FAQs about Prosthetics

Prosthetic fillers also known as orthotics because they are insoles which contain padding to replace the missing toes.  They are custom fit by Sunshine Prosthetics and Orthotics to  minimize patient discomfort and allow natural walking by improving balance.  They can be prescribed for  partial, transmet, or Symes amputations.

A prosthesis is an external device designed to replace a missing part of the body, including arms, hands, fingers, legs, toes, breasts and even eyes.

A prosthetist is a healthcare professional, specifically educated and trained to manage comprehensive prosthetic patient care.  This involves patient assessment, treatment plan formation and implementation and follow-up management.

Amputations may be the result of diabetes, bacterial infections, circulatory diseases and trauma.  Some people may be born with congenital birth defects which leave them with non-functioning limbs that may become more useful once removed and replaced with prostheses.

A prosthetic limb can enhance your quality of life after an amputation.  With a lower limb amputation, above or below the knee, a prosthesis may help you gain freedom of movement and avoid dependence on wheelchairs or crutches.  Upper limb amputees may also benefit from a prosthesis, depending on what functions you want to regain.  At Sunshine P&O we also fit partial foot and hand prostheses.  We have partial foot inserts to replace part of an amputated foot or toes.  There are also partial hand prostheses to help regain functions with the replacement of fingers.

Although a prosthesis will never completely replace your natural limb, it can help restore all or most of your original functioning.  This is partially reliant on your level of amputation.  Below the Knee amputees usually do well in returning to former lifestyles.  Above the knee amputees may proceed more slowly but usually can return to former lifestyles as well.  Depending on personal goals and needs, patients with upper limb amputations have varied rates of success in restoring former lifestyles.

With a prescription for a prosthesis from your doctor,  we will make the necessary measurements of your residual limb, using the latest in scanning technology.  We will discuss various types of prostheses with you, including your lifestyle, then design the best for your needs.  We will custom fit it, instruct you on the use and care of it and also make any needed repairs and adjustments.

We can help you find other health professionals such a physical or occupational therapists for additional instruction and training on using your prosthesis as well as necessary strengthening programs.  We can also get you products needed to wear and care for your prosthesis, including socks and liners.

The weight of the prosthetic depends on the type and the components.  The average weight of a typical below the knee prosthetic is about 4 lbs.  The average weight of an above the knee prosthetic is about 8 lbs.  Your natural leg is usually about 1/6 of your bodyweight.

It is not recommended that you wear your prosthesis to bed because excessive wear may cause harm to your residual limb.

If your limb changes volume and the socket feels loose or moves while walking, or there is pain on the bottom of the limb, ask your Sunshine P&O prosthetist about obtaining socks.

Donning refers to putting the prosthetic or orthotic device onto the body.

Doffing refers to removing the prosthetic or orthotic device from the body.

There are several ways for an amputee to don a prosthetic, depending on their individual anatomy, preference and the design of the prosthesis.  Pull-in: Most users work with a donning sock to be sure that all necessary tissue is contained within the suction socket.  The donning sock is used where there is no liner interface and requires a lotion (wet fit)  or powder (dry fit).  The choice is up to the comfort and convenience of the amputee.  Push-in donning is for amputees with longer above knee residual limbs, some prefer to push the residual limb into the prosthetic’s socket, using a wet or  dry fit.

There are cosmetic coverings for the outer structure of a prosthetic (“endoskeletal structure”).  They are more than just for looks;  they protect the inner components from exposure to harmful external elements.   There are also foam covers which can be applied to the outside of the prosthesis.  These covers can be custom shaped, based on the patient’s measurements.  At Sunshine P&O, we use a state-of-the-art technology – a 3D scanner to get the exact measurements and shape.  There are also custom protective skins which can be painted or sprayed onto the foam cover.  Whether or not you cover a prosthetic is a personal decision.  Many athletes chose not to cover their prosthetic legs in order to keep it as lightweight as possible.

Prosthetic socks area work over the residual limb.  They come in various thicknesses and materials and provide cushioning, reduce and absorb friction, protect the skin, absorb perspiration and compensate for any shrinkage and/or swelling of the residual limb.  A residual limb will change size and shape over time.  Different thicknesses of socks (ply) are used to compensate for any increase or decrease in size of the residual limb.   Your prosthetist will show you how to put on the sock, when to put it on and how to use the most efficient one for your needed fit.

