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jberna

Sliding Liner

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I have a problem that is baffling even my prosthetist. I have had this liner for about three months, fits great, has worked great. All through the summer it worked well. I used the Certain Dri antipersperant that worked great on keeping my stump from sweating.

Then all of the sudden, about two weeks ago, my liner started sliding down my leg. Once it started to go, within a few steps it would slide down up to four inches. It would be down to the middle of my knee, which made walking a pain. I would sit down, take it off, wipe it out, then put it back on.

This weekend we went to Zion, hiked some canyons there (beautiful!) but I had to stop about five times in a two mile hike, just to pull my liner back up. Even with a tiny bit of sweat it would start to go.... :ph34r:

I have used the certain dri, just like before, and it seems to have stopped working. Plus, my liner NEVER used to slide down unless I was riding the bike hard or sweating hard...now it does in just everyday life walking....

It is not too big, my prosthetist measured that...he is ordering me a different kind, with a thicker gel in it. Right now I have an Iceross liner, with pin. I have been using a great sleeve that helps, but once my liner goes, my sleeve also slides.

Anyone have similar issues? Any suggestions? I just got my permanant socket and was so pleased it fit so well, then this liner thing started....a problem I didnt expect! :o

judy

Utah

LBK

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Hello Judy,

I saw you are a LBK and from your description I understood you have an Iceross, thus a silicon liner from Ossur.

I (LBK) have used different types of Ossur liners and the times my silicon liner slipped off my stump were only when I swam with it, it never happened to me while sweating.

So I started thinking about your problem:

What I have learned about the suction effect of silicon liners is that with a perfect fitting of the silicon liner on the skin the sweat production is reduced to very very little.

The liner stays on the stump because the high friction effect of the pressure on dry skin.

This can take some weeks because the sweat-glants producing the sweat have "to get used" to their sealed environment.

This works best when there's direct contact between the skin and the silicon surface of the liner.

What could be possible, is that any products you apply to the skin refrain the sweat-glants from their reaction of stopping to work.

I think also whith a stump which has a very conical form, slipping off will happen easier.

Another possibility is that the measurement of the stump for the exact size of liner has been wrong or a wrong size has been delivered by the Ossur-dealer.

Ossur has a method of taking the exact measure to fit a liner perfectly.

Maybe it's a good idea of measuring the stump again and check the size of liner you wear.

Ofcourse you can always consult Ossur directly about your problems via their homepage.

I'm interested in how things work out Judy, please get me informed about your progres.

Good luck,

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Judy you have most probably 'got a puncture'. I've had the same thing happen and it had me baffled the exact same way until I noticed the next day when donning it that it had a tiny weeny hole right through near the bottom. It only has to be miniscule and what happens is with every step it sucks in air which breaks the suction hence your leg ends up dropping off every few steps :ph34r: I'd lay odds on it <_< :)

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Luckily I've never experienced a puncture in one of my liners so I don't know about it.

But you are right, it could very well be the cause of Judy's sliding liner problem.

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I have an Alpha liner (lock in) and from other postings I think it's a gel material. One thing I've noticed is that leg hairs can get embedded in the gel and work their way in quite deeply. I don't know if the silicon type is tougher but could this be the cause of puncture's. I wouldn't have thought the hole would have to be very big to allow air in over time.

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Hi Muz. I'm not sure about the hair thing, and you're right an Alpha liner is a gel liner only its a SOFT gel liner which makes it even more prone to these kinds of problems being that bit less durable. In fact what I have found with Alphas is that some of them are actually made 'faulty' if you like with an air bubble in 'em which I found quickly pops when you start to use it, leaving one with a puncture as mentioned before. I also have one where the bottom bit where pin attaches is kind of on the peesh so I only use it for emergencies and have to put it on wonky to align the pin <_< Come back Iceross all is forgiven-well almost :blink: :)

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You guys are amazing! :D Thanks for your ideas....I had never thought of a puncture, will do the water test this morning! And Co, thanks for your tips too. It is nice to have people around who know about this stuff. The thing that was baffling me was that this liner fit fine, never slid unless I was drenched in sweat, for the whole hot utah summer....and now it slides when I am just walking around the house in the daytime, totally cool, no sweat....

It almost feels like the liner has "stretched out"....my stump measures exactly the same as before so to me the only answer was that the liner stretched. BUT my prosthetist said that really isnt possible...for it to stretch.. :blink:

So I like the puncture idea, will try that...in the meantime will call my pros. and get back in there today. He had a new liner with a different kind of gel he wanted me to try, hope it helps....I just got a really comfortable socket (hiked two miles this weekend) and now the thing wont stay ON because my liner is whacked out! :blink:

THANKS again guys...you are PRICELESS! ;)

Judy

utah

lbk

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I am going in today to get a new liner...new kind, more "sport", whatever that means. I did the puncture test...my 11 year old son thought that was fun! No leaks that we could find.....just baffling....there were about four times yesterday that I was just around the house, cool autumn day, no sweat, and all of the sudden my liner is hanging off my knee....ARRRGGG :blink: !

Maybe this new liner will help somehow...I finally got a socket that feels great and my liner wigs out!

Keep you posted, just for future reference...

