I have heard that people need to adjust the amount of prosthetic socks they wear throughout the day. How do I determine the amount of prosthetic socks I should wear?

Answer:
Greg Michalov CP, COA
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In the age of prosthetic technology with computer controlled knee systems, various gel liner designs as well as microprocessor controlled socket systems and feet, the importance of the tried and true prosthetic sock might not seem very “high tech.”   The reality is that the understanding and use of prosthetic socks has never been more relevant.  For new prosthetic users I always make it a point of explanation that sock ply management is their first means of adjusting the fit of their prosthetic socket.

prostheticsocksDuring the initial prosthetic fitting I try to paint a picture of how their limb should be supported in the socket during weight bearing.  While the prosthetic fit will vary depending on the specific design of the socket, two key sensations of when to add a layer or ply of sock can be the presence of increased pressure on the patella or knee cap and an increased feeling of weight being carried towards the bottom of the limb.  If let gone too far the presence of increased redness or a blister at the bottom of the limb can be tell tail signs of “dropping in” to the socket too far.  Many times the addition of a ply or two of sock can help to boost the limb up in the socket reestablishing the intended weight bearing design.  That said, adding too many sock ply layers can have an opposite effect of feeling too tall on the prosthetic side.  So again “painting that picture” of what should feel normal is key to the understanding of the user.
So it begs the question “Why did my prosthesis fit great on Friday but not so great on Monday?” or even “Why did my prosthesis fit well this morning but is bothersome to wear by the afternoon?”  Changes in limb volume occurs via a number of factors including medications, salt intake, level of activity, kidney dialysis treatments, perspiration output or simply the compressive nature of having their prosthesis on for a period of time.  These issues are especially critical for the new user to realize and act upon to avoid problems.

Lastly and most importantly communication with your Prosthetist is essential.  While we want to know of your successes, it is our pursuit to work with you through the challenges as well.

Greg Michalov CP, COA