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3 Tips to Manage Socket Fit

Posted by Bryan Potok, CPO on

Lower back pain, pressure over a bone, wearing a dozen sock ply too many—all of these are good reasons to manage your residual limb’s volume changes proactively. If you’re already wearing a 25-ply sock, but you’re still wondering what else can be done to make your prosthesis feel comfortable, your residual limb doesn't swell and shrink uniformly.

A below-knee amputee enjoys a day on the field because of proper socket volume management.

If you’re dealing with lower back pain, tightness in some areas of your socket and looseness in others, and you’re still uncomfortable wearing a 25-ply sock, continue reading. We have three tips that can save you from unnecessary discomfort. 

The simplest of all solutions

This is the simplest of all three solutions, yet we understand that not everyone has access to a secondary liner. If your prosthetic socket is either too loose or too tight because of weight loss or gain, then switch your liner for one that has a different thickness. 

If you’re dealing with a loose socket, we recommend going from a 6mm thickness liner to a 9mm one. Then, reduce your prosthetic sock ply by 10-15 plies. If you’re an above-knee amputee, this simple change can help you manage any rotation you may have been experiencing in your prosthetic leg. If you’re a below-knee prosthetic user, bending your knee will be easier because a 9mm liner still features a 3mm thickness in the back, which avoids knee flexion restrictions.

However, if you find that your socket is too tight, reduce your liner thickness from 6mm to 3mm. Then, add a thin sock to take up any new-found volume within your socket.

Add a gel sheath or sock when your socket is loose

If you don’t wear a prosthetic liner, or the one you have is only 3mm in thickness, you have two options. One, add a skin reliever sheath over or underneath your liner. Doing this will surely make you feel comfortable while also reducing your sock ply.

Two, add a Silipos Ultra Cushion Gel Liner over or under your prosthetic liner to increase cushioning and create a comfortably tight socket fit. As a bonus, choosing this option will help keep your limb cooler in the summer and warmer in the winter, as a result of its CoolMax outer covering.

Whichever option you choose, we highly recommend testing these gel sheaths and socks at home to ensure they don’t affect your suspension while you’re out and about.

Incorporate targeted solutions

There are no cookie-cutter solutions to managing residual limb volume, which is why we added this section. Each person is different. Some amputees find that their limb doesn’t shrink uniformly.

If this is you and you’re a below-knee prosthetic user, you’ll find that your prosthetic leg is either too loose along the bottom or around the knee. In situations where your socket is loose along the bottom, you can use either a half sock by Comfort or Silipos Mineral Oil Gel Roll-On.

If you prefer the half-sock option, we recommend adding it over your liner. This limits the “bell clanging” of your residual limb within your socket without feeling uncomfortably tight around your knee.

If you’re going the gel roll-on route, use it before applying your prosthetic liner. It will snug up the lower part of your prosthetic socket without affecting the upper portion.

Another targeted solution is applicable for both below- and above-knee prosthetic users who experience looseness along the top part of their sockets, but the lower part feels just right. Take an old prosthetic sock and grab scissors to remove the toe portion of the sock and apply your new half sock to your limb. This DIY technique works wonders, especially for above-knee amputees, who can immediately experience less socket rotation. This also reduces the obnoxious noises you may have noticed emanating from your socket. 

Which of these solutions have you tried yourself? Please don’t hesitate to share your experiences with us. And if you have any questions, please send us an email or leave a comment below.

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  • These tips are helpful, when your experiencing loose or tight fit it helps to know what other amputees have tried. I have an older type prosthesis that doesn’t allow for liners but one of the best things I have done in the 50 years I’ve had it is to try to keep my weight and exercise routine as consistent as possible.

    Dan Fincham on

  • My husband has the same problem. They heated the spot over the shin bone and firmed a small raised circle to accommodate it. Better, though not perfect.

    Marjorie Wimmersberger on

  • My socket hurts so much I cannot wear it. I have used all the suggestions above, but the pain from my pointed shin bone hitting the socket is excruciating and caused bleeding and blisters. Also my calf muscle is being squeezed like a vise.

    Mark on

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