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  • Writer's pictureGainesville Prosthetics

Volume Gain/Loss & Socks

Individuals with lower-limb amputation(s) experience significant changes in the shape and volume of their residual limb during the post-operative recovery period, which typically lasts 12 to 18 months. Even after this initial recovery period, the residual limb continues to undergo daily fluctuations in volume, which can vary among individuals and cause challenges.

Managing the volume of the residual limb is crucial for making decisions regarding the timing of fitting the first prosthesis, determining when a new prosthetic socket is needed, designing the prosthetic socket, and prescribing strategies to accommodate daily volume fluctuations. One common method of managing volume changes is by adjusting the thickness of the sock worn on the residual limb. Sock thickness is measured using a "ply" rating, ranging from 1-ply to 6-ply. By changing the ply number or the number of socks worn, amputees can compensate for changes in the size of their residual limb.

Monitoring the ply of the sock is a common way to track changes in residual limb volume. If there is an increased need to add socks, it indicates a significant reduction in limb volume (volume loss) and may necessitate a new prosthetic socket. If there is a need to remove socks, it indicates volume gain.

Possible causes of volume loss include weight loss, cold environments, diuretics, increased activity, and increased wearing time of prostheses or shrinkers. Possible causes of volume gain include weight gain, hot environments, fluid retention, medication changes, decreased activity, dermatitis, and decreased wearing time of prostheses or shrinkers.

Potential problems related to volume loss include the residual limb feeling loose in the socket, pistoning, and pressure on bony areas. Potential problems related to volume gain include the residual limb feeling too tight with sock(s), improper fitting socket, and pinching. Back pain and discomfort are symptoms associated with both volume loss and gain.


  • Sanders, J. E., & Fatone, S. (2011). Residual limb volume change: Systematic review of measurement and Management. The Journal of Rehabilitation Research and Development, 48(8), 949.

  • Development, W. (2019, December 16). Prosthetic Socks and liners. Amputee Coalition.

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