Amputee Rehabilitation

Amputations may be necessary due to many conditions such as:

• Peripheral vascular disease (poor circulation)
• Diabetes
• Infection
• Foot ulcers
• Trauma causing the limb to be crushed or severed
• Tumors
• Congenital defect

Physical therapists help patients prepare for surgery, and regain strength, movement, and function following surgery.

Before surgery, a physical therapist may:

• Prescribe exercises for preoperative conditioning, and to improve the strength and flexibility of the hip and knee
• Teach you how to walk with a walker or crutches
• Educate you about what to expect after the procedure

Your physical therapist will work with you as you heal following the amputation, help to fit your prosthesis, and guide your rehabilitation to ensure you regain your strength and movement in the safest way possible. Treatment may include:

• Prevention of contractures:  A contracture is the development of soft-tissue tightness that limits joint motion. It is important to prevent contractures early so they do not become permanent.  Your therapist will teach you how to stretch and position your limb to maintain normal range of motion.
• Compression to reduce swelling:  Your physical therapist will help you maintain compression on your residual limb to protect it, reduce and control swelling, and help it heal. Compression can be accomplished by:
  • Wrapping the limb with elastic bandages
  • Wearing an elastic shrinker sock

  These methods also help shape the limb to prepare it for fitting the prosthetic leg.

• Pain management:  Your physical therapist will help with pain management in a variety of ways, including:
  • Manual therapy, which may include “hands-on” treatments performed by your physical therapist, including soft tissue (ie, muscle, tendon) mobilization, joint manipulation, or gentle range-of-motion exercises, in order to improve circulation and joint motion
  • Stump management, including skin care and stump sock use
  • Desensitization to help modify how sensitive an area is to clothing, pressure, or touch.

  Approximately 80% of people who undergo amputations experience a phenomenon called phantom limb pain, a condition in which some of their pain feels like it is actually coming from the amputated limb. Your physical therapist will work with you to lessen and eliminate the sensation.

• Prosthetic fitting and training:  Your physical therapist will work with a prosthetist to prescribe the best prosthesis for your life situation and activity goals.  The prosthesis will be modified to fit as needed over this time.
• Functional training: Your therapist will teach you the skills you need for successful use of your new prosthetic limb. You will learn how to care for your residual limb with skin checks and hygiene, and continue contracture prevention with exercise and positioning.

  Your physical therapist will teach you how to put your new prosthesis on and take it off, and how to manage a good fit with the socket type you receive. Your therapist will help you to gradually build up tolerance for wearing your prosthesis for increasingly longer times, while protecting the skin integrity of your residual limb.