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kennie

Uncofortable socket

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I’m seeking help over socket design.

My left leg was amputated ATK 2 years ago and my NH prosthesis consists of a Trias foot, Otto Bock 3R92 knee, and an Iceross silicone liner in a hard socket. I find this combination quite good for walking, but the socket gives me a problem.

It comes well up to the groin and I am told this is necessary so that my weight on that side is supported on the “bum bone” - a shorter socket would allow me to slip forward off that support bone.

This is OK for walking, but is most uncomfortable for sitting, driving a car etc. because the socket digs into the groin; I hoped that over time the area would become hardened and the discomfort would be lessened - but this has not happened.

Many similar amputees would seem to have no difficulty in wearing their prosthetic legs through the day - I have come to wear mine for walking or standing only.

Is this a common problem, or are there sockets which eliminate this digging-in-the-groin problem? Comments and advice will be most welcome. kennie

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'kennie'

Welcome to the forum...:smile:...there are several AKA on here that can give you all the information you need.

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I’m seeking help over socket design.

My left leg was amputated ATK 2 years ago and my NH prosthesis consists of a Trias foot, Otto Bock 3R92 knee, and an Iceross silicone liner in a hard socket. I find this combination quite good for walking, but the socket gives me a problem.

It comes well up to the groin and I am told this is necessary so that my weight on that side is supported on the “bum bone” - a shorter socket would allow me to slip forward off that support bone.

This is OK for walking, but is most uncomfortable for sitting, driving a car etc. because the socket digs into the groin; I hoped that over time the area would become hardened and the discomfort would be lessened - but this has not happened.

Many similar amputees would seem to have no difficulty in wearing their prosthetic legs through the day - I have come to wear mine for walking or standing only.

Is this a common problem, or are there sockets which eliminate this digging-in-the-groin problem? Comments and advice will be most welcome. kennie

:smile: Welcome to the forum. I have a flexible inner socket that makes it more comfortable in the groin and for sitting. There is a rigid frame around that supports the butt bone but it is cut out in the back. I have tried the hard socket and will never go back. It also depends how someone casts my limb.

I do have to admit that if I am sitting for more than 3 hrs., I prefer to remove my prosthesis. When I had a hard type they would also pad the top and back with a padding material which seemed to help a little. Take care, Mark :cool:

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I’m seeking help over socket design.

My left leg was amputated ATK 2 years ago and my NH prosthesis consists of a Trias foot, Otto Bock 3R92 knee, and an Iceross silicone liner in a hard socket. I find this combination quite good for walking, but the socket gives me a problem.

It comes well up to the groin and I am told this is necessary so that my weight on that side is supported on the “bum bone” - a shorter socket would allow me to slip forward off that support bone.

This is OK for walking, but is most uncomfortable for sitting, driving a car etc. because the socket digs into the groin; I hoped that over time the area would become hardened and the discomfort would be lessened - but this has not happened.

Many similar amputees would seem to have no difficulty in wearing their prosthetic legs through the day - I have come to wear mine for walking or standing only.

Is this a common problem, or are there sockets which eliminate this digging-in-the-groin problem? Comments and advice will be most welcome. kennie

The trim line can come down to ease these problems, go back and insist something is done, this is not how your socket should be. Material and types of sockets vary, but what you are experiencing is unacceptable, tell you Prothetist so.

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Hello Kennie,

I agree with Ian on this, I got mine trimmed down by a couple of Millie meters (mm)

At the time I thought that it wouldn’t make that much difference, but as soon as I put it on it made a huge difference, well worth a trip back to see you leg man.

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Hi Kenny

Sorry to hear about your socket woes. The pits, the absolute pits I tell you.

Do you know what type of socket you have?

I have had 3 types.

The first was a QUAD socket - very high and square at the top. Not nice at all. Very sore. And not possibe to trim down without losing stability.

The second was an IC socket - not so square at the top, but high none-the-less. Could trim it down a bit, but the way it is designed, you can't trim too much without losing stability as well. I had this socket as a full hard socket, and then as a socket with a soft inner. This socket was better than the QUAD, but still with the discomfort you are talking about.

My third type of socket is now a MAS - amazing design. The trim lines are extremely low compared to my other two sockets and I wouldn't change it for the world.

I will see if I can find my "comparison" pics of the sockets where you can see the difference at the top between the IC socket and the MAS socket.

Ally

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This is a "picture in progress" of the MAS socket while we were making it. Next to the MAS is the IC socket (yellow).

You can clearly see how low the MAS is cut at the top, while still giving incredible stability, not to mention comfort. The MAS is cut lower in the groin, in the front, and also at the back (so you can sit without bruising your butt).

mas2.jpg

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I’m seeking help over socket design.

My left leg was amputated ATK 2 years ago and my NH prosthesis consists of a Trias foot, Otto Bock 3R92 knee, and an Iceross silicone liner in a hard socket. I find this combination quite good for walking, but the socket gives me a problem.

