Back to Class with Orthotic and Prosthetic Devices

This is an encore posting of some Back to Class questions!

We have three questions about returning to school with orthotic and/or prosthetic devices.

QUESTION: 

The start of school is approaching and I am about to start my back to school shopping.   I wear both a prosthesis and an Ankle Foot Orthosis.  Is there anything I should be aware of for my brace or prosthesis?  - Tammy V

ANSWER:

Hi Tammy,

Before going back to school, it is a good idea to do a thorough inspection of your orthosis and prosthesis.  If there are any cracks, creaks or abnormal movements with either device be sure to schedule an appointment with your orthotist or prosthetist to have the devices checked out.   Also, if any of your liners, socks, sleeves, straps or buckles are ready to be replaced, it is better to schedule an appointment before school starts.  This way you won’t miss any classes.

As for your personal shopping, it is important to pay attention to what shoes you purchase for both your prosthesis and orthosis.  Typically, with an AFO we recommend that patients purchase shoes ½ size longer.  It may also be important to purchase a wide shoe in order to fit the device into the shoe.   For both your AFO and prosthesis, it is important that the new shoes also have similar heel heights to the shoes you brought to your most recent appointment with your orthotist or prosthetist.  

QUESTION: 

I want to try out for a school sport this fall.  As a below knee amputee and prosthetic user is there anything specific I should know before trying a sport and are there any restrictions?  - Derek Z

ANSWER:

Hi Derek,

We never want a prosthesis to limit a person’s potential activities.  We have patients who play or have played many of the common fall sports, such as football, soccer, volleyball, cross country and more!  That being said, here are some things to think about when starting a new sport.  1) Before going through a large change in activity levels it is always a good idea to contact your prosthetist.  Different prosthesis setups are intended for different levels of activity.  If your current prosthesis was not built with the expectation of high activity it has a higher chance of malfunctioning or holding you back.   2)  In whichever sport you decide to participate, it is important that you regularly inspect your residual limb for wounds or bruising.  Especially in the beginning, new, unfamiliar movements can change how your limb contacts the prosthesis.  Changes can be made to your prosthetic socket if this becomes an issue.   3) Be ready to sweat!  Prosthetic users almost always deal with the issue of sweating in their socket/liner.  With increased activity, it is very normal and expected.  It may be helpful to remove your prosthesis during breaks in play in order to air out your limb.  Bring extra prosthetic socks to practice and games.   As you sweat the size of your limb may shrink throughout the day, if this is the case, socks can help improve the fit and can assist in preventing unwanted limb movement within the socket.  Also clean your socket and liners daily.  Mild soap a damp cloth and rubbing alcohol can help with personal hygiene, component longevity and odor!  4) Have fun!  

QUESTION:

I am a fairly new above knee amputee.  My limb is very sensitive and I struggle to wear my prosthesis for more than a couple hours at a time.  Any recommendations to help get me through a day of school?  -  Julia D

ANSWER:

Hi Julia,    

Never feel like you have to keep your leg on during an entire school day.  It is common for amputees, especially new amputees, to limit the wear time of their prosthesis.  Schools want to help students who may need accommodations, so rather than struggle, take your time and do what you need to get through the days.  Talk to your prosthetist about writing a schedule down to help you gradually increase your tolerance.  Bring your prosthetist’s recommendations and contact information with you to school. Speak with your school counselor and ask for a meeting with your parents, teachers and the school nurse about your necessity to take breaks with the prosthesis throughout the day.  Your school will help you develop a plan that works for your needs and they can call your prosthetist if they have questions.

We also recommend that you do some work to help desensitize the limb.  First, become aware of issues that create stress for you. Trying to control stress is very important.  Relaxation techniques have been shown to significantly help with residual limb pain.  A second recommendation would be to start desensitizing exercises.  A common exercise is to lightly touch and rub hypersensitive areas of your limb with different textured materials. At first the materials should be extremely smooth and soft, for example silk.  You can do this for about 2-5 minutes, or to your tolerance, several times per day.  Once your limb can handle the silk material you can gradually use more coarse materials.  A common progression in material would be silk, cotton, corduroy, then wool.  If there are any open wounds on your limb do not rub it with any material. Never hesitate to give us a call if you have questions.

Thank you all for your questions!  

Do you have a question you would like to Ask Us? Email us at info@dankmeyer.com.