Author Archives: Alec McMorris

The 9 Stages of Post-Amputation Physical Therapy & Prosthetic Training

Losing a limb can be incredibly traumatic, and can affect a person both physically and mentally. New amputees don’t just have to manage their grief over their lost limb, but will also have to relearn how to do things that might have been second nature to them. Undergoing an amputation is a life-changing experience, but with the help of modern prosthetics, a seamless rehabilitation is not just possible, but highly achievable.

Over 2 million people live with limb loss in the U.S, and this number is expected to double by 2050 due to the rising prevalence of diabetes and vascular disease. Apart from disease, amputations can be caused by trauma, cancer, or congenital disorders. The majority of amputations are in the lower extremity, which makes physical therapy extremely important during the rehabilitation process.

What Is Amputation Rehabilitation?

Losing a limb, especially a lower limb, will severely impact a person’s mobility and ability to perform daily activities. These obstacles can create a lot of mental stress, as the amputee may feel isolated and unable to easily reintegrate into society. The goal of amputation rehabilitation is to facilitate the recovery of the amputee with prosthetic training so they can return to their lives.

Due to the different hurdles a new amputee faces after their surgery, it’s necessary that amputation rehabilitation is done with a multidisciplinary team. Rehabilitation teams will usually have a physiotherapist in charge, and may include a prosthetist as well to ensure that the prosthesis fitting and training goes smoothly.

Phases of Amputation Rehabilitation

Amputation rehabilitation can be a long and arduous process involving an entire team dedicated to the patient to ensure that they return to a high level of social integration. Amputation rehabilitation typically has nine stages, although certain phases may not be standardized.

Similarly, not everyone will go through the rehabilitation process in the same way—people experience different milestones at different moments in their recovery depending on several factors such as the cause of limb loss, their rehabilitation team, support systems, and more.

1.   Pre-Operative Phase

The pre-operative phase primarily focuses on educating the patient and preparing them for the journey of recovery. This phase is important for those who are facing limb loss due reasons that do not involve accidents or trauma, which require instant treatment. It is important for the doctor or rehabilitation team to take this time to explore patient expectations, and reinforce rational expectations while providing clarity for false assumptions. This time is also used to discuss the surgery as well as to draw up post-operative plans, including choosing and planning out the prosthetic limb with the prosthetist.

2.   During Surgery

Patients will be asleep during the surgery phase, but they can always ask their doctor or surgeon about the procedure beforehand to understand the process of amputation surgery and reconstruction.

3.   Immediate Post-Operative Phase

The immediate post-operative phase begins immediately after the amputation and mostly focuses on recovery in terms of medical and wound care as well as discharge planning. Rehabilitation in this phase will initially involve a lot of pain control and emotional support, but physiotherapy is also necessary at this point to prevent loss of motion.

While there is no easy part of recovery, this stage will likely be one of the most challenging ones for new amputees to face. Apart from the mental difficulties of accepting their new body and mobility, they will also face physical problems. Physical therapy in this period will therefore be focused on ensuring that they don’t lose out on critical mobility skills with specific exercises to improve strength, tolerance, and range of motion.

4.   Pre-Prosthetic Training Phase

This phase is a continuation of the previous phase, with even more emphasis placed on physical therapy to strengthen the limb and maintain flexibility. Pre-prosthetic training also proceeds with the final shaping of the limb to fit the patient’s future prosthesis. Pre-prosthetic training can happen in an inpatient and outpatient capacity and prepares the limb for the prosthetic limb while it heals. Many rehabilitation teams will also conduct pre-prosthetic training prior to the surgery as well.

The main goals of this phase are to promote mobility, self-care, and comprehensive limb support. Patients can also experiment with early walking aids (EWA) to properly narrow down their choice of prostheses options before placing an order, along with exercise therapy and pre-fitting management.

5.   Prosthetic Prescription Phase

The prosthetic prescription phase has two main components:

●      Casting and measuring. The prosthetist will cast and measure the patient’s residuum (the part of the limb remaining after an amputation). The physiotherapist can assist during the casting process to make sure that the pelvis maintains a neutral alignment.

