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tomer

seal in socker and liner for AK

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hi

i'm getting a new socket with the Ossur 5 rings seal in liner. Currently my leg guy made a clear socket so any changes are still possible.

i find it really good and feels very snug while walking but..every time i sit down, air comes in and the vacuum degrades until a point where the socket is released completely. it doesn't bother me so some when the enter the car which is quite low but getting out , is not nice at all..as i have to move the leg while it's totally released from the socket.

is this normal? i suspect losing the vacuum also has to do with the bolts my leg guy had to drill in to strengthen the clear (temp.) socket .

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Unless you have really significant volume changes daily with your leg, that is an indication of poor socket fit. Your socket is too loose where the rings are on the Ossur liner. The socket may be "not round" which causes the liner rings to kink. You should ask your leg man to modify or remold the socket.

However, to tighten it up you can take a prosthetic sock, cut the closed end off, and slip it over the liner between the rings and the top of the liner.

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thanks. the socket fit is really good (feel very tight and holds well) as long as i'm walking , the problem is when i'm sitting down and lift the leg up a bit , to enter the car for example.

is there anyone here with AK seal in socket ?

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To keep it from popping forward when sitting you must have tight fit around all 5 rings when standing. However, if only 1 or 2 rings have a tight fit, it will feel fine when walking, but it will pop forward when you sit. This was the big problem with the previous single-ring seal-in liners...they tended to pop-off when sitting even though they worked great when walking.

You need also check to ensure that the Ossur liner is a very tight fit on your leg...if it is too large it will tend to fold slightly and go out of round. When you stand an gravity pushes more of your body mass down towards the the end of your limb, the leg will enlarge slightly and fill-up the liner. However, as your skin/fat transitions causing your leg shape to change as you transition from sitting to standing, you will get an air channel which will cause the lose of vacuum. Therefore, make sure the liner is a good tight fit against your skin when sitting and holding your leg at 90 degrees to your body. If you have some looseness, try the next smaller size liner. Also try using the straight vs. conical versions of the Ossur liner.

If you have a clear socket you need to see all 360 degress of the tip of all 5 rings evenly folded over against the socket.

BTW I have this set-up.

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To keep it from popping forward when sitting you must have tight fit around all 5 rings when standing. However, if only 1 or 2 rings have a tight fit, it will feel fine when walking, but it will pop forward when you sit. This was the big problem with the previous single-ring seal-in liners...they tended to pop-off when sitting even though they worked great when walking.

You need also check to ensure that the Ossur liner is a very tight fit on your leg...if it is too large it will tend to fold slightly and go out of round. When you stand an gravity pushes more of your body mass down towards the the end of your limb, the leg will enlarge slightly and fill-up the liner. However, as your skin/fat transitions causing your leg shape to change as you transition from sitting to standing, you will get an air channel which will cause the lose of vacuum. Therefore, make sure the liner is a good tight fit against your skin when sitting and holding your leg at 90 degrees to your body. If you have some looseness, try the next smaller size liner. Also try using the straight vs. conical versions of the Ossur liner.

If you have a clear socket you need to see all 360 degress of the tip of all 5 rings evenly folded over against the socket.

BTW I have this set-up.

thank you so much for this informative reply. I'm going to see him tomorrow and demand a better socket.

and another question:

When I pop out of the socket and stand up to retain vacuum again, do i need to spray the liner again? i asked him this several times and he advised i don't need to. but i have a feeling i damage the rings everytime this happens.

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No, you won't damage the rings by putting it on "dry". However, I've often found you get a much better "feeling" of fit if you use the spray...but occasionally when I don't have any spray handy I just put it on dry.

If the liner/socket is truly tight and well-fitted it should be a good bit more difficult to get all the way down in the socket when putting it on "dry" vs. "wet".

If the socket is just as easy to get on dry as it is wet than that would be a clear indication of too loose a fit.

I will say that, since going to the 5-ring liner nearly a year ago, I have never - not once - had the socket "pop off". (I did occasionally have this problem with the old single ring liner, particularly when sitting down on a hard surface.)

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To keep it from popping forward when sitting you must have tight fit around all 5 rings when standing. However, if only 1 or 2 rings have a tight fit, it will feel fine when walking, but it will pop forward when you sit. This was the big problem with the previous single-ring seal-in liners...they tended to pop-off when sitting even though they worked great when walking.

