The Stages of Prosthetic Fitting

Limb amputation presents challenges to getting back to an independent life. A successful prosthetic fitting is vital in this process to help you restore your mobility and get back to the activities you enjoy. Every person’s situation is unique, meaning your prosthetic needs to be custom-designed to fit your body perfectly to help you achieve optimal results.

 

While there are several options for limb prostheses, the fitting process (after evaluation of the treatment result) generally follows the same stages no matter which limb prosthetic you choose. Usually, the stages for fitting the prosthesis involve training sessions and both occupational and physical therapy. With that in mind, here is an overview of the steps of a prosthetic fitting.

Schedule a Meeting with a Prosthetist

Amputees have unique needs, so you will need to schedule a meeting with a certified and experienced prosthetist for assessment. That means if your amputation is planned (and not emergency-related), you may have a physical and medical evaluation along with some education from your care provider. Some of the things you will have to discuss with your doctor may include your short-term and long-term goals, the possibility of phantom pain, and planned pain management. Similarly, you can consult someone or a peer who has undergone amputation and can answer your questions regarding their experience.

Amputation Surgery

Once you outline the goals you intend to accomplish with a prosthetic, your next step is to undergo amputation surgery. Once complete, the care team will work to manage any pain and keep you comfortable at all times. Wound dressing options available to you may include:

 

• Ace bandage wrap

• Removable rigid dressing (RRD), such as immediate postoperative prosthesis (IPOP) or AmpuShield

 

During your hospital stay, you will have to communicate frequently with your care team to ensure your pain is managed effectively. Your hospital stay may be shorter or longer, depending on the nature of your amputation and the time you need to recover.

 

Throughout your hospital stay, the care team will work to promote wound healing by maintaining the range of motion of the amputated limb, offering support and continuous education, and training you on mobility exercises. Following the surgery, you may be released from the hospital after three to 10 days. Subsequently, once you’ve gained your appetite, balance, and strength, you may be released to a rehabilitation center or a skilled nursing facility.

Pre-Prosthetic Training

At this stage, your care providers focus on training and preparing you for the prosthesis. Your team will focus on limb shaping, muscle strengthening, skincare, and pain management. Your residual limb may experience swelling, requiring you to use a compression sock or a shrinker to combat or control the pain. After this, you will collaborate with your physical therapist and care team to avoid muscle tightening (contractures) and gain strength.

 

Typically, pre-prosthetic training will take place at your home, rehab center, or a skilled nursing center, depending on the plan developed by your care providers. The training may include desensitizing your scar tissue and residual limb. Experts recommend various things you can do to achieve this, such as massaging the end of the limb in a circular motion. After this, you may want to meet with your prosthetist for limb evaluation. He or she will assess your limb and ask you several questions about your work, hobbies, and prosthetic goals.

 

Understanding this information will help your prosthetist develop a reasonable prosthetic treatment plan. If necessary, you can stay connected with a peer mentor to guide you and answer your questions.

Prosthetic Prescription and Fabrication

After your wound is fully healed and the swelling has reduced, your caregiver will start the process of creating your socket. Several ways can be used to build a socket, and since sockets are custom-made, your clinician will discuss how to achieve the best fit. Initially, you will be fitted with a clear diagnostic. The socket’s primary purpose is to enable your prosthetist to make modifications and adjustments before your final or definitive prosthesis is built.

Prosthesis Delivery

Prosthesis delivery is the last stage of your prosthetic fitting process. Once you receive your final prosthesis, your clinician or physician will give you a wearing schedule/plan to help you get accustomed to wearing your prosthetic. After this, you will continue with your occupational therapy if you’re an upper-extremity amputee or physical therapy if you’re a lower-extremity amputee. Therapy will provide you with additional training with your finished prosthesis.

 

During the first year of your prosthetic procedure, you will have occasional appointments with your clinician for adjustments and modifications. With time, you will get used to wearing a prosthetic, and adapting it to your everyday life will become routine. However, that doesn’t mean it is going to be easy at first. It may be challenging at times, but with commitment, dedication, and hard work, the integration will become seamless.

 

If you’re a first-time prosthetic wearer, you will receive additional support to make you as comfortable as possible. After prosthesis delivery, your prosthetist will schedule follow-up visits for one to two weeks. These appointments will allow for continuous assessment to ensure that your new prosthesis fits and functions appropriately.