Bespoke Fairings™ are specialized coverings which surround a prosthetic leg which are created through a three-dimensional scanning to capture the actual leg shape.  In addition to regaining lost contour, the patient has the choice to express their personality in the design and materials used.

This depends on changes in the residual limb size, activity levels, body weight/height and general wear and tear on the components.  In early stages, residual limbs frequently change size and shape, most often within the first 6 months after amputation.  This may require socket changes or adjustments. We recommend an evaluation at least every 6 months by a certified prosthetist.  Early detection of a problem can prevent major problems.

We at Sunshine P&O attend conferences all throughout the year to learn about new devices and equipment.  Our Resource page will provide you with a list of organizations that support, educate and advocate the amputee community. Among these are:

360 O&P – online Orthotics and Prosthetics Community

American Academy of Orthotists & Prosthetists (AAOP) – a resource for the latest prosthetic and orthotics information

American Orthotics & Prosthetics Association (AOPA) –  Mission: to work for favorable treatment of the O&P business in laws, regulation and services; to help members improve their management and marketing skills; and to raise awareness and understanding of the industry and the association.

Amplitude Media Group (AMG) – AMG recently launched a website and is offering bimonthly e-newsletters to subscribers. Both are geared toward amputees, their families, and their caregivers. It is a sister company to O&P Edge.

Amputee Coalition – Mission: to reach out to and empower people affected by limb loss to achieve their full potential through education,support and advocacy, and to promote limb loss prevention.

Active Amp – an online community for amputees with an active lifestyle – amputee sports directories and links, resources for adults and children, legislation and technology

Adaptive Action Sports – the first adaptive snowboard and skateboard specific non-profit organization, Adaptive Action Sports creates skateboard, snowboard and other action sport camps, events and programs for youth, young adults and wounded veterans living with permanent physical disabilities, TBI and PTSD.

Adaptive Climbing Group – a community for people with disabilities to have opportunities to inclusively participate in the sport of climbing. Adaptive Climbing is taking the already existing abilities of a person and helping them participate in the sport. They work with the Brooklyn Boulders Foundation, which assists children in local urban areas to have access to affordable climbing and mentorships they work to make sure that children with disabilities are included in this popular initiative. (newsletter)

Athletes with Disabilities Network – ADN’s mission is to promote a better quality of life for people with physical disabilities by creating awareness and offering opportunities to get involved with athletic, recreational and educational activities nationwide.

Disabled Sports USA –  Disabled Sports USA provides national leadership and opportunities for individuals with disabilities to develop independence, confidence, and fitness through participation in community sports, recreation and educational programs.

Extremity Games – The Extremity Games is an adaptive sports competition, similar to the X Games, for athletes with amputations and limb differences.

National Amputee Golf Association (NAGA) – First Swing Program teaches adaptive golf to people with physical disabilities.

Wounded Warrior Amputee Softball Team – WWAST athletes are examples of amputees who continue to push the limits of modern prosthetic technology with more and more applications. It is comprised of young competitive, athletic veterans and active duty soldiers who have lost limbs post-9/11, while serving their country in the military/war. The team includes individuals with a variety of amputations of the arm, above knee, below knee, bilateral below knee and foot.

Barr Foundation – Mission:  a non-profit organization established in 1993 to assist amputees with prosthetic rehabilitation. They provide assistance to amputees domestically and internationally who would otherwise have no other financial resources.

Camp No Limits – Mission: Camp No Limits is a non-profit organization 501 (c)(3) providing camps for children with limb loss, and education, mentorship, and support to these children and their families.

Challenged Athletes Foundation (CAF) – Mission: to provide opportunities and support to people with physical disabilities so they can pursue active lifestyles through physical fitness and competitive athletics. CAF believes that involvement in sports at any level increases self-esteem, encourages independence and enhances quality of life.

Never Say Never Foundation – The Never Say Never Foundation was formed to help disabled youth overcome adversity with a positive attitude. Focusing on amputee athletes, their goal is to push the limits of adaptive sports and show the world that anything is possible! Mentoring and sponsoring athletes, fund raising, hosting adaptive events and stunt shows, motivational speaking, and providing disabled youth with the necessary tools to compete at the highest level of sports.

Orthotic and Prosthetic Activities Foundation – Mission: Enabling individuals served by the orthotic and prosthetic community to enjoy the rewards of personal achievement, physical fitness and social interaction. FIRST Activity clinics available in swimming, diving, horseback riding, rock climbing, golf and more.