You need also check to ensure that the Ossur liner is a very tight fit on your leg...if it is too large it will tend to fold slightly and go out of round. When you stand an gravity pushes more of your body mass down towards the the end of your limb, the leg will enlarge slightly and fill-up the liner. However, as your skin/fat transitions causing your leg shape to change as you transition from sitting to standing, you will get an air channel which will cause the lose of vacuum. Therefore, make sure the liner is a good tight fit against your skin when sitting and holding your leg at 90 degrees to your body. If you have some looseness, try the next smaller size liner. Also try using the straight vs. conical versions of the Ossur liner.

If you have a clear socket you need to see all 360 degress of the tip of all 5 rings evenly folded over against the socket.

BTW I have this set-up.

another thing i noticed: i think as the liner is too long (he needs to cut it some more), when i lift the leg up, it does go out of round with 2 "rings of air" . maybe this could be solved just by cutting the liner

..

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I will say that, since going to the 5-ring liner nearly a year ago, I have never - not once - had the socket "pop off". (I did occasionally have this problem with the old single ring liner, particularly when sitting down on a hard surface.)

does it ever loose some vacuum but not completely, when sitting down?

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To keep it from popping forward when sitting you must have tight fit around all 5 rings when standing. However, if only 1 or 2 rings have a tight fit, it will feel fine when walking, but it will pop forward when you sit. This was the big problem with the previous single-ring seal-in liners...they tended to pop-off when sitting even though they worked great when walking.

You need also check to ensure that the Ossur liner is a very tight fit on your leg...if it is too large it will tend to fold slightly and go out of round. When you stand an gravity pushes more of your body mass down towards the the end of your limb, the leg will enlarge slightly and fill-up the liner. However, as your skin/fat transitions causing your leg shape to change as you transition from sitting to standing, you will get an air channel which will cause the lose of vacuum. Therefore, make sure the liner is a good tight fit against your skin when sitting and holding your leg at 90 degrees to your body. If you have some looseness, try the next smaller size liner. Also try using the straight vs. conical versions of the Ossur liner.

If you have a clear socket you need to see all 360 degress of the tip of all 5 rings evenly folded over against the socket.

BTW I have this set-up.

another thing i noticed: i think as the liner is too long (he needs to cut it some more), when i lift the leg up, it does go out of round with 2 "rings of air" . maybe this could be solved just by cutting the liner

..

Hi there,

I just wanted to reiterate what Tomer was saying about the fit of the socket. I have used Ossur liners for about 7 years now, and I have NEVER had a problem with them slipping off while sitting down. I have a relatively short residual limb, and my liners have always been cut so they don't roll down. As long as the liners are the correct length, and more importantly, as long as the socket fits correctly, it shouldn't slip off. Good luck with your fittings!

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To keep it from popping forward when sitting you must have tight fit around all 5 rings when standing. However, if only 1 or 2 rings have a tight fit, it will feel fine when walking, but it will pop forward when you sit. This was the big problem with the previous single-ring seal-in liners...they tended to pop-off when sitting even though they worked great when walking.

You need also check to ensure that the Ossur liner is a very tight fit on your leg...if it is too large it will tend to fold slightly and go out of round. When you stand an gravity pushes more of your body mass down towards the the end of your limb, the leg will enlarge slightly and fill-up the liner. However, as your skin/fat transitions causing your leg shape to change as you transition from sitting to standing, you will get an air channel which will cause the lose of vacuum. Therefore, make sure the liner is a good tight fit against your skin when sitting and holding your leg at 90 degrees to your body. If you have some looseness, try the next smaller size liner. Also try using the straight vs. conical versions of the Ossur liner.

If you have a clear socket you need to see all 360 degress of the tip of all 5 rings evenly folded over against the socket.

BTW I have this set-up.

another thing i noticed: i think as the liner is too long (he needs to cut it some more), when i lift the leg up, it does go out of round with 2 "rings of air" . maybe this could be solved just by cutting the liner

..

Hi there,

I just wanted to reiterate what Tomer was saying about the fit of the socket. I have used Ossur liners for about 7 years now, and I have NEVER had a problem with them slipping off while sitting down. I have a relatively short residual limb, and my liners have always been cut so they don't roll down. As long as the liners are the correct length, and more importantly, as long as the socket fits correctly, it shouldn't slip off. Good luck with your fittings!

Whoops, I meant to say that I wanted to reiterate what cwrm4 was saying.... :unsure: Good luck with the fitting, Tomer.

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ok so i'm after a long day at the workshop. he added a lot of filling to the clear socket, which made it almost impossible to get into all the way . with the improved (clear) socket the vacuum lasted better while sitting . He's now going to create a definitive socket and we'll see from there.