At FIT Prosthetics, we pride ourselves on guiding you through the complexity of modern technology so you can find the best prosthetic option for you. We aim to provide a complete and seamless service that supports your rehabilitation every step of the way. If you are looking to learn more about our services and mobility solutions, please contact us to schedule your consultation.

 

Resources:

 

Important Steps for a Successful Prosthetic Process

 

http://poaprosthetics.com/pdf/What_to_Expect_with_Your_Prosthetic_Care.pdf

OSSUR PRO-FLEX

Pro-Flex prosthetic feet feature a proprietary 3-blade design with full effective toe lever and a more anatomical split toe. This gives the push-off you need for a more fluid, natural and confident stride. Pro-Flex is now available with heel-height adjustability to accommodate a variety of your daily activities.

USER REVIEW

This Ossur Pro-FLex is great foot for vacuum users. I really like the XC Torsion (Twist-ability). Because of the long split toe you have a really clean rollover. As a result your momentum continues moving forward, and causes you to use less overall energy. This foot comes in 6 variations. The newest being the Pro-Flex LP (Low Profile) Align. The Align has a button on the ankle that you use to shift the heel height position. This allows you to wear all kinds of shoes that have different sole/heel heights, without having the prosthetist make a physical alignment adjustment. The Pivot allows for 27 degrees of ankle motion, creating a safer platform on ramps and stairs.

 

Click here to visit The Ossur Pro-Flex Webpage.

How Does Your Residual Limb Change After Amputation?

After an amputation, you may notice changes in your residual limb. It’s important to be familiar with the most common residual limb changes, and how you can address your concerns with your doctor and your prosthetist.

After your amputation surgery, you may experience discomfort, challenges with dressing and cleaning your wound, and disorientation with the way your stump feels. These are all normal challenges, and most patients are able to adjust fairly quickly.
There are also natural changes to residual limbs that may surprise or upset many recent amputees. Most of the time, these changes are completely normal. Sometimes, they are cause for concern.
Here are the most common changes in residual limbs after amputation, and how you can address them. 

Changes in Stump Shape and Volume

In the first 12-18 months after amputation, your residual limb will undergo a number of changes in size and shape. Residual limb volume, in particular, changes a lot as you heal from your amputation.

Some studies show that residual limbs can decrease in volume by anywhere from 17% to 35% in the first few months after amputation surgery. These size fluctuations can make rehabilitation and prosthetic socket fitting challenging, especially if an amputee is also exercising less without altering his diet. 

Many changes in the volume of your residual limb are natural side effects of limb loss.

Stump shrinkage, for instance, happens as postoperative muscle atrophy sets in. This occurs because you are using your residual limb far less than you used your full limb before surgery. Shrinkage should stabilize almost completely within 6-8 months after amputation.


Another source size fluctuation is a residual limb is 
post-operative edema. Edema is swelling that results from excess fluid in the residual limb’s soft tissues. It is important for new amputees to control edema by using compression or shrinker socks for the first 12-18 months after amputation. Individuals using compression or shrinker socks should remove them several times a day to check for skin breakdown and wounds.

It is also important to establish a post-amputation exercise routine to control weight gain. Many amputees naturally move less after surgery, due to pain from healing, new mobility issues and psychological adjustments. However, weight gain impacts the size of your residual limb the same way it does the rest of your body. This can cause fit issues with your prosthetic socket and can lead to irritation, skin breakdown and setbacks in your post-amputation rehabilitation.

Talk to your physical therapist or rehabilitation team for ideas on maintaining an adequate activity level to prevent weight gain after your surgery.

Skin Problems

Many amputees experience skin problems, wounds and infections after surgery. This is especially true if the patient has diabetes, vascular disease or other illnesses that cause slower wound healing.

For diabetics, good post-amputation wound care is imperative. If you have diabetes, it is vital to check your stump several times a day for sores, wounds or other signs of infection.

While compression or shrinker socks are important to aid in stump size adjustment, they can also cause sores, blisters or skin breakdown if they aren’t continually monitored. Untreated stump wounds can lead to serious infection and may require hospitalization.

After your amputation, it is vital to carefully clean your surgical wound multiple times per day using a mild soap and clean water. Pat your wound dry using a gentle cloth. Avoid soaking your stump, as it can lead to skin breakdown.