It comes well up to the groin and I am told this is necessary so that my weight on that side is supported on the “bum bone” - a shorter socket would allow me to slip forward off that support bone.

This is OK for walking, but is most uncomfortable for sitting, driving a car etc. because the socket digs into the groin; I hoped that over time the area would become hardened and the discomfort would be lessened - but this has not happened.

Many similar amputees would seem to have no difficulty in wearing their prosthetic legs through the day - I have come to wear mine for walking or standing only.

Is this a common problem, or are there sockets which eliminate this digging-in-the-groin problem? Comments and advice will be most welcome. kennie

Hi Kennie..I am an AK and have had a revision recently and am starting the process all over again. I too have the hard socket with liner..I have found that as long as your "bum bone" is sitting on the shelf you can have the front trimmed down..just as Mick says a few millimeters make a huge difference. You should not have to be so uncomfortable so see if your pros will do this for you. Ally is so good at helping with all kinds of things, she helped me a lot a few years ago about the MAS socket..I would love to have one but my pros told me it would be too expensive for him to even attempt it. I was very disappointed, but not much I could do. Good Luck!!!

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I’m seeking help over socket design.

My left leg was amputated ATK 2 years ago and my NH prosthesis consists of a Trias foot, Otto Bock 3R92 knee, and an Iceross silicone liner in a hard socket. I find this combination quite good for walking, but the socket gives me a problem.

It comes well up to the groin and I am told this is necessary so that my weight on that side is supported on the “bum bone” - a shorter socket would allow me to slip forward off that support bone.

This is OK for walking, but is most uncomfortable for sitting, driving a car etc. because the socket digs into the groin; I hoped that over time the area would become hardened and the discomfort would be lessened - but this has not happened.

Many similar amputees would seem to have no difficulty in wearing their prosthetic legs through the day - I have come to wear mine for walking or standing only.

Is this a common problem, or are there sockets which eliminate this digging-in-the-groin problem? Comments and advice will be most welcome. kennie

Hi Kennie..I am an AK and have had a revision recently and am starting the process all over again. I too have the hard socket with liner..I have found that as long as your "bum bone" is sitting on the shelf you can have the front trimmed down..just as Mick says a few millimeters make a huge difference. You should not have to be so uncomfortable so see if your pros will do this for you. Ally is so good at helping with all kinds of things, she helped me a lot a few years ago about the MAS socket..I would love to have one but my pros told me it would be too expensive for him to even attempt it. I was very disappointed, but not much I could do. Good Luck!!!

It shouldn't be any more expensive unless he's talking about the money it would cost to train him! There are sockets I've seen that come close to being a MAS in terms of the amount they can be cut down. If your Prosthetist is any good, I think you should be comfortable regardless.

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OBL is right. The MAS should not cost more than another socket (a Quad or IC in my experience).

The only additional expense I can see might be the test sockets....when we made my 1st MAS we stopped counting new test sockets after the 12th one! The second MAS we made went much more smoothly though. I guess both my CP and I knew what to expect by then.

Patience of a saint, my CP...bless him.

:smile:

PS : Hiya Jen - hope you're well and walking up a storm :biggrin:

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OBL is right. The MAS should not cost more than another socket (a Quad or IC in my experience).

The only additional expense I can see might be the test sockets....when we made my 1st MAS we stopped counting new test sockets after the 12th one! The second MAS we made went much more smoothly though. I guess both my CP and I knew what to expect by then.

Patience of a saint, my CP...bless him.

:smile:

PS : Hiya Jen - hope you're well and walking up a storm :biggrin:

Your Prothetist was learning at the same time though wasn't he? I suspect with practice it doesn't take 12 check sockets...

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As a 'newbie' have been really pleased at the quick responses from helpful fellow ATKs. Have now some useful ammunition for further discussions with my prosthetist who has been reluctant so far to trim the front of the socket - but has otherwise been very helpful and encouraging.

Thanks, again, but any further comments and advice still welcome. Regards to all, Kennie

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LOL oneblueleg.. you are probably right about the training!!! I gave up on it tho probably shouldn't but got fed up..he is hopefully retiring soon and there is one other pros now here so when I am due for the next one hopefully I can see him. I totally agree with you about being comfortable..I just need to be more forceful.. :smile:

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OBL is right. The MAS should not cost more than another socket (a Quad or IC in my experience).

The only additional expense I can see might be the test sockets....when we made my 1st MAS we stopped counting new test sockets after the 12th one! The second MAS we made went much more smoothly though. I guess both my CP and I knew what to expect by then.

Patience of a saint, my CP...bless him.

:smile:

PS : Hiya Jen - hope you're well and walking up a storm :biggrin:

Hi Ally..Thanks..I am very well and walking just need to get a better fit..hope all is well with you

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This is a "picture in progress" of the MAS socket while we were making it. Next to the MAS is the IC socket (yellow).