●      Fitting of the prosthetic limb. The prosthetist will then fit the primary prosthesis to the limb to ensure that the alignment and length suit the patient correctly when standing and walking. Physiotherapy is also necessary at this point to provide mobility guidance and training for weight-bearing and static balance.

This phase is a prominent milestone in the recovery process and is vital to the prolonged success of the prosthetic limb.

6.   Prosthetic Training Phase

Once the patient has been successfully fitted for a prosthesis, the patient will begin specialized physical therapy—to increase strength and endurance, increase mobility, and maximize comfort and functionality. During this process, the prosthetist can adjust the prosthesis as required as and when problems arise. The first few months will require a temporary prosthesis as their limb continues to heal, after which they will be fitted with a permanent prosthetic limb.

Physical therapy becomes the core aspect of the rehabilitation process in this phase. Apart from exercises, the patient will also need to be educated on how to properly remove and put on the prosthesis, how to put on footwear and get dressed, as well as training for weight-bearing and skin integrity. They will also have to practice integrating the prosthesis into all their activities. Once the basics of weight-bearing training are over, the patient will have to practice balance, sensory reintegration, muscle re-education, and gait training.

7.   Functional Training Phase

At this point in the rehabilitation process, the patient will probably have learned to function more independently. They will have been discharged, meaning that occupational therapy will now play a large role as the patient resumes their role in their family, community, as well as their hobbies. Occupational therapists will also assist with vocational rehabilitation and training or job modifications.

They will still undergo physical therapy and will learn how to best use their prosthetic limb, as well as how to care for it with regular skin checks and hygiene. It is also important to continue doing contracture prevention exercises as the new amputee slowly reintegrates back into their lifestyle.

8.   Guided Rehabilitation Phase

This phase mostly focuses on the patient’s specific goals as they return to their daily activities. At this point, the rehabilitation plan will need to be tailored or modified to better suit the specific goals and needs of the new amputee. This can include goals such as wanting to go on a hike, running, swimming, cycling, etc., for which the physical therapist can provide strengthening and stretching exercises to specifically achieve that goal.

If you have a specific sport you would like to do; you can also consult a recreational physical therapist who can help you return to your preferred sports and can help you with adaptive recreation equipment.

9.   Follow-Ups Phase

The follow-up or maintenance phase ensures that the patient’s rehabilitation plan and goals continue to grow or change to fit the patient. The patient will be reviewed regularly by the rehabilitation team, namely the physiotherapist, the consultant, and the prosthetic team. They will assess the current function of the prosthesis, if the patient is in need of any adjustments or even a new prosthesis. Depending on the current status of the patient, their physical therapy program can be modified as well.

The goal of these follow-ups is to ensure that the patient has achieved a level of autonomy and function similar or higher than they did before the amputation, as well as to ascertain their physical, mental, and emotional health.

At Fit Prosthetics, we understand that the journey of a new amputee is a difficult one—but you don’t have to do it alone. We are dedicated to being there for you from the initial consultation to the end of your rehabilitation. We provide a wide range of services to provide for your specific needs, so contact us today.

To learn more about funding options and our partners, check out our resources here. We look forward to helping you achieve your goals!

The Challenger Foot by Ottobock

The Challenger is a multi-purpose foot developed for the varying demands from everyday walking to recreational sports.

High deflection of the curved main spring provides excellent shock absorption, which is desired for court sports like tennis or basketball, and energy return for activities such as sprinting and long distance running. The base spring and adjustable heel damping allow for stability and control during rapid movements, while walking, and while standing.

The Challenger fits with most lower profile shoes and comes with exchangeable heel wedges to support a large variety of sports and other individual needs. Excellent choice for active individuals with below or above knee fittings.


The Challenger Foot is a great high activity foot. It feels very similar to the AllPro Foot by Fillauer. The adjustable heel damping allows for more control specific to the users needs. The big benefit of this foot is that it does not need a footshell. It fits snug into most shoes so you don’t need to worry about the extra play between the shoe and footshell. I recommend this foot for high activity users that enjoy playing extra sports, or have a little one to chase around. Contact us today to request a trial!


What you should know about Diabetic Limb Loss

Diabetes is a condition in which your body cannot produce the insulin that’s needed to moderate your blood glucose levels. When you begin to experience a disruption in your natural metabolism of carbohydrates, your body begins to have increased levels of glucose in both the urine and the blood, thus resulting in diabetes.

