When I begin to train a new amputee in the use of their prosthetic leg, obviously safety is uppermost in my mind. So from the start there are some principles that I encourage all amputees to adhere to.
Before putting your prosthetic leg “on” and after taking your prosthetic leg “off” at the end of the day, it is essential to examine your stump thoroughly for any areas of excessive redness, blisters or rubbing. By doing this you will be alerted to any potential fitting problems with your socket and avoid incidences of broken areas on your residual limb which could lead to infection and an inability to continue wearing your prosthesis.
When starting to walk, especially if you are an above knee amputee, you should step off with your intact leg first. This is because you have the most efficient control of the prosthetic knee joint (or your own knee if you are a below knee amputee) when it is directly underneath you as you bear weight on it. Stepping off with the prosthetic leg first puts your knee in front of your weight bearing line and requires much harder work from your bottom (gluteal) muscles to prevent it from buckling. Additionally once you have stepped off with your intact leg you will have the momentum of the prosthesis to assist you in swinging it forwards, thus requiring less energy as you walk.
The principle of keeping your prosthetic leg underneath you has particular relevance when you are turning around, for example to sit in a chair. If you turn and put your prosthetic foot out to the side, using it like a strut you risk losing control of your knee joint and falling. I encourage all amputees to keep control of the knee joint by keeping the prosthetic leg underneath them and using the intact leg as the one doing the turning. Note that it is important never to spin on your prosthesis as the knee may also buckle in this situation and the rotation it causes between your socket and the skin of your stump can be quite uncomfortable.
I always say to amputees that I see,”You have 2 legs now, think of and use your prosthetic leg as a leg, not just a strut”. This will help to keep you moving safely.
Until next time… Cathy… The Amputee Coach
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