Check your stump daily for signs of rubbing, irritation, blisters, redness or sores. If you develop any of these skin problems after your amputation, you should visit your doctor immediately. You may need a different limb sock or a different socket fitting to alleviate these problems.

Muscle Contractures

Muscle contracture is the semi-permanent or permanent limitation of movement in the soft tissues. It is caused by shortening or stiffening of the muscles, tendons, ligaments and skin that is in close proximity to your residual limb. Above-the-knee amputees can experience hip flexion contracture, while below-the-knee amputees can experience knee flexion contracture. Muscle contracture in an amputee poses many challenges, including painful rehabilitation, slowed rehabilitation and issues wearing and using a prosthetic device.

Post-amputation contracture is typically caused by extended immobility of the residual limb and surrounding soft tissues and structures. Many amputees have suffered from mobility problems for a long time before amputation, so they may not know how important it is to exercise, stretch and maintain movement in their residual limbs.


It’s important not to lie in bed for long periods of time following amputation.

Transtibial amputees should avoid lying with the residual limb hanging over the edge of a bed or with the knees flexed. They should also avoid lying with a pillow under the knees. Transfemoral amputees should avoid lying with pillows under the thigh. For all amputees, regular stretching and exercising of the muscles near the residual limb is imperative to help avoid post-amputation contractures.

If you aren’t sure about exercises and activities that can help you, talk to your physical therapist or rehabilitation team. They will have creative exercises that are comfortable on your body but provide you with the activity you need to avoid issues with your muscles, tendons and ligaments after your amputation.

Amputation Support at FIT Prosthetics in Salt Lake

As you adjust to life after limb loss, it’s important to have resources available to help you navigate the changes, challenges and questions you’ll face along the way.

FIT Prosthetics offers a full range of support resources for amputees, including pre-amputation evaluation, custom and ongoing prosthetic fittings, delivery and more.

Contact us today to learn more!

Socket Fit With Your Limb Prosthesis

It’s important for all prosthetic devices to provide a good “socket fit” for the wearer. Without a good socket fit, a prosthesis can be uncomfortable and cause issues like skin breakdown, sores and even ulcers. A poorly fitting socket can also slow down or stall an amputee’s rehabilitation and may contribute to falls and balance issues for lower limb amputees.

Here’s what you should know about the importance of a good “socket fit” of your prosthesis.

What Does “Socket Fit” Mean?

The socket is the primary interface between a residual limb (stump) and a prosthetic device. The socket wraps the end point of the residual limb and forms a suction between the residual limb and the prosthesis. Most sockets are made of polypropylene and have a socket liner that helps facilitate a comfortable fit between the stump and the prosthesis. 

Socket fit is the most important part of a prosthetic device, especially for lower limb amputees, because it helps distribute the wearer’s weight and allow fluid, comfortable movement.

For upper limb amputees, the socket fit connects the prosthesis to the other parts of the arm, like a wrist joint or elbow joint.

A socket is custom made to fit the contours and dimensions of each unique residual limb, to achieve an optimal fit.


A poorly fitting socket can cause serious issues with prosthetic feet, prosthetic legs, prosthetic arms and prosthetic hands. Poor fit can cause sores, ulcers, injury, balance issues and general discomfort. Poor fit can also cause setbacks in an amputee’s rehabilitation process.

How Do You Get A Good Fit With Your Prosthetic Socket?

The most important part of getting a good socket fit with your prosthesis is to communicate honestly with your prosthetist throughout the prosthetic fitting process.


Before your final socket is made, 
your prosthetist can make a test socket to ensure that the fit and function of your socket is ideal. The test socket is made from a clear material so your prosthetist can observe any issues with the fit of the socket. Rubbing, redness, discomfort and blisters can be adjusted before the final socket is created. 

Another important part of achieving good socket fit is to carefully observe any changes in the shape or size of your residual limb.

The body is ever changing, especially if diet and exercise change. Because a residual limb is part of the body, it is vulnerable to these changes, too. This can cause the socket fit of a prosthesis to change.

Minimizing changes in weight are an important part of maintaining a good socket fit with your prosthesis. You should also regularly check your stump for changes in skin texture and appearance, and pay close attention to how your prosthesis feels during wear. Changes in wear can signal a worsening socket fit.

