep in mind, it is very general information and every case is different. Some doctors use different approaches than others, and have more conservative rehabilitation protocols. 

Attached below is the link to the Hip Replacement Interactive Module.

http://orthoinfo.aaos.org/icm/default.cfm?screen=icm001_s01_p1

Enjoy! (And you know where to come for therapy)

MEET THE PHYSICIANS: CARONDELET ORTHOPAEDICS

CARONDELET ORTHOPAEDIC SURGEONS
A Division of Signature Medical Group of KC, PA
10777 Nall Avenue, Suite 300
Overland Park, Kansas 66211

Please note all information listed below is the most current information on the physicians' clinic websites. Any incorrect information is not the responsibility of Champion Performance and Physical Therapy, but we'd like to get the information corrected immediately. Please contact us with any changes at 913-291-2290. We do not accept submissions of change to any information listed below without a valid NPI number. 

David Clymer, MD

Focus lies within total joint arthroplasty, sports medicine, and spine (pediatric and adult). A notably conservative surgeon, Dr. Clymer emphasizes the exhaustion of non-surgical treatment options prior to resorting to surgery. 

Scott Luallin, MD

Focus lies within sports medicine, Carticel knee implantations, and total hip replacements.  Dr. Luallin is also the medical team director for Sporting Kansas City, and has been since the team's inauguration in 1996.

Greg Van den Berghe, MD

Focus lies within sports medicine, as well as the shoulder.  Dr. Van den Berghe is a Master Instructor of Arthroscopy at the Orthopaedic Learning Center in Chicago, IL. 

Matthew Kneidel, MD

Focus lies within the foot and ankle, as well as general orthopedic surgery.

Valerie Deardorff, MD

Focus lies within the finger, hand, and wrist.

Scott Abraham, MD

Focus lies within total joint replacement, sports medicine, as well as fracture management.  While Dr. Abraham is a general orthopedic surgeon, he also uses Verilast technology; an advanced bearing surface for knee and hip replacement surgery. 

Jenny Chandra, MD

Focus lies within rehabilitation of the neck and back, as well as an emphasis in migraine management.  Dr. Chandra is also involved in the conduction of EMG/nerve conduction research studies. 

Michael Khadavi, MD

Focus lies within non-operative spinal intervention and musculoskeletal treatment, but is most prominently known for his musculoskeletal subspecialty in the biomechanics of running medicine. Dr. Khadavi is the director of sports and running medicine at Carondelet Orthopaedics, and has implemented a running injury management and prevention program titled RunSafe. 

For more information, visit www.c-ortho.com

A newer blog segment called MEET THE PHYSICIANS provides general focus information of some of the best, and most prominent orthopedic clinics in the Kansas City metro area, respectively. From these clinics, a number of their most prominent surgeons refer to us here at CHAMPION Performance and Physical Therapy. 

AMBULATION AIDS

If you break a bone in your leg or foot, have a procedure on your knee or lower leg, or suffer a stroke, your doctor may recommend that you use a walking aid while you are healing or recovering. Using crutches, a cane, or a walker can help keep your weight off your injured or weak leg, assist with balance, and enable you to perform your daily activities more safely. Keep in mind: it's best that you talk to your surgeon and their staff, as well as your physical therapist for actual training. These are just helpful notes to help you remember when you get home. 

When you are first learning to use your walking aid, you may wish to have a friend or family member nearby to help steady you and give you support. In the beginning, everything you do may seem more difficult. With just a few tips and a little practice, though, most people are able to quickly gain confidence and learn how to use a walking aid safely.

Make Your Home Safer

Making some simple safety modifications to your home can help prevent slips and falls when using your walking aid:

• Remove throw rugs, electrical cords, food spills, and anything else that may cause you to fall.
• Arrange furniture so that you have a clear pathway between rooms.
• Keep stairs clear of packages, boxes, or clutter.
• Walk only in well-lit rooms and install a nightlight along the route between your bedroom and the bathroom.
• In the bathroom, use nonslip bath mats, grab bars, a raised toilet seat, and a shower tub seat.
• Simplify your household to keep the items you need within easy reach and everything else out of the way.
• Carry things hands-free by using a backpack, fanny pack, or an apron with pockets.

Crutches

If you are unable to bear any weight on your leg or foot, you may have to use crutches.

If your injury or surgery requires you to get around without putting any weight on your leg or foot, you may have to use crutches.