Wounded Warriors Project – Mission: To raise awareness and to enlist the public’s aid for the needs of injured service members; to help injured servicemen and women aid and assist each other; and to provide unique, direct programs and services to meet their needs.

Amputee Coalition – Mission: to reach out to and empower people affected by limb loss to achieve their full potential through education, support and advocacy, and to promote limb loss prevention. Their website contains information on the latest legislation for the disabled and updates on states which have passed Fair Insurance for Amputees laws. Updates on Federal legislation and resources for discrimination issues.

American Orthotic Prosthetic Association – updates on their pending lawsuits and advocacy efforts on behalf of fairness in health insurance coverage for those with orthotics and prosthetics.

The National Association for the Advancement of Orthotics and Prosthetics is a non-profit trade association dedicated to educating the public and promoting public policy that is in the interest of the O&P patient.

Some below-the-knee right leg amputees can drive effectively with their prosthetic; others may find a left-foot gas pedal installation better suited for their needs.  These pedals are inexpensive and fold out of the way for general use.  Other amputees might find hand controls a better option.

Phantom pain describes the sensations felt by amputees which may include itching, pins and needle feelings, stabbing pains, pressure, tingling, cramping, a sense of swelling – all in the area of the missing limb.  Most amputees experience these sensations althouigh the degree to which they are felt will vary.  The sensations come and go.  They may occur several times a day, for a few hours at a time.  After time passes after the amputation, they will become less frequent and intense and short lasting.  Your prosthetist will discuss options for helping reduce the pain.

Generally, your prosthesis should be kept as dry as possible to protect the components.  However, there are covers which go over them to help prevent water from entering.  There are also special prostheses designed for water activities such as swimming and showering.

A well fitting prosthesis will allow you to regain much of the function you have lost.  There are limitations depending on the type of prosthesis and your personal health and abilities.  Your prosthetist, physical therapist, and doctor, will work with you to ensure you get the most from your prosthesis.

There are different ways a prosthetic limb stays on, depending on the device itself.  Some use suction and a suspension sleeve, others may use straps or have a pin mechanism and roll on liner.  Your prosthetist will discuss the details with you.

Exercise plays a very important role in being prepared for your first prosthesis.  You will find that the stronger and more flexible you are, the easier it will be to work with your new prosthesis.  Your physical therapist will help by teaching you some exercises specific to your unique needs.  People often can begin their exercising while they are on bed rest and then increase the amount and type of exercise as they heal.  There are massage exercises to prepare the stump for continual contact with the prosthetic.

Once your residual limb, your stump, has healed and swelling has gone down and it is wrapped properly, you should be able to use your prosthetic leg with little to no pain.  You may feel some pressure but pain should be minimal.  Your prosthetist will give you a specific schedule for using your new prosthesis which will allow the residual limb to gradually adjust.  If you do feel pain while wearing your prosthetic leg, you should let your prosthetist know right away.

Your first fitting for your temporary prosthetic limb will be after your surgical wounds have healed and swelling is minimal.  This is usually 6-8 weeks after surgery, depending on how quickly you heal.

While most medical insurance coverage will include prosthetic limbs with a prescription from your doctor, it is best to check your policy and call your insurance company to be sure.

Lifetime of a prosthesis varies depending on the specific limb, usage, and your age, but it is typically 3-5 years.  During the first year of recovery after amputation, parts of your “temporary” prosthesis may have to be replaced, usually the portion that surrounds your residual limb.  This piece is called the “socket”.  Your limb will change in size during the first year as part of the normal healing process (“limb maturation”) and the socket may be replaced several times.

There should be a balance between these two which will change as the child grows. Small children will need the guidance from their parents; as they become teenagers, they will want to make their own decisions. At this point they will also be more influenced by peers, and amputee role models.

Replacing the prothesis every time the child grows (ie every few months) can be a mistake because it takes several months for the child to get adapted to a new prosthesis. The good news is that there are adjustable features which can be built into a prosthesis for a child to make minor adjustments until a whole new device is needed. In addition, a new prosthesis for a child may come with padding built in which can be adjusted to accommodate growth. Sometimes the length can also be adjusted to match the length of the other limb. A new prosthesis may be required in cases where there is a significant change in body weight, skin ulceration, bone overgrowth or trauma to the residual limb. Your Sunshine Prosthetics & Orthotics prosthetist is able to tell you when a change is necessary.