Unfortunately, you won’t always feel any symptoms of diabetes, at least not right away. It’s vital to see your physician every year to get blood work done and have your glucose levels checked. If left untreated, diabetes can cause a wide variety of additional health concerns, including kidney damage, heart disease, nerve damage, and limb loss. Read on to learn more about the link between diabetes and limb loss.

The Effects of Diabetes on Your Limbs

One of the most serious complications caused by diabetes is referred to as diabetic limb loss, which is something that can happen as your condition worsens over time. Approximately five out of every 1,000 individuals suffering from diabetes will require a lower extremity amputation, per a 2014 National Diabetes Statistics Report.

Fortunately, there are options that can be customized to fit your lifestyle following an amputation. InMotion Prosthetics has the latest in prosthetic limbs tailored to suit a variety of lifestyles. There are many styles you can choose from.

But first, let’s explore why diabetic limb loss happens and what symptoms to look out for. Keeping yourself in the loop is the first step in limb loss prevention!

What Is Diabetic Limb Loss?

Diabetic limb loss occurs when your system undergoes a disruption in the flow of blood through your arteries. This is known as peripheral artery disease, or PAD. It includes a thinning of your arteries, thus limiting the amount of blood necessary for keeping your feet and legs healthy and safe from further harm.

PAD may lead to other complications such as open sores or ulcers. You might even experience infections which are serious enough to lead to gangrene. All of these physical problems are the result of a lack of blood flow to your lower limbs. This lack of blood flow can increase numbness in your limbs, making it much harder for you to feel any sensations in that area.

This is when you experience diabetic neuropathy, which involves the lack of feeling in a certain limb. This is also due to blood flow that has been seriously limited due to diabetes.

Neuropathy and its Impact on Nerve Function and Limb Loss

Neuropathy is best described as significant nerve damage which results from increased levels of sugar in your blood that destroy blood vessels. This can significantly impact your nerves and lead to that loss of feeling in the affected areas, which are typically your legs and feet.

You won’t necessarily feel any sensations such as pain or movement, which can be dangerous in some situations. If you can’t feel anything, then an injury or an ulcer may not be treated in time. That’s why it’s important to check your feet and legs for any cuts, burns, or bruises in order to prevent the possibility of gangrene and a potential amputation of the affected limb.

What to Look for When Checking Your Feet and Legs

It’s important to do an inspection of your feet and legs at least one time per day. This inspection should include looking for all cuts, big or small, plus any ulcers or other injuries. Even bruises and other abrasions should be noted when found.

There are other areas to cover when you do a daily check of your feet and legs. You should look for any toenail injuries and note anything unusual or suspicious. Blisters, calluses, and white spots should be reported immediately to your doctor. Other issues such as plantar warts and ingrown toenails also need attention. Any discoloration could be an indicator of a significant drop in blood supply.

What You Can Do to Minimize the Possibility of Limb Loss

There are preventive steps you can take to keep your limbs as healthy as possible. For instance, you can wear protective shoes to help keep your feet comfortable and safe during normal walking. These special shoes require a doctor’s prescription and can be covered by most insurance, including Medicare. They offer complete protection over your entire foot in an effort to protect them from anything that could lead to a serious injury.

Another solution is to make regular visits to see your doctor. They can help you with your questions and concerns and will even work out a continuing treatment plan for you. That plan will include working on diet, exercise, and weight loss. They may also adjust your medications as needed and show you how to check your feet for cuts, warts, and dead tissue.

If an infection does happen, there are initial steps your doctor can take other than a complete limb amputation. They can do surgery to remove old, dead, and damaged tissue or prescribe an antibiotic to ward off the infection. In some cases, a foot topical can be applied. In other cases, a special procedure known as revascularization can be done to improve circulation to that limb.

Lifestyle Changes

There are certain lifestyle changes you can make to reduce the likelihood of diabetic limb loss. One is to cut out sodas and sugars. You can also move around more and increase your daily exercise routine—a minimum of 30 minutes per day is highly recommended for best results. Regular blood pressure checks can help ensure that you have proper circulation and that there is no PAD to worry about.

