At the end of 2008, I needed a few extra continuing ed credits, so I decided to take one of the inaugural RCR courses at Northwestern University organized by OPGA. Two days before I left for Chicago, OPGA called to let me know that one of their “hands on participants” had cancelled, and they were looking for a volunteer to take the spot. I must admit, my first thought was “no,” but I realized that the worst that could happen was to fail miserably so I took the spot and have not looked back since.
Dale Perkins, CPO with Rehab Systems in Boise, ID challenged my conventional thinking as well as historical perspective of transtibial socket design with the development of the RCR socket. The socket design is a result of challenges he experienced by putting a patellar bar in his own prosthetic socket. Dale underwent a closed femoral shortening on his limb to even his knee center, as well as to get a better foot under his socket. One of the unintended consequences of the femoral shortening was that the quadriceps were now long, which meant he had to undergo quadriceps strengthening. He had no issues in his socket at the time of the surgery, however, as he gained strength, he realized his patellar tendon was starting to bother him. He evaluated his socket and decided to remove the bar and essentially relieved the tendon. He found that once the tendon was relieved, he was able to continue strengthening his quadriceps. He also found that he was getting more extension than he had previously achieved with the bar. With the added normal extension moment he was getting at midstance, his gait pattern improved as well.