Amputee limb shrinkage – yes, it is real.
Shrinkage…volume loss…volume reduction are all terms for when the residual limb (stump) gets smaller. Typically this is caused by either atrophying of the muscles or reduction in edema.
When a person undergoes an amputation, the distal end becomes swollen. It has fluid retained in the limb, especially the distal end. With compression (usually shrinker socks, ace wrap or rigid removable dressings), this fluid gets moved up out of the limb and the limb becomes smaller.
Compression will also keep the swelling from increasing and also reduce pain (throbbing, phantom pain).
Care and use of these compression garments will be given to the patient at the hospital after amputation. Most garments are machine washable. I typically instruct hand washing, to insure that the amount that they stretch is decreased. Like anything stretchy, it will stretch out over a couple of weeks and a replacement will be necessary. This can be provided by a prosthetist, as proper sizing is needed. If ace wrap is being utilized, it is imperative that the patient is taught how to properly wrap the limb.
Muscle atrophy will occur, typically 3-6 months post fitting of the prosthesis. Muscle atrophy is when the muscles get smaller from decreasing in use. This is largely seen around the back of the calf for transtibial (below the knee, BK) amputees and around the gluteus muscles (buttocks) or quadriceps for transfemoral (above the knee, AK) amputees. This is totally normal.
- The muscles in the calf are used to control the ankle (dorsiflex, plantarflex, inversion, eversion). In transtibial amputees (below the knee, BK), the ankle is no longer there, therefore those muscles do not have the same muscular requirements as before, and they will atrophy.
- In transfemoral amputees (above the knee, AK) the gluteus muscles, which are the main hip extensors, will tend to get smaller on the amputated side over time due to reduced use and over compensation on the sound side. The function of the quadriceps is to flex the hip and extend the knee, if the knee is no longer there, those muscles will get smaller too.
- If you are concerned about atrophy or limb shrinkage consult your doctor.
An exercise routine can be incorporated to help strengthen these muscles. The best way to keep them strong and healthy is to walk and keep them active through daily exercise.
Consult your doctor and/or physical therapist prior to starting any exercise regiment.