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  • Writer's pictureGainesville Prosthetics

Prosthetic Socks As Volume Management

Socks are an essential element to wearing and maintaining your prosthesis on a consistent full-time and daily basis. Prosthetic socks are garments of various sizes and thicknesses, most commonly made from wool, synthetic fibers, or cotton. They function to manage volume gain and loss on a daily basis, and even throughout the day, to ensure a comfortable and proper fit of your prosthesis. Prosthetic socks come in varying levels of thickness, known as "ply," often in 1, 3, or 5 ply, with others available depending on an individual's unique needs. The larger the ply number, the thicker the sock. Socks can be stacked as necessary, but it is recommended to contact your prosthetist for adjustments if you need 8 ply of socks or greater.

You may have noticed how drastically your residual limb volume can change, even from morning to night, and you may already wear a shrinker in order to manage these changes in volume. While wearing a shrinker any time you are not wearing your prosthesis is the best practice, what do you do when you are wearing your prosthesis, and your limb volume is still significantly changing? This is where prosthetic socks come in.

Several factors can influence both volume loss and volume gain within your residual limb. Volume loss can be caused by overall weight loss, increased activity or time wearing your prosthesis, cold temperatures, and diuretics such as blood pressure medication. Significant volume loss leads to feelings of looseness or shortened height in your socket, greater pressure or discomfort in bony areas, back pain, and slipping of the socket while walking, known as pistoning.

Conversely, factors that lead to volume gain include overall weight gain, decreased activity or time wearing your prosthesis, increased appetite, blood pressure fluctuations, hot temperatures, dermatitis, and medications. Volume gain often leads to a tight or ill-fitting socket, pressure causing pain or discomfort in new areas, feeling too tall in your leg, pinching, and back pain.

Changes in volume, while they can be predictable, are difficult to manage on an individual scale. It is for this reason that we use socks. You will know that it is time to add a sock when your leg feels loose in your socket, you have pain or excessive pressure at the bottom or end of your limb, or if you have pain on the inside of the limb near the top of your socket. In contrast, you will know it is time to remove a sock when your socket is excessively tight and difficult to don, you feel a throbbing sensation at the bottom of your leg, or if you notice red or purple discoloration, blisters, or an orange peel-like appearance on your residual limb. It is also crucial to remember that if you have a wound or blister that is warm, yellow, secreting or contains pus or milky fluid, or is excessively swollen, you may have an infection and should contact your physician immediately.

Prosthetic socks should be added and removed one ply at a time. To don a sock, first scrunch it down to the bottom seam with both hands. Stretch it horizontally and pull it over your limb, ensuring it is snug and void of any wrinkles. Ensure the bottom seam is worn away from any bony areas. If you find yourself consistently needing more than 8 ply of socks, contact your prosthetist to reevaluate the fitting of your prosthesis. Similarly, contact your prosthetist if you are unable to maintain socket comfort, with or without socks. When not wearing your prosthesis, remember to wear your shrinker in order to help maintain the shape and volume of your limb.

Prosthetic socks should be changed out and cleaned daily. Follow the manufacturer's instructions for cleaning if able; when in doubt, machine or hand wash your socks with mild soap on low settings, and hang to dry or machine dry on low heat settings. Your prosthetist will give you a supply of socks so that you are able to both clean and wear as many as needed.

Transtibial (Below Knee) Donning Socks to Ensure Proper Socket Fit

Transtibial (Below Knee) Donning a Sock Over a Locking, or Pin Liner

Transtibial (Below Knee) Donning a Sock Over a Cushion Liner

Transfemoral (Above Knee) Donning a Sock Over a Seal

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