It’s also important to pay attention to the way your prosthesis fits throughout all activity levels. If your prosthesis doesn’t feel comfortable and natural when you’re very active, your prosthetist needs to readjust your fit.

Achieving A Good Socket Fit With FIT Prosthetics

Becoming an amputee can bring challenges and setbacks. However, it’s important to work closely with your amputee rehabilitation and prosthetic team to make those challenges easier to weather.

 

FIT Prosthetics in Salt Lake is proud to offer a full range of resources and support for amputees, including pre-amputation evaluation to advanced prosthetic fittings, follow ups and more. 

Contact FIT Prosthetics today to learn more. 

Lower Limb Amputation + Diabetes

 

Diabetes is a chronic condition that impacts multiple organ systems, including the renal system, peripheral nervous system and vascular system. Over time, complications from diabetes can lead to leg, ankle and foot problems that place diabetics at a higher risk of needing a lower limb amputation.

According to the American Journal of Managed Care, approximately 200,000 non-traumatic amputations occur in the United States each year1.

In a study from 2008, vascular disease, including diabetes and PAD, was the cause of amputation in 54% of Americans living with limb loss in the United States2.

In the majority of cases, a diabetic foot ulcer is the initial event that leads to lower limb amputation in people with diabetes3.

If you’re a diabetic who is at risk of lower limb amputation, here’s what you should know.

How Does Diabetes Increase the Risk of Lower Limb Amputation?

Diabetes can cause serious complications with the peripheral nervous system and vascular system.

Chronic high blood sugar can cause fats and other substances to build up on the walls of the blood vessels, causing them to narrow. This condition is known as atherosclerosis.


Over time, atherosclerosis 
can progress to Peripheral Artery Disease (PAD), a condition that causes poor circulation in the extremities, especially the legs and feet. 

PAD that isn’t carefully managed can cause extremely slow healing in the feet and legs. Over time, blood flow may become so compromised that even small wounds on the legs, ankles and feet don’t heal at all. 


Diabetics are also at high risk of developing 
nerve damage in the extremities. This condition is known as peripheral neuropathy, and it can cause numbness, tingling and loss of sensation in the legs and feet.

What is the Most Common Cause of Lower Limb Amputation Among Diabetics?

The most common cause of lower limb amputations in diabetics is lower limb ulcers, particularly foot ulcers.

Non-healing wounds on diabetics can begin as small nicks, scrapes or cuts, typically on the feet or lower legs.  Poor circulation caused by PAD impedes the healing process in the lower limbs because the blood vessels cannot effectively deliver nutrients to the damaged tissue. Open wounds that aren’t healing properly can easily become infected, causing potentially life-threatening side effects.

An infected ulcer on the foot or lower leg can cause infection in surrounding tissues and can spread to the bones. Oftentimes, the only way to treat the infection is to amputate the affected area.

Can Other Complications of Diabetes Lead to Lower Limb Amputation?

Peripheral neuropathy, a condition that causes nerve damage in the extremities, is a common side effect of diabetes. In fact, up to 50% of diabetics may experience some form of diabetic neuropathy. Like PAD, peripheral neuropathy increases a diabetic’s risk of amputation. 

Symptoms of peripheral neuropathy can range from numbness and tingling in the lower limbs to issues with the blood vessels, digestive tract and urinary tract.

Nerve damage caused by PN makes it difficult for diabetic people to know when they have sustained an injury on the lower limbs, especially injuries that aren’t easy to see. Cuts and nicks on the bottoms of the feet, backs of the ankles and other hard-to-see areas may not produce a strong pain response, so they often go unnoticed until they have developed into open sores (diabetic ulcers).

When peripheral neuropathy is accompanied by poor circulation or PAD, wounds on the legs and feet won’t heal normally. Over time, they may become infected or gangrenous. Many times, the only option for removing the infection of gangrene is to amputate the lower leg, foot or toe.

How Can Diabetics Lower Their Risk of Lower Limb Amputation?

It is vital for all diabetics to follow their doctors’ recommendations for managing their diabetes and its side effects.

The most important way to prevent complications of diabetes is control blood sugar levels through medication, diet and monitoring your blood sugar daily.