Unfortunately, there are occasions when holistic measures such as diet and exercise don’t work. In instances when all other treatments have failed, limb amputation may be the final solution.

Factors Which Contribute to Diabetic Limb Loss

There are factors that may increase your risk of an amputation. One is having a family history of diabetes. That alone is enough to warrant a cause for concern and a routine trip to the doctor for blood sugar monitoring. This can help ward off any possibility of a potential lower limb amputation.

Other factors include open sores, bunions, and infections. When you have been diagnosed with diabetes, getting your legs and feet checked becomes a must. Washing your feet thoroughly can help prevent a serious infection that could lead to an amputation down the road.

What to Expect

The good news is that amputation can be done in a way that doesn’t limit your life—and that’s where FIT Prosthetics comes in.

Your operation will typically require a stay in the hospital. After the procedure, you may end up staying for a few days under observation. Vitals and blood work will be assessed, and you will need frequent wound cleansing and dressing changes.

Recovery takes time after any operation, especially an amputation. You may need weeks of ongoing support, along with intense physical therapy, just to get you back on your feet again. Our team can help support you through the prosthesis stage, fitting you with the right prosthetic limb for your specific lifestyle and needs.

Can Diabetics Wear Prosthetic Limbs?

Most people who receive an amputation due to diabetes complications will use a prosthesis. You will need to be evaluated and declared an eligible candidate for a prosthetic limb, however. The next step of being fitted for a prosthetic limb will generally happen after you’ve healed from your procedure.

Staff at FIT Prosthetics can work with patients from all walks of life, from small children to seniors. Before making the prosthesis, the patient is evaluated. Questions are asked about lifestyle, work, hobbies, and level of physical activity. This gives our team a chance to design a custom limb that’s right for you.

We offer a variety of prosthetic limbs from which to choose. We have limbs that can help you walk as if they were natural. This is thanks to special microprocessor technology that allows each limb to be specially programmed to bend, flex, and move in the most authentic way. Fingers can grip, toes can move, and dexterity is possible in every corner. But this is only the beginning.

Next, getting adjusted to your brand-new prosthesis should be your main goal. Your doctor may require physical therapy just to get you familiar with the use of your new limb. Our team at FIT PROSTHETICS can answer your questions and address your concerns as you go through the recovery and adjustment process.

If you or a loved one is dealing with diabetic limb loss, contact FIT Prosthetics in Murray, UT, to find out how we can help make the process a smoother one.

Taleo Side Flex by OTTOBOCK

The 1C58 Taleo Side Flex was designed for active users who navigate varied indoor and outdoor environments and place a high value on secure, effortless walking and socket comfort. Thanks to innovative technology, it offers more freedom of movement in everyday life and ensures secure, full-surface ground contact with its Terrain Adaption Unit – even on uneven surfaces and slopes. The prosthetic foot’s terrain adaptation reduces the lateral load on the knee or in the socket, which can often cause discomfort to the user, and can minimize compensating movements. You decide where you go.


We have reviewed the Taleo family of feet before. Since then Ottobock has come out with another version of this amazing foot. The side flex version offers all of the benefits of the other feet. It feels very safe and secure on all walking conditions, and has and amazing return. Creating a smooth roll over with no dead spots. The side flex adds 10 degrees of flex in both directions, for more control and balance walking on uneven terrain. I love all versions of these feet for their safety and mobility. Call for a demo today!


Linx is the world’s only fully integrated limb and winner of multiple awards for design and innovation.

Working as one Limb, Linx delivers an experience that mimics the incredible and complex structure of the human leg by actively sensing and analyzing data on the user movement, activity, environment and terrain providing a coordinated stream of instructions to the hydraulic support system.

The result is a walking experience that is closer to nature than ever before.



In my opinion this the most “complete” knee/ankle device on the market today. The benefit of this microprocessor set up is that the knee and ankle are ran by a single control system. This system feels very natural and fluid throughout its swing phase. I find this leg allows for walking on uneven or “natural” terrain much easier. Because you get a little push out of the ankle, it takes less energy and momentum to continue through your gait. I think this is a good system for higher activity patients who still don’t feel super safe on their MPK.

Linx - Integrated Limb System - Blatchford US & Canada