How we treat amputation

Compression is applied to produce a limb that is conical and stable rather than bulbous and changeable, because that is the shape a socket can hold. Alongside it, the hip and knee are stretched daily.

A fixed flexion contracture at the hip or knee is the most common avoidable reason a prosthesis cannot be used well, and it develops quietly in someone who spends the first weeks sitting.

Walking on a prosthesis is cardiovascularly expensive, and the higher the amputation the more expensive it becomes. Conditioning is therefore treated as a component of prosthetic readiness rather than as general exercise.

This is also where an honest conversation about candidacy happens. Where the cardiac or respiratory capacity is not there, the plan changes to wheelchair independence rather than continuing towards a device that will not be used.

Learning to walk on a prosthesis is a training programme: loading, weight transfer, step length, then stairs, slopes and uneven ground. Gait analysis shows what is actually happening at the hip and knee, and alignment is adjusted from the data rather than from appearance.

The anti-gravity treadmill lets loading be introduced in controlled increments where the limb is not ready for full weight — useful early, and useful again after a socket change.

Phantom and residual limb pain are addressed from the first week: desensitisation, early loading, medication review where indicated, and graded motor imagery including mirror work.

Pain that is dismissed becomes a reason people stop wearing a prosthesis, so it is managed rather than tolerated.