Leg Amputation and Shoes

As an amputee physiotherapist, I am often asked for advice by recent lower limb amputees on appropriate footwear.

One of the most common questions is:

What is the best type of shoe to wear on my prosthetic foot?

This is a very important question for several reasons.

Firstly, the most important issue for an amputee is taking care of your remaining foot.  The shoes that you choose should be comfortable and supportive of your foot and also offer some shock absorption.  They should not cause rubbing, blisters or pain in the foot.

Things to consider regarding the shoe for your prosthesis include:

  • The heel height that you choose will be the heel height that your prosthesis is aligned for.  This is important because it means that if you change the shoe on your prosthesis and it has a different heel height, you will alter the alignment of your prosthesis and this will affect your walking pattern and possibly the safety of your prosthesis.  For example, an increase in heel height for an above knee amputee will cause the knee to be less stable and give way more freely which could result in a fall.
  • The heel of the shoe should have a significant surface area to assist with balance on your prosthesis
  • The shoe you choose should have a firm heel counter (the part of the shoe that encompasses the heel of your prosthetic foot).  This will prevent the heel of the prosthesis slipping off the shoe as in the case of sling back shoes.
  • Avoid long pointy toed shoes as these will make it harder for you to clear the ground as you swing the prosthesis through when walking.
  • The sole should not be slippery
  • If you are a diabetic amputee, you should always consult your podiatrist about appropriate footwear, especially in the case of Charcot’s deformities.  In this situation, I recommend that you will need to have your shoes especially made.
  • If you are unsure about the  heel height of your shoe and the alignment of your prosthesis, always consult your prosthetist.

Please let me know if you have any other questions, comments or feedback. 

Until next time,

Cathy … The Amputee Coach

8 Comments to “Leg Amputation and Shoes”

  1. eric 30 May 2012 at 2:41 pm #

    I am an above the knee amputee and flat footed too and my good foot(real) is always hurting me since I stand all day working. So what type of shoes do you think would benefit me?

    • Cathy Howells 5 June 2012 at 1:30 am #

      Hi Eric,

      Thanks for your question.

      If you are flat footed it is likely that you will need an orthotic in your shoe to help keep your foot in the correct alignment and help to maintain the arch in your foot. So advice from an orthotist or podiatrist could be most helpful to you.

      Shoes that can absorb shock and have good support around your heel and under the arch of your foot are essential.

      Just a thought – I presume you are wearing your prosthesis at work. Are you sharing your weight on your prosthesis and other foot equally?
      If not you will be unduly stressing your remaining foot. I would suggest a checkup with your clinic physiotherapist to check your leg length, posture, weight bearing and core strength as these could all affect the way you are standing and could increase the stress on your remaining foot.

      Hope this helps you find the way forward.
      Kind Regards,
      Cathy Howells – The Amputee Coach

  2. Johnny 14 January 2013 at 5:55 pm #

    Im a recent left above knee amputee, im due to be fitted with a prosthetic leg soon. Before my accident I worked as a motor cop and I ride the bike a lot. Is it still possible to ride a bike with a prosthetic leg?
    Also will I be able to wear tall leather riding boots on the prosthetic. I have many pairs of 20″ tall Dehner patrol boots with a 2 inch heel and a couple of pairs of cowboy boots with a 3 inch heel.
    Also do I need to wear socks on my prosthetic leg?


    • Cathy Howells 18 January 2013 at 3:54 am #

      Hi Johnny,
      Thanks for your question, you raise some interesting points.
      Yes, it is possible for you to ride a motorbike with your prosthesis on.

      If your leather boots have zips, you should be able to get the prosthetic foot into them. A shoe horn will help.
      A one inch difference in the heel height of your patrol and cowboy boots is significant and you will not be able to interchange them on your prosthesis without altering its alignment and therefore safety and function. This is more fully explained in the Amputee Coach Book, Chapter 6. Your prosthetist may be able to help allow for the change in heel height.

      Because this is your first prosthesis pick the most common heel height in your wardrobe. Also remember that heavy boots will make it harder to learn to walk and control your prosthesis.
      You will need to wear a sock on your prosthetic foot to prevent squeaking when you walk.

      I hope this helps.
      Good Luck with your rehab.
      Cathy Howells

  3. Adamifoluwa Adeniyi. 16 March 2013 at 12:05 pm #

    I am below the left knee amputee,got this from RMA,my question is,can i still drive a car and how long should it take me after leaving the hospital before i can start driving? And,must my shoes be customized?
    Thank you…

    • Cathy Howells 19 March 2013 at 9:56 pm #

      Dear Adamifoluwa,
      Because you have a (L)BKA there will be no problems for you if you drive an automatic car. If your car is a manual you will need to go for driving lessons and a test to have your license endorsed.
      You can drive as soon as your doctor says its OK and you are not affected by any medication you are or have been taking.
      You will not need custom made shoes. Your regular shoes will be fitted onto your prosthetic foot when your prosthetist makes your prosthesis.
      Good luck with your rehab
      Cathy Howells OAM
      on behalf of The Amputee Coach Team

  4. Julie Bartolomew 22 June 2013 at 12:55 am #

    I am an AKA left knee. I am fortunate that I made the decision to amputate and not the ortho’s who performed 15 of 16 surgeries for MRSA. Now I’m getting a new leg since C-leg didn’t work for me. I am consistent with a 1 inch heel. Can you give me any help, clues before I enter rehab for 4 weeks? Thank for your previous comments.

    • Cathy Howells 25 June 2013 at 12:37 am #

      Hi Julie,
      Thanks for your question.
      The best preparation for you would be to work on your core strength keep, stretching your hip flexors and do the buttock strengthening exercise on page 169 of The Amputee Coach, whilst visualising toe-off on your new prosthesis.

      I hope the problems you had with the C-leg were not due to lack of specialised gait training that is required to use it.
      Good luck with your rehab
      Cathy Howells OAM

Leave a Reply