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I'm on My Fourth Check Socket - Is this normal?

Posted by Bryan Potok, CPO on

Scott Sabolich, CP, LP, a third-generation certified prosthetist and owner and clinical director of Scott Sabolich Prosthetics & Research in Oklahoma, says, "The socket is the most critical component of your prosthesis. If it doesn’t fit correctly, you can experience pain, sores and blisters, and the prosthesis will feel heavy and cumbersome. Your mobility may be compromised, or the prosthesis may even end up in the back of your closet."

Once based more in the arts, socket design is now rapidly changing into a science. It has gone a long way from using hard plastic and wooden sockets, and has evolved into contoured, customizable sockets for amputees to get the most out of their prosthesis.

How many check sockets are normal when first getting a new prosthetic leg.

What Is a Check Socket?

A check or test socket is a temporary prosthetic socket that's made to diagnose the fit of a new prosthetic socket.  Like a rough draft or beta version, before your Prosthetist finalizes the design. From there, your Prosthetist gathers information and uses that data to create a socket that's custom made for you.

Often times multiple check sockets are fabricated to attain a precise fit. If a new check socket is needed, it's usually based off of your previous test socket. With each subsequent test socket, you can expect that your 4th test socket looks a lot different from the original socket model. Some Prosthetists claim that the unique characteristics of your residual limb may become washed out with each successive check socket.

This is not always the case when designing a socket for a vacuum suspension system. Occasionally multiple check sockets are necessary to dial in just the right fit with minimal sock ply and uniform compression.

My Prosthetist Has Tried 4 Times—Why Doesn't It Fit?

Your Prosthetist's artistic socket style may suit others, but it may not be for everyone; even the best Prosthetists can struggle with some fittings. Seeing your Prosthetist takes multiple visits and effort so it’s understandable if you feel stressed and frustrated. However, know that these instances are not isolated.

If you have a good working relationship with your Prosthetist, have a candid conversation with them and express how you feel at this time. Sometimes, it's best to regroup and start from scratch to create a fresh, new mold.

When there are too many fittings and mold changes, your Prosthetist may lose their way with all the new variables introduced into your socket. If your Prosthetist works at a prosthetic facility with multiple certified practitioners, it will help for a fresh pair of eyes to examine your prosthetic socket. Again, communication is key. Use this opportunity to foster a more positive relationship with your Prosthetist and work together to get the best socket for you.

But Don't You Worry!

Your insurance typically covers two prosthetic test sockets with each new prosthetic leg, so don't worry about the extra costs. Again, getting the ideal fit may mean a bit of work between you and your Prosthetist. Always remember that your Prosthetist wants nothing more than to give you a prosthetic socket that fits great—one that allows maximum mobility and gives you the utmost comfort possible. Also, bear in mind that your residual limb never stays the same and can encounter volume changes. It's up to you to keep your weight within the range of +/- 2% of your normal body weight. 

It's always best to schedule all of your fitting appointments at the same time of the day each time.  Leave a comment below to share your experience.

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  • I only had one fitting and my prosthetic is too large. I have extra socks to make it fit and sometimes it just won’t stay on. What can I do. Can I get a new prosthetic leg since I have only had one. Will the insurance company pay for another one.

    James Heliton on

  • I’ve worn an A/K prosthesis for 65 years and have experienced the many changes in how limbs are fitted. I suggest that when patients are having difficulty in fittings, ask the prosthetist to explain the cause of the problem. This creates a dialogue in which the patient can gain greater knowledge of his/her personal fitting issues and have the opportunity to have input that may help determine the cause of problems as well as the resolution. I’m not suggesting that the patient try to become the prosthetist, but instead, gain an understanding of what/why a problem exists as well as how the prosthetist will resolve the issue. A patient’s feedback to the prosthetist is important to resolving fitting problems. Indeed, weight gain or loss can present a problem. The patient and the prosthetist are a TEAM working together throughout the fitting process. I have experienced situations in which I recognized that the prosthetist didn’t have the experience or knowhow to resolve a particular problem, in which case, I went to a different company, asked how they would resolve my unique problem. Having gained knowledge over the years, their approach made sense to me. I became their patient and had (and still have) excellent results. Again, the open communication between patient and prosthetist along with a patient’s understanding of the fitting process; the patient’s personal issues that may be challenging, if any; and an open dialogue with the prosthetist are, all, mutually beneficial to provide and receive a good fitting prosthesis.

    Margaret Lee on

  • After an amputation, a stump can swell, larger than your extremity originally was. * Getting your stump, to shrink as small as possible, is your first objective. * The more you use your prosthesis, the greater your stump will change its shape & size, over time. * My stump changed many times, over a 40 year span. *

    Keoni Ronald May on

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