If you have diabetes, your doctor may also recommend that you make adjustments to your lifestyle, like altering your exercise regimen, quitting smoking and drinking less.

It is extremely important for diabetics with PAD and nerve damage to check their feet, ankles and lower legs daily. This includes paying special attention to the bottoms of the feet, between the toes, the backs of the ankles and the backs of the legs for any cuts or sores that are forming.


If you get a cut or nick on your leg or foot, you should carefully follow protocols for 
diabetic wound care given to you by your doctor. 

Advice for Diabetics Facing Lower Limb Amputation

If you’re facing a lower limb amputation due to diabetes, it’s important to be prepared for the challenges and changes ahead.

Recovery and rehabilitation following a lower limb amputation is important for all patients, especially those with co-existing diseases that require management. For diabetics, it’s important to practice careful wound care following an amputation, as vascular issues may contribute to slow healing. As you recover from your amputation, it’s important to

It’s also vital for lower limbs amputees to find a trusted prosthetic partner that can provide resources and support throughout the amputation process.

If you’re a diabetic facing lower limb amputation in Salt Lake, Ogden, Provo or anywhere in Utah, FIT Prosthetics offers a complete range of amputee support. This includes pre-amputation evaluation and advanced fitting for your prosthetic device.

Contact our team today to learn more about our support and services for lower limb amputees. 

Sources:

  1. “Diabetic Amputations May Be Rising in the United States | AJMC.” 13 Dec. 2018, https://www.ajmc.com/view/diabetic-amputations-may-be-rising-in-the-united-states.
  2. “Estimating the prevalence of limb loss in the United … – PubMed.” https://pubmed.ncbi.nlm.nih.gov/18295618/. 
  3. “Evidence-based management of PAD & the diabetic foot.” https://pubmed.ncbi.nlm.nih.gov/23540807/

Ottobock Taleo

Active individuals (K3) who navigate varied indoor & outdoor environments and place a high value on effortless walking and the ability to go wherever life takes them.

Features include: Smooth rollover due to no dead spots and easy rollover from heel strike to toe off.

Energy efficient walking that returns the energy suited to every varying step.

Terrain conformance to navigate on uneven and rising terrain safely and comfortably.

Customizable with 3 different heel wedges.

Waterproof incl. salt and chlorine water

Slim connection adapter for easier cosmetic fitting

Sizes 22 – 30

Minimum clearance height (Size 26): 6 ¼” (158mm)

Up to 150kg / 330 lbs

The scope of delivery for the Taleo includes the footshell with connection cap, a Spectra-Sock, and a transparent (soft), grey (medium), and black (stiff) heel wedge.

 

 

USER REVIEW

I really love how smooth this foot is. It comes in multiple configurations including a Low Profile version, and a Vacuum version with torsion control (Twist-ability). The split keel (sole) design allows the foot to flex with ground variances, making for a smooth rollover. The foot comes with 3 heel wedges. Each wedge has a different level of stiffness. This allows the prosthetist to get your heel strike as comfortable as possible when you land. This foot has no dead spots in it. Which means as you’re rolling over from heel to toe it is a smooth transition, distributing energy through the duration of the rollover. This makes the foot super easy to walk on, especially for Above Knee (AK) users that need a little more energy to continue their momentum through their gait. I love this foot for all users. It has a great return for high activity users, but is safe and comfortable for those of us just working through our day to day lives.

 

 

 

 

Click here to visit the Ottobock Taleo Webpage!

 

 

What To Expect After Amputation?

FITPROSTHETICS is dedicated to helping our clients regain their independence, mobility and quality of life following an amputation. Part of this dedication is providing pre-amputation evaluation to clients who need it.

If you’re preparing for an amputation, our team can help you navigate the many questions you may have. One of the most common questions our clients have before their surgery is, What Should I Expect After My Limb Amputation?
During our pre-amputation evaluation, we provide our clients with the information they need to feel empowered and educated throughout the process. 
Here are a few important tips on what to expect following your amputation surgery.

Expect Some Changes to Your Residual Limb

Many amputees are concerned about the fit and comfort of their prosthetic limb as they heal and rehabilitate after amputation surgery. This is because changes can occur in a residual limb after amputation that may make successful use of prosthetics challenging, especially if these changes aren’t expected or correctly managed.

