Making Adjustments to a Below-knee Prosthetic Leg 

Thanks for the feedback! This is actually something I'm in the process of doing. The videos have been received really well, so I'm working on stepping up the filming and detail to better show how everything works.

Two years out and I have phantom pain outrage

It's a hybrid system from Ossur that uses both pin and vacuum. Then, for some activities, I can even add a sleeve over the top for additional suspension/security. www.ossur.com/en-us/prosthetics/liners-sleeves-sockets

Unfortunately, I won't be much help on that front and wouldn't really be comfortable with that kind of stuff since it's so specific to the individual. Your best bet is to work with your prosthetist. I'm about 4 hours from mine, but I'll occasionally send him photos of hot spots, and he's usually able to provide some good advice on how to alleviate it.

Get an I WALK. If you don't have a prosthetic leg that is perfect for below the knee amputee. I know, I have used it before I got prosthetic legs.

I use sketchers there great give them a try sir

@@Glen-dv5jq You are doing well. I want to contact you.

@Garrett Dimon I need some help with grants and different clinic and so on

You're right, Susan. And I try to acknowledge that in the video. Getting familiar with learning to adjust your own leg isn't something I share lightly, but as someone who wants to stay active and enjoy life, the other options aren't always feasible. In my case, and I'm sure many others, the devices for quick-switching of feet aren't a viable option. For me, insurance wouldn't cover them, and they aren't cheap. For others, they simply don't have the vertical height to spare to between their residual limb and their foot to insert a taller component. And in other cases, having multiple sockets for different feet isn't practical either due to cost. Finally, I live 4 hours away from my prosthetist, and it's not uncommon to need minor adjustments that can't justify an 8-hour round-trip drive. So learning to manage some of this myself was necessary.

@@AdaptableOrg Hello, I heard your disclaimer and I understand your reasoning for it as well (distance, isolation cost of parts etc). You have to understand that the information you gave is just enough to make someone do something dangerous. Remember the majority of amputees in NorthAmerica lose their limbs to pathologies that affect circulation. They may not have the dexterity, strength or cognitive ability to make the same logical choices as you describe in the video. What they hear is that they can self-adjust. These devices are medical grade and are fit by a specialist. Overwhelmingly, in my practice when someone self adjusts it usually has a pretty terrible effect and I am trying to problem solve what is wrong since most of the time they don't want to tell me they self-adjusted. Then I have to reset everything and start again and mark everything to prevent tampering. That can be expensive as well but more importantly, it can be dangerous to the overwhelming majority of patients that do not have the same high-level function that you have. Also, there are many different causes why excessive moments are felt in a socket. Your example of toeing in and out a foot is only one of the many reasons why this is happening. You fail to mention socket fit can be an issue and also personal health changes. I have had patients who have had strokes and have not realized that it is them that is affected not the leg. See what I mean? However, I am always a fan of compromise. When I have a patient that is very particular about alignment (or find they change when they are home) and want to self-adjust I suggest using wedges in the shoe. I'm sure you used them in different shoes to accommodate different heel heights. Wedging the shoe will give the tiltng effect that you are doing with adjusting the grub screws. That alignment can be transferred to the leg when the person can see their prosthetist. It will not compromise their device and it is totally reversible. What you are suggesting has some good stuff in it for you. You have to remember this population comes in many health stages. The majority are geriatric and dysvascular. Many have cognitive, balance, and strength issues. Remember they are watching this video and so is their family. I know because I have to spend countless hours with patients explaining not to self-adjust, and that running feet will not give someone the ability to run.

how do you adjust heel height?

I think every patient that is mentally capable of adjusting their foot should be taught how. I mean seriously we can’t be expected to go see our prosthetist every time we go from wearing dress shoes to athletic shoes. For some people that would be a daily thing.

@@markkicksass2448 that’s the problem. Diabetes can effect cognition and people can make some dangerous mistakes. I agree. Far distance with the direct guidance from a prosthetist with someone who is normal cognition. it can be fine. Wedging shoes should resolve most issues with heel height and are reversible and doesn’t effect the integrity of the leg ( lock tight and torquing where appropriate) It does come down to the patient. It is their leg. However if you muck it up get ready to have longer appointments to fix it or potential injury from mistakes. I don’t remember the video but a disclaimer would be a good idea. Think of the population you are speaking to. That’s all I’m saying. You can be doing more harm then good.