Prosthetic Categories

Prosthetic Socket Alignment: Side to Side

    You just received your new prosthetic socket, and it fits amazingly well. So, why is it uncomfortable to walk? In our Prosthetic Socket Alignment series, we explore the ideal balance and alignment for your prosthetic leg. In this article, we discuss the alignment of your socket and its relation to the rest of the prosthesis when inspected from side-to-side. Read about the ideal socket alignment when examined from front to back here.

     An illustrated below-knee amputee with prosthesis shows how to determine correct socket alignment when inspected from side to side.

    Ideal prosthetic alignment

    A prosthetic leg is a complex system. For this system to function well, it requires your entire prosthesis to be in "balance." This means everything needs to be ideal, including suspension and alignment.

    One of the quickest ways to figure out if your alignment is correct is to have someone take a photo of you standing and wearing your prosthetic leg from behind. Using an app on your phone--like Skitch or similar--divide your socket into two equal parts. Proceed to draw a mid-line from your socket down to your foot. The line should also bisect the heel of your prosthetic foot or fall slightly to the inside (within 3/16 inch.)

    Prosthetic alignment issues

    Review your photo. You'll know it's time to schedule an appointment with your prosthetist when you find that the line is falling through the outside heel. If this is the case, you're likely experiencing too much pressure or discomfort along the top side bone (fibular head) if you're a below-the-knee (BK) amputee. If you're an above-the-knee (AK) amputee, you'll find that you lack side-to-side stability when walking with your prosthetic leg.

    However, if you discover that the line falls too far to the inside of your prosthetic heel, your walking pattern is likely similar to that of someone with knock knees. If you're a below-knee prosthetic user, you might also experience discomfort along the top inside and bottom outside of your socket. If you're an above-knee amputee, bringing the prosthesis underneath you during single-limb support may be an uncomfortable experience. You may also experience discomfort along the top inside brim near your pubic bone.

    Whichever the case may be, a trip to your prosthetist can solve these issues. Often, re-centering the socket in relation to your prosthetic foot can make your socket feel more comfortable. The adjustment can also prevent pressure and friction-related discomfort. 

    Please don't hesitate to contact us with your questions. You can also leave your questions in the comments section below.