Short below-knee residual limb: can a below-knee prosthesis still be comfortable? A customer story
A short below-knee residual limb can narrow the choice of socket types, but refining the socket repeatedly and changing the prosthetic foot can still change how walking feels. Our customer kept the conventional socket type used for years and switched from a wooden prosthetic foot to a carbon fibre one — and said it felt as though long walks would now be less tiring. Results vary from person to person.
Who was our customer?
Our customer had a short residual limb below the knee and had worn a conventional (traditional-socket) below-knee prosthesis for many years. There was still some pain in the residual limb, which made fitting a prosthesis more demanding.
Why is a short residual limb harder to fit?
In a below-knee prosthesis, the remaining part of the leg generally works like a lever inside the socket to move the prosthesis, while the socket walls share the body weight. With a short residual limb that lever is shorter and there is less surface in contact with the socket, so holding the prosthesis securely is harder.
For this reason, suction liners or pin-lock liners do not always suit a short limb. Our customer had been using a conventional socket, and the new prosthesis was made the same way. To account for the short limb and the pain, we adjusted the socket several times until the fit was right. Liner types are covered in a separate journal article.
What changed this time was the foot
Previously our customer used a relatively inexpensive wooden prosthetic foot. It did the basic job, but long walks left the foot, ankle and knee joints feeling tired. This time our customer chose a carbon fibre foot (for example, Pro-Flex Pivot), designed with a moving ankle section and known for making slopes easier to walk on.
| Wooden prosthetic foot | Carbon fibre prosthetic foot | |
|---|---|---|
| Build | Solid body, basic function | Flexes like a leaf spring and springs back |
| Slopes and stairs | Little ankle movement, can feel awkward | Models with a moving ankle follow the ground more easily |
| Suits | People who do not walk a great deal | People who walk a lot and for long periods |
| Cost | Generally lower | Varies widely by model |
These are general tendencies; products within each type differ.
How did it feel after the change?
After walking between the parallel bars, our customer told us it was far less tiring than before and that long walks now felt possible. With a short, still-painful residual limb this was not a simple fitting, but after repeated adjustments we heard the word "comfortable". How walking feels does vary with the residual limb and activity level.
How do you choose a prosthetic foot?
- Daily activity — how often and how long you walk
- Everyday terrain — mostly flat, or plenty of slopes and stairs
- Residual limb — length, pain and skin condition, decided together with the socket type
- Cost and funding — cost depends on the components; Korean residents can check health insurance and workers' compensation support with the relevant public agencies, and overseas customers receive guidance in consultation
The most expensive component matters less than the right combination for your residual limb and daily life. After delivery we provide after-sales care while you use it, and if a repair is not possible we will talk you through a remake.
Frequently asked questions
Can I have a below-knee prosthesis with a short residual limb?
It depends on the residual limb. The choice of socket types can be narrower, so, as with this customer, a conventional socket may be refined several times to get the fit right.
What is a conventional prosthesis?
The term usually refers to a traditional socket design that does not rely on a suction liner or a pin-lock liner. Depending on the residual limb, it can still be the right choice today.
Who is a carbon fibre prosthetic foot suited to?
It is often recommended for people who walk a lot or frequently use slopes and stairs. We choose it together in consultation, based on your activity level and residual limb.
Can a prosthesis be made if the residual limb is still painful?
This customer still had some pain, and the socket went through several adjustments. If pain persists, please see your doctor as well; fitting proceeds according to your condition.