Proper Positioning

• When standing up straight, the top of your crutches should be about 1-2 inches below your armpits.
• The handgrips of the crutches should be even with the top of your hip line.
• Your elbows should be slightly bent when you hold the handgrips.
• To avoid damage to the nerves and blood vessels in your armpit, your weight should rest on your hands, not on the underarm supports.

Walking

Lean forward slightly and put your crutches about one foot in front of you. Begin your step as if you were going to use the injured foot or leg but, instead, shift your weight to the crutches. Bring your body forward slowly between the crutches. Finish the step normally with your good leg. When your good leg is on the ground, move your crutches ahead in preparation for your next step. Always look forward, not down at your feet.

Sitting

To sit, back up to a sturdy chair. Put your injured foot in front of you and hold both crutches in one hand. Use the other hand to feel behind you for the seat of your chair. Slowly lower yourself into the chair. When you are seated, lean your crutches in a nearby spot. Be sure to lean them upside down—crutches tend to fall over when they are leaned on their tips.

To stand up, inch yourself to the front of the chair. Hold both crutches in the hand on your uninjured side. Push yourself up and stand on your good leg.

Stairs

To walk up and down stairs with crutches, you need to be both strong and flexible. Facing the stairway, hold the handrail with one hand and tuck both crutches under your armpit on the other side. When you are going up, lead with your good foot, keeping your injured foot raised behind you. When you are going down, hold your injured foot up in front, and hop down each step on your good foot. Take it one step at a time. You may want someone to help you, at least at first. If you encounter a stairway with no handrails, use the crutches under both arms and hop up or down each step on your good leg, using more strength.

If you feel unsteady, it may be easier to sit on each step and move up or down on your bottom. Start by sitting on the lowest step with your injured leg out in front. Hold both crutches flat against the stairs in your opposite hand. Scoot your bottom up to the next step, using your free hand and good leg for support. Face the same direction when you go down the steps in this manner.

Top of page

Canes

A cane can help if you have minor problems with balance or stability or weakness in your leg or trunk.

©Thinkstock, 2015

A cane can be helpful if you have minor problems with balance or stability, some weakness in your leg or trunk, an injury, or a pain. If you are elderly, using a single point cane may help you to walk more comfortably and safely and, in some cases, may make it easier for you to continue living independently.

Proper Positioning

• When standing up straight, the top of your cane should reach to the crease in your wrist.
• Your elbow should be slightly bent when you hold your cane.
• Hold the cane in the hand opposite the side that needs support. For example, if your right leg is injured, hold the cane in your left hand.

Walking

To start, set your cane about one small stride ahead of you and step off on your injured leg. Finish the step with your good leg.

Stairs

To climb stairs, place your cane in the hand opposite your injured leg. With your free hand, grasp the handrail. Step up on your good leg first, then step up on the injured leg. To come down stairs, put your cane on the step first, then your injured leg and then, finally, your good leg, which carries your body weight.

Walkers

If you have had total knee or total hip replacement surgery, or you have another significant problem, you may need more help with balance and walking than you can get with crutches or a cane. A pickup walker with four legs will give you the most stability. A walker lets you keep all or some of your weight off of your lower body as you take steps. With a walker, you use your arms to support some of your body weight. As your strength and endurance get better, you may gradually be able to carry more weight in your legs.

Positioning

• When standing up straight, the top of your walker should reach to the crease in your wrist.
• Your elbows should be slightly bent when you hold the handgrips of the walker.
• Keep your back straight. Don't hunch over the walker.
• Check to be sure the rubber tips on your walker's legs are in good shape. If they become uneven or worn, you can purchase new tips at a drug store or medical supply store.

Walking

First, position your walker about one step ahead of you, making sure that all four legs of the walker are on even ground. With both hands, grip the top of the walker for support and move your injured leg into the middle area of the walker. Do not step all the way to the front. Push straight down on the handgrips of the walker as you bring your good leg up so it is even with your injured leg. Always take small steps when you turn and move slowly.

Sitting

To sit, back up until your legs touch the chair. Use your hands to feel behind you for the seat of the chair. Slowly lower yourself into the chair.

To stand up, push yourself up using the strength of your arms and grasp the walker's handgrips. Do not pull on or tilt the walker to help you stand up.

Stairs

Never climb stairs or use an escalator with your walker.