Orthopaedic Surgery - Therapy Advice Following a Lower Limb Amputation

What is an amputation?

An amputation is the complete or partial surgical removal of part of the body, usually a limb.

Types of amputations

The type of amputation being performed will be discussed with you by the doctors before you have surgery.

The most common lower limb amputations are:

  • Below knee amputation (trans-tibial) - the bottom section of the leg is removed, keeping the knee joint intact
  • Above knee amputation (trans-femoral) - the leg is removed above the knee, at mid-thigh leve

Amputation locations

Other types of lower limb amputation are:

  • Digit amputation: one or multiple toes are removed
  • Partial foot amputation: the toes and lower half of the foot are amputated, leaving the heel intact
  • Knee disarticulation: the lower limb is removed through the middle of the knee joint
  • Hip disarticulation: the lower limb is removed through the hip joint, removing the entire leg
  • Hemipelvectomy: the entire leg and a section of the pelvis are removed

Therapy input following your operation

All patients who have a lower limb amputation will initially be dependent on a wheelchair for mobility.

It is important that you don’t start standing and walking following your amputation until you have been advised to do by your therapy staff.

This is to protect your stump, prevent damaging your remaining limb and to prevent you falling.

Your therapists will teach you how to get in and out of your wheelchair safely following your operation.

Occupational Therapist

Your occupational therapist may contact you before you are admitted for your operation. They will discuss your home situation and your current level of mobility with you.

This is to allow your discharge to be planned early and enable any equipment you might need to be ordered for you.

The occupational therapist will also discuss wheelchairs with you. If you do not already have one, they will measure and order one for you so that it is available for you to use after your operation. They will ensure that you can get in and out of your wheelchair and that you can manoeuvre your wheelchair safely.

Physiotherapist

Your physiotherapist will review you as soon as possible after your operation. You will be taught suitable exercises and they will ensure that you can safely move from the bed into your wheelchair.

Exercises

Exercises are important following your amputation to help you improve your muscle strength and maintain the movement in your joints.

Your physiotherapist will guide you on which exercises should be done and how many to complete. Only complete the exercises ticked in your leaflet.

All of the exercises should be done slowly and smoothly. If you feel any increase in pain or symptoms that you are worried about stop doing the exercises and tell your physiotherapist or doctor.

Exercise 1 - sit up in bed with your legs straight out in front of you. Push the back of your knees into the bed, tightening the muscles on the top ofyour thigh. Hold for 5 seconds and repeat stated times

Exercise 2 - Sit up in bed with your legs straight out in front of you. Place a rolled up towel under your knee of your stump leg. Push down into the towel and raise your stump until your knee is straight. Hold for 5 seconds. Repeat this as stated times

Exercise 3 - Sit up in bed with your legs straight out in front of you. Tighten your thigh and lift your stump off the bed. Keep your knee as straight as possible. Hold for 5 seconds. Repeat amount of times stated

Exercise 4 - Sit up in bed with your legs straight out in front of you. Place a rolled up towel between your thighs. Squeeze the towel between your legs. Hold for 5 seconds. Repeat as many times as stated

Exercise 5 - Sit up in bed with your legs straight out in front of you. With your stump leg, imagine you are trying to move your foot up and down. The muscles in your stump should be working when you do this. Hold for 5 seconds. Repeat as many times as stated

Exercise 6 - Sit up in bed or lie on your back with your legs straight out in front of you. Squeeze your buttocks together as tightly as possible. Hold for 5 seconds. Repeat as many times as stated.

Exercise 7 - Lie on your back  as flat as possible. Put your legs straight out in front of you. use your hands to pull your thigh as close to your chest as possible. Push your opposite leg down flat onto the bed. Hold for 5 seconds. Repeat this as many times as stated

Exercise 8 - Lie on your back and place a rolled up towel under your stump. bend your other leg so that your foot is resting on the bed. Relax your arms by your side. Tighten your stomach, squeeze your buttocks together and push your stump down into the towel. Lift your bottom up off the bed. Hold for 5 seconds. Repeat this as many times as stated

Exercise 9 - Lie on your non-operated side and bend your knee underneath you for support. Lift your stump leg up as high as possible. Do not let your hips roll forwards or backwards. Repeat this as many times as stated.

Exercise 10 - Lie on your non-operated side and bend your knee underneath you for support. Bring your stump leg forwards towards your chest then push it backwards as far as possible. Do not let your hips roll forwards or backwards. Repeat this as many times as stated.

Exercise 11 - Lie flat on your stomach. Keep both legs straight and close togehter. Lift your stump leg off the bed as far as you can. Keep your hips flat on the bed and knee straight. Hold for 5 seconds. Repeat this as many times as stated.

Therapy following discharge from hospital

You will be referred to your local limb fitting centre to be assessed for your suitability for an artificial leg. This will be discussed with you in depth at your initial appointment with them. Not all patients are suitable for an artificial leg and some people may only have one for cosmetic reasons.

You may also be referred to your local physiotherapy department for on-going amputee rehabilitation. You should also try to continue with the exercises taught to you by your physiotherapist on the ward.

It is very important that you do not attempt to stand or mobilise until you have been advised to by your physiotherapist.

Contact details

In-patient Therapy Office, Salford Royal Hospital
0161 206 4557

Ward B6, Salford Royal Hospital
0161 206 4574
 

Date of Review: January 2025
Date of Next Review: January 2027
Ref No: PI_SU_1553 (Salford)

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