Prosthetic Fit - If the leg fits, wear it!

This post is for the millions of amputee readers I have....  it may be of some interest to non-amputees but it might also bore you to tears.  If it is the latter I do apologize...

Prosthetic Fit

Your prosthesis should fit nicely - great function without pain is the goal.  Why then do we spend days, weeks, months and sometimes years accepting a less than ideal fit?

REASONS

 "I don't want to be too much of a pain in the @ss to my prosthetist."

 "I need to adjust to the socket."

"My limb is changing.  I might as well wait."

"I lost a limb - nobody said it would be all roses."

"Maybe this is as good as it gets."

"Maybe if I put more cream/vaseline etc. on the spot it will go away."

These are a few of the reasons I have put up with pain for longer than I should have.  None of them is particularly valid.  I have learnt over the years that I can reasonably expect a VERY high quality of service from my prosthesis.  When everything is perfect with my leg I don't think about it at all...  and I can push it to some pretty exciting places on the activity chart.

So then, what do I do when the fit is less than ideal?

The first thing is to realize it.  This sounds obvious but it is often the hardest part.  Often my fit will deteriorate so gradually that I won't notice until it is WAY off.  This process can, and often does, take months.  Try to pay attention and when others say "Hey are you limping?" or "Hey are you limping more?"  think hard about it.  Are you?  Probably.

Then I try to figure out why things are off.  I look for red areas on my limb after wearing the prosthesis for a few hours.  I do some rudimentary leg length measurements to see if I am in too deep or wearing too many (or few) sock ply.

Often I can figure out what is going on this way.  Part of this is experience - after you duff your foot on the ground for the thirtieth time you remember, "Hey the last time I did this I was wearing too many socks!"

Often hot spots or sensitive areas will develop when my prosthetic socks get a bit too old.  They don't have the same fluff-factor (thickness) as they did when they were new.  That means 5 ply = 4 (or maybe 3.5) either way it will very gradually start to fit wrong and hurt.

Skin problems will more than likely be the symptom that first alerts you to an issue.  It is important to know the difference between a skin problem that is a symptom of a bad fit and one that is a symptom of life...  i.e. super-red painful areas where there is some binding = bad fit.  Sudden red inflamed areas can be an ingrown hair or other issue....  experience will help you to figure out the difference.  You can read my post on skin problems for help.

I like to exhaust my own ideas before I trouble my prosthetist.  This is not because it is so much trouble for him, but because it is trouble for me too.  It's a whole lot better for everyone if I can learn to diagnose a bad fit and try a few things to relieve it.

If that doesn't work though, you can bet his phone will be ringing.  I tell him the issues and get some input from him.  Sometimes I will have been doing exactly the wrong thing to try to fix it - thus exacerbating the situation....  hey, at least I tried!

Nine times out of ten he can instruct me and I will not require any actual work to be done on the prosthesis.  Sometimes, I have decided that a new socket is the answer...  these decisions are yours and his/hers to make together.  In my experience the prosthetist should be willing to exhaust himself trying to make it fit.  There should be no limit to the number of adjustments he is willing to make in order to help you with your fit. 

The prosthetist should also be willing (and able) to teach you everything you need to know about your leg.  There are numerous small adjustments you can make yourself on most legs if you know how.  It isn't difficult and you shouldn't be afraid to ask.

Once I have a new socket I like to test it extensively in the first few days.  

- If it is a running leg - I run.  

- If it is a walking leg - I play golf.  The golf course is perfect for testing out legs - 6 miles of walking - uphill, downhill, sidehills, rough terrain (where my ball always is), flat terrain etc.  You know if the leg fits after walking the course.  (Note:  If you are a new amputee you will want to pick a challenge that is a bit less demanding - but use the same theories.)

Ultimately, I feel that you should "expect" comfort and function that will allow you to do the things you want to do in your life.  You should also "expect" that it won't always be easy...  There WILL be problems and you will need to get as good as you can at diagnosing them and working with your prosthetist to establish a great fit and maintain it.  Like almost everything in life it will get easier with experience and time. 

If anyone ever needs advice or to ask a question please leave a comment or drop me a line at: 

meyrick@meyrickjonesracing.com

Cheers!

P.S.  If this helped you please leave a comment - it feels good to help!

 

Tweet this!