You can clearly see how low the MAS is cut at the top, while still giving incredible stability, not to mention comfort. The MAS is cut lower in the groin, in the front, and also at the back (so you can sit without bruising your butt).

mas2.jpg

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This is a "picture in progress" of the MAS socket while we were making it. Next to the MAS is the IC socket (yellow).

You can clearly see how low the MAS is cut at the top, while still giving incredible stability, not to mention comfort. The MAS is cut lower in the groin, in the front, and also at the back (so you can sit without bruising your butt).

mas2.jpg

Hi Ally

Don't know what type my socket is - it was cast over a silicon liner (on the stump) and is therefore a good fit but very hard; I think carbon fibre is included in its construction which makes modification difficult.

Very interested to hear your recommendation of the MAS socket - which I would like to try (NHS permitting).

Regards and thanks, Kennie

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Hi Ally

Don't know what type my socket is - it was cast over a silicon liner (on the stump) and is therefore a good fit but very hard; I think carbon fibre is included in its construction which makes modification difficult.

Very interested to hear your recommendation of the MAS socket - which I would like to try (NHS permitting).

Regards and thanks, Kennie

The container, which is the Carbon bit, can be a lot more giving if it's made from Polypropylene or Northvane, I hate Carbon Fibre laminated outer sockets (containers)

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Hi Ally

Don't know what type my socket is - it was cast over a silicon liner (on the stump) and is therefore a good fit but very hard; I think carbon fibre is included in its construction which makes modification difficult.

Very interested to hear your recommendation of the MAS socket - which I would like to try (NHS permitting).

Regards and thanks, Kennie

The container, which is the Carbon bit, can be a lot more giving if it's made from Polypropylene or Northvane, I hate Carbon Fibre laminated outer sockets (containers)

You just need to make sure you are working with a prosthetist that knows what will work best for you and incorporate his skill in that socket design. A good fitting true IC, muscle contoured socket is better than a poorly fitted MAS and vice-versa. Their are many out their that go to a week/end course and, wala, they can not do a MAS, IC, Comfortflex, well not all can. I personally did not like the MAS but may have not kept after the fit/control when my limb changed. I have always been comfortable with IC, anatomical control, muscle contoured, flexible inner, rigid outer carbon fiber (print design) frame design since my experience with a prosthetic research (CAT-CAM) center (CA) in the 80's. The key is ensuring you work with a competent prosthetist that will do what it takes to make you comfortable. Seems like Ally has a good leg man, Mark :smile:

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Hi Ally

Don't know what type my socket is - it was cast over a silicon liner (on the stump) and is therefore a good fit but very hard; I think carbon fibre is included in its construction which makes modification difficult.

Very interested to hear your recommendation of the MAS socket - which I would like to try (NHS permitting).

Regards and thanks, Kennie

The container, which is the Carbon bit, can be a lot more giving if it's made from Polypropylene or Northvane, I hate Carbon Fibre laminated outer sockets (containers)

You just need to make sure you are working with a prosthetist that knows what will work best for you and incorporate his skill in that socket design. A good fitting true IC, muscle contoured socket is better than a poorly fitted MAS and vice-versa. Their are many out their that go to a week/end course and, wala, they can not do a MAS, IC, Comfortflex, well not all can. I personally did not like the MAS but may have not kept after the fit/control when my limb changed. I have always been comfortable with IC, anatomical control, muscle contoured, flexible inner, rigid outer carbon fiber (print design) frame design since my experience with a prosthetic research (CAT-CAM) center (CA) in the 80's. The key is ensuring you work with a competent prosthetist that will do what it takes to make you comfortable. Seems like Ally has a good leg man, Mark :smile:

Couldn't agree more, loads of sense being spoken there.... I should qualify, I was only offering my own personal preferences... Mark is right in every way...

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OBL is right. The MAS should not cost more than another socket (a Quad or IC in my experience).

The only additional expense I can see might be the test sockets....when we made my 1st MAS we stopped counting new test sockets after the 12th one! The second MAS we made went much more smoothly though. I guess both my CP and I knew what to expect by then.

Patience of a saint, my CP...bless him.

:smile:

PS : Hiya Jen - hope you're well and walking up a storm :biggrin:

Your Prothetist was learning at the same time though wasn't he? I suspect with practice it doesn't take 12 check sockets...

:laugh::laugh::laugh::tongue: Oh make NO mistake, we certainly didn't make 12 test sockets the second time around! Once the CP has mastered the MAS, he shouldn't make more test sockets than an IC or quad. My CP made a perfect MAS for a gentleman with only 2 test sockets since we guinea-pigged yours-truely.

When we made my first MAS, we purposefully broke nearly every MAS rule in the book to see what would happen. Surprise surprise....the MAS is a very precise socket.....can't bend or break no rules with this baby.

:biggrin:

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