Judy

LBK

Utah

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HI

I had two Alpha Liners and I must say they didnt last long. They puntured after about two months wear. I now have a silicone from Otto Bock and this fits much better and stays on ....doesnt move at all.

The one thing my guy said to me with the Alphas do not use any baby powder or any sprays with it........maybe its the spray you are using.....just a thought

REGARDS

JENNY SOUTH AFRICA.

PS They also told me that the Alphas were not for heavy duty use whatsever more for the non so active.!!!!!!!!!!

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Hi Judy,

I think that maybe it is due to volume loss of your limb. You haven't been at this for all that long and that takes place durring the first couple of years depending on activity level, and I know that you are very active.

Best regards,

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I quite often have the same problem, but only usually after sweating lots, I too wear an iceross. One thing I do find is that they generally seem much more retentive when new. I don't know whether they maybe stretch slightly or whether the fitting surface just becomes slightly less grippy. If the antiperspirant you use seems to have stopped working I have heard that a product called ODABAN is very good (www.odaban.com). I ordered some myself recently so hopefully it'll do the trick!

Hope your new liner sorts you out

Mike

LBK

Scotland

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Update on the situation....I suspect Mike might have something with the loss of "stickiness"...I get a sense that either that happened or it stretched just slightly. I think Johnny is right too....They keep measuring my stump and say it has not changed but recently they said if I am becoming more "conical", shaped like an upside down ice cream cone, the measurements can be deceiving and it can make it slip off.

In the meantime I have the new "sport" liner, my Iceross, called "sensil gel". I have had it four days, two where I just wore a sleeve to hold it on, and two once I got a pin that fit it. I like the overall feel of a sleeve, but it tended to cause irritation to my thigh. I get rashes very easily that take forever to heal. So now I just have the pin holding it on and it seems to be working well.

I am very careful to keep my liners clean, never put anything on my skin right before I put them on....do put lotion on the stump at night, and when I use an antipersperant put that on at nights, thinking it will all soak in by morning. Hope this liner lasts longer! So far so good.... :)

Thanks for ALL the help, you guys are great!

judy

utah

lbk

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Hi Judy,

I too, wear the Ossur liners. Sometimes, I react to the liners when they are new with a rash as well. What I have done is use a clear gel Benadryl lotion. It is aloe based and works well without leaving any residue on the liners. It absorbs really well.

The only time that I have had a problem with slipping liners are when they are either too big or if the socket is making them piston and they work off. I too use the Certain-dry in the summer here in Illinois.

I learned at the ACA convention in an Ossur seminar that you could even use a good quality handsoap to wash the liners if needed. What if you gave it a good washing with some other soap and then tried it the next day? I know that Ian (who works for Ossur) said to make sure that they are rinsed really well. To rinse twice.

I'm sure that you have probably tried a lot of these things, but, I wanted to let you know about the Benadryl gel. I hope it helps you as well as it does me.

Higgy

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Thanks Higgy...I will try those things..thanks for offering some other solutions!

Judy

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Hi!

Another product you should definitely try for sweating is called alum or some know it better by 'Crystalux' which is basically the label name. Alum is an all natural deodorant with absolutely no aluminum chloride in it which most other antipersperants cannot claim - especially the prescription ones. This product can be bought in some department stores or you can purchase it at www.awardprosthetics.com and click on the 'Articles' link and go to the In Motion 'Don't Sweat It' Article. This article explains about alum and at the bottom is a link to the price list to purchase it.

One thing to note is that even though it comes in either solid or spray, I would try the solid first. Often when people try the spray first the think the product doesn't work and it is simply that it isn't a strong enough concentration. If the solid tends to dry out your skin then I would recommend using a moisturizer at night when you remove & clean liner and stump and if your skin is still really dried out then the chances are that the solid is too concentrated and you can either purchase a spray or crush up the stone and add to water in a spritzer bottle and that way you can control the concentration.

The other thing to note is that when you use it make sure that you wet the stone under the tap and then apply generously to the stump/leg/armpit (even apply twice if unsure) and then let it air dry before you don your liner, etc.

If you purchase it from Award Prosthetics they will provide you with detailed instructions.

Good luck!

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I'm a bit confused about the use of alum vs aluminium chloride here. I notice lots of anti perspirants (including my own underarm one by King of Shaves) claim to be aluminium free and then go on to list alum as the effective ingredient. Are people getting worried here because of the reported possibility of links with Alzheimer's disease? If this is the case then the use of alum should be discontinued as this is just aluminium sulphate, however the Alzheimer Society now believe it's very unlikely that aluminium is a contributing factor in this. If on the other hand people look at alum as being something natural (then associate natural with beneficial) it should be remembered that there are many naturally occuring substances that are definitely not beneficial. Some examples: Ricin, strychnine, pitchblende (killed the Curies), radon, and even some of the things that are essential to life such as salt (sodium chloride) are harmful in large doses.

By all means use whatever works for you but don't be fooled by marketing jargon even when it comes from a medical expert and don't be put off by urban myths.

Sorry for the cynical lecture :)

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Tracy, thanks for the help...dont know why my certaindri has stopped working but am open to using something new....cant tell you how much I appreciate this info! :D

Judy

Utah

LBk

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