If this is your first prosthesis, the only constant is change. The socket that felt comfortable twenty-four hours earlier is likely to feel different. You are experiencing pressure in areas where there was none previously. Why does this happen? Because your residual limb changes as you use your new prosthesis.
Specifically, all of the post-surgical swelling in your limb will lessen as you continue to wear the prosthesis. At the same time, muscles that may have atrophied as a result of your relatively inactive post-surgical lifestyle will begin to grow again. These factors change the way your prosthesis fits from day to day, and in some instances, from hour to hour. You can expect these changes to lessen over time. Most patients’ residual limbs stabilize three to six months after receiving their first prosthesis. Once this happens, the prosthetist will begin fitting you with a new inner socket (commonly called a “permanent” socket) that better fits your changed limb.
Even if you have been wearing a prosthesis for years, delivery of a new device necessitated by normal maturational changes to your residual limb undergoes an adjustment period. While your limb does not change shape as dramatically as a new amputee’s, you still need time to acclimate to the new fit, which often shifts pressure to different parts of your anatomy.
An important part of successful post-delivery rehabilitation depends on your ability to effectively communicate what you are feeling while wearing the prosthesis. If you are experiencing poking, pinching, irritation, pressure, or skin breakdown, we need to know. We cannot help you if we are unaware that there is an issue!
This is not to say that wearing a prosthesis is always a comfortable, problem-free process. Especially as a new amputee, there is a certain degree of discomfort that you will experience as your body adapts to bearing weight on soft tissue and bony areas that never had to before. However, the more you wear your prosthesis, the shorter this transition period will be. In addition, close communication with the prosthetist can lead to suggestions and adjustments that help minimize both the duration and intensity of discomfort.
DO NOT EVER MAKE ANY ADJUSTMENTS TO YOUR PROSTHESIS YOURSELF! A prosthesis is a sophisticated device that requires professional training and extensive experience to safely modify. Acting as your own prosthetist places you at significant risk for serious bodily injury, voids applicable manufacturers’ warrantees, and potentially exposes you to significant out-of-pocket expenses for any repairs/replacements that need to be made as a result. If you are experiencing problems, make sure to contact your prosthetist for a safe and effective remedy.
Following the delivery of your prosthesis, subsequent visits will focus primarily on continued gait training, socket adjustments, and alignment adjustments. Intensive physical therapy with a qualified physical therapist may begin as early as the day of delivery of your prosthesis.
The importance of physical therapy cannot be overstated. A physical therapist will help you regain strength, improve balance, improve cardiovascular endurance, teach you how to use your prosthesis on steps, ramps, and uneven terrain, how get up and down from the floor, and teach you how to be safe in many different situations and physical environments. Research shows that amputees require dramatically more energy to walk at even half the speed of able-bodied individuals. Therefore, an aggressive gait training program as well as aggressive stretching, strengthening, and a cardiovascular program is an important part of your rehabilitation. These activities permit your heart and lungs to operate more efficiently, permitting you to wear and use your prosthesis longer without getting as tired as you otherwise would. If you have other medical issues that make this type of physical therapy regimen impractical, we will speak with your doctor to design a program that is appropriate for you.
At A Step Ahead, we know that successful outcomes require more than a good prosthesis and basic gait training. A comprehensive, multi-disciplinary approach to patient care that includes high quality physical therapy provides patients the best opportunity to achieve their functional goals.
Whether your goal is to be able to walk your dog down the block or complete a triathlon, your access to the experience and expertise both of our prosthetic staff and the referrals to the appropriate therapy will help you reach your goals.