After your surgery, you should expect some swelling and soreness in your residual limb. You should also expect your stump to change shape significantly as you heal. As swelling subsides, your limb will decrease in volume and may visibly change shape.

To enjoy a successful prosthetic fitting, it’s important for many patients to shrink their residual limb using a shrinker sock or compression sock. This can help manage stump changes that make prosthetic wear more challenging. It’s also important for patients to manage post-amputation weight gain.

Expect Changes in Limb Sensation

Many amputees experience changes in sensation in their residual limb. Some experience a sensation of burning, throbbing, or squeezing. Others report a sensation of involuntary movement, numbness or itching. Residual limb pain can occur in up to 50% of individuals who have undergone an amputation. Physical touch, such as massage or regular tapping, can help desensitize the residual limb area and prepare the skin and muscles for a good prosthetic fit. 

Phantom pain, or the feeling of pain in the limb that was amputated, is also common in amputees. It is caused by signals in the brain and spinal cord adjusting to the new lack of signals from a previously healthy limb. Typically, phantom pain improves over time, but it’s important to seek input from your doctor if it doesn’t. Similarly, residual limb pain that doesn’t improve or which affects your ability to function normally should be reported to your doctor.

Expect Changes in the Fit of Your Prosthesis

As you heal from your amputation surgery, the muscles in your residual limb will naturally change shape as you use them less.

Typically, these changes stabilize within 6 to 8 months after amputation surgery. Some amputees may heal more quickly, while others may take longer.

Once your stump’s shape and size has stabilized, you can begin the process of being fitted for a custom prosthetic device. This process typically takes several appointments with your prosthetic team due to adjustments in your level of rehabilitation, as well as issues with the fit, comfort or usability of your prosthetic device.

Many amputees are disheartened when they don’t accomplish a perfect prosthetic fit immediately. It’s important to know that finding a good socket fit and adjusting to wearing your prosthesis can take several weeks. Typically, amputees need around four sessions with their prosthetic team to find the fit and functionality that works for them.

You should never suffer through a poor socket fit, discomfort or pain when using a prosthesis. Talk to your rehabilitation team and prosthetic provider to make any necessary adjustments to your prosthesis.

The Importance of a Great Prosthetic Team

As you recover from your amputation, it’s important to have trusted, reliable resources available to you.

One of the most important resources during this time is your prosthetic team. If you’re facing an amputation in the near future, it’s not too early to find a prosthetic company you trust. Reach out, visit the clinic, and connect with the team members. Doing so can help alleviate your fears and provide peace of mind during your journey from amputation to prosthesis use.

FIT PROSTHETICS offers a full range of services to our clients, including  pre-amputation evaluation, advanced prosthetic fitting and ongoing support.

Contact us today to learn more about our services and how we can help you! 

AllPro foot from Fillauer

This is my regular everyday foot. For higher activity users I think this is the best foot on the market. The high end flexibility and rocker toe allow for a high energy return over a multitude of ground variances, while maintaining a smooth roll-over.

High energy return=Less energy output from the user. I wear this foot during most of my activities: Walking, Running, Hiking, Coaching, Etc. I do not use this foot in my super high activities such as Snowboarding or Surfing. The reasons I don’t use this foot during these activities is because of the shape (difficult to fit into a boot), and the high energy return is almost too much with the amount of force going on during those activities. I recommend this foot to many K3/4 users. If you’re looking for a foot that can keep up with a fast paced gate and a high return, this may be the foot for you!

The AllPro foot

from Fillauer

FEATURES:

  • Industry-leading flexibility provides excellent plantar and dorsiflexio
  • Carbon composite design for dynamic response
  • Rocker toe for easy and smooth roll-over
  • Multiaxial function
  • RPI pyramid adapter allows prosthetist to optimize alignment and performance for adult TT and TF amputees.*
  • Adjustable heel bumpers

The AllPro foot from Fillauer crosses all boundaries, combining high flexibility and dynamic performance into a foot that allows the user to work and play like a pro. Whether walking on a flat surface or traversing steep hills, the AllPro performs to meet the amputee’s multiaxial needs. If exercise or sports are on the activity list, this “do-it-all” foot easily transitions from the gym to the tennis and basketball courts, as well as the soccer, football, and lacrosse fields.

 

Click here to Visit the Fillauer ALLPRO Webpage!