If you've recently undergone a below-knee amputation, a well-balanced rehabilitation program will help you return to your life as seamlessly as possible. As part of your rehabilitation, a physical therapist will consider your overall health, your residual limb's condition, your current physical fitness level and your old hobbies and interests when developing your personalized exercise program.
At the Hospital
Being physically active soon after your surgery will help increase circulation to encourage healing, reduce risk of stiffness from immobility and help you re-establish your independence. As a result, your physical therapist may begin having you gently stretch your leg and hip muscles within the first two to three days at the hospital. She may also instruct you on safely moving in and out of your bed, properly putting weight on your residual limb and using crutches or a wheelchair until you start wearing your prosthesis.
Home Exercises
You will also go through physical therapy after you are out of the hospital to continue building strength and to maintain a healthy range of motion. Your physical therapist will show you how to do stretches for the inner thighs, hamstrings, quadriceps, hips and abdomen. Stomach-lying is one position he will encourage you to enter for at least 30 minutes twice daily. Being stomach-down on a flat surface will help prevent your quadriceps muscles from getting too tight and enable you to further stretch by pulling your residual limb backward. You can also raise your arms and elevate your head from this position to stretch the muscles in your back, knees and hips. Your therapist will also encourage you to train your brain by regularly performing day-to-day activities such as kneeling down and reaching for objects across a table.
Using a Prosthesis
Depending on your individual circumstances, your doctor or physical therapist may have you practice with a prosthesis as soon as 10 to 14 days into your recovery, according to MetroHealth Heart & Vascular Center. A prosthesis takes getting used to, so your therapist will encourage you to perform exercises to perfect your mobility while wearing one. Learning how to balance properly is significant, because you will constantly need to shift all your weight to your prosthesis during normal activities such as walking. Leaning over into the prosthetic leg, kicking a ball with your nonprosthetic leg, holding a rail as you move your nonprosthetic leg up and down steps and dancing are just a few activities that will help you develop balance as well as agility.
Risky Activities
Your hip and knee are at risk of remaining in a flexed or bent position after you have a below-the-knee amputation, according to Ohio State University Medical Center. As a result, your doctor or physical therapist will also make suggestions about what not to do. For instance, she will recommend not placing your residual limb on a pillow when you lie down or placing a pillow between your knees or thighs unless she tells you otherwise. She will also advise against crossing your legs while sitting, hanging your residual limb over the side of your bed for long periods of time or staying in one position for any extended time.
References
- UW Health; Below the Knee Amputation; March 2011
- The Ohio State University Medical Center: Below Knee Amputee Exercise Program
- "Atlas of Limb Prosthetics"; Chapter 23; Physical Therapy Management of Adult Lower-Limb Amputees; Robert S. Gailey, Jr., M.S.Ed., P.T., et al.
- "Senior Step" from the National Limb Loss Information Center; Keep Moving: Exercises for People With Lower-Extremity Amputations; Melissa Wolff-Burke, EdD, PT, ATC, and Elizabeth Cole, PT; December 2010
- Beth Israel Deaconess Medical Center; Below-the-Knee Amputation; Patricia Griffin Kellicker, BSN; September 2010
- MetroHealth: MetroHealth Heart & Vascular Center: Amputations