I noticed that after the adjustments he did , all the 5 rings were pressed down nicely. we'll see how it goes..

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hi, i wear the old version ( one ring) of the ossür seal in liner now for 8 month. my problem is, that i have volume changes....get thinner most time. to get the right volume i wear socks...sometimes up to three. works quite ok, until i could put the end of the socks under the lip of the liner. my technician glued now some cork in the socket....backside and outer (lateral?) side. works fine , but i get thinner and need probably a new socket soon.

has anybody experience with this 5 ring-seal-in-liner and socks?

for me the one ring version seems the better solution......or better ideas?

when i am in my socket, im am fixed in it...no air inside over the day, no pumping...nothing but really got fit.

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Like Thomas, I use the "1-ring" liner.

You are not supposed to lost any suction when you sit down, 5 rings or not.

Luck,

Ally

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hi ally,

i dont loose suction....but i have the problem with the changing volume of my stump. ...hurts the at other places

my question is: does anybody wear the "olympic"(5 rings) seal in liner with additional socks?

at the moment i think that i need a new socket.....seems i "dive" too deep in.

ciao thomas

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Hi Tomer,

When I read your post I said I know exactly what you are talking about--mine does it all the time. Some time if I am sitting for a long time I( just let the leg come off and rest my stump on it. I also loose it in the gym with some of the equipment, but I can feel it slipping. My leg fellow gave me a clear silicon liner that is only as long as the rings to put on underneath the liner and that has helped.p

I like the system so much that I am willing to put up with a little hiccup.

Peace, Beth Marie

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hi ally,

i dont loose suction....but i have the problem with the changing volume of my stump. ...hurts the at other places

my question is: does anybody wear the "olympic"(5 rings) seal in liner with additional socks?

at the moment i think that i need a new socket.....seems i "dive" too deep in.

ciao thomas

Thomas

I am recent also and have shrunk considerable in the short 7 months of my new leg wearing days. I have the single seal in liner and had to wear 10 ply of socks before I had a new socket made. I am on my second socket and my leg guy thinks that I will need another one in 8-12 months. All part of the process.

As for the 5 ring version I have tried it and like the fit but waiting on Ossur's 1 ply sock to help with some volume change that will help keep me from spinning. Boy it sucks to have your toe constantly pointing in. lol

I'll post back when I have tried it out more.

Erik

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Hi Tomer,

When I read your post I said I know exactly what you are talking about--mine does it all the time. Some time if I am sitting for a long time I( just let the leg come off and rest my stump on it. I also loose it in the gym with some of the equipment, but I can feel it slipping. My leg fellow gave me a clear silicon liner that is only as long as the rings to put on underneath the liner and that has helped.p

I like the system so much that I am willing to put up with a little hiccup.

Peace, Beth Marie

Hi Beth Marie

I don't think it's suppose to be like this..specially not with the 5 rings . but I don't know how it works for BK

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more on this:

i went to get the final socket last monday. same issue, when i sat down slowly it began to loose vacuum . I was quite upset but knew i should keep my cool as much as possible if I want to go home with a good leg. so I asked if there are any adjustments he could do to improve this situation.

that's when he (the leg guy) kinda lost his cool..and told me to take off the leg and he's returning me to my "old" socket (*lynard pull in with a string, which recently got too small for me as I gained weight) and that he doesn't know what to do, other than making a new socket with a pin as the seal in doesn't work for and i couldn't handle the lynard. there's not a chance in the world my insurance company will approve another socket and standard liner in one month! just because he obviously got something wrong with the seal in socket.

so he took the leg and returned it to me with my "old" socket. i asked him if maybe there could be something wrong with the valve and he told me it's possible (at this point he started to sound reasonable again) and he's going to create a new clear socket and see how we go from there.

some background:

i have to travel 110km which is about 70 miles every time i go to see him. normally i spend around 4-5 hours there, more than half of this time i spend waiting while he's working the leg or taking care of other customers. now i know i made a mistake choosing him as my leg guy as things are going way more complicated that i expected and all this traveling every week to see him, is driving me crazy.

obviously now it's too late as i have to get things finished with this socket. i guess my first impression of him on our first meeting, was too good to be true...

continue..

5 minutes after i left his "clinic" he calls me , that he found the problem with the socket - a leak from the valve. and that he can start working on it, if I'm patient enough to wait for another couple of hours...did my thinking and drove home.

this monday i'm going back. can't say i'm optimistic this time. (good thing i did not sign the receipt for the socket and liner....)

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i'm so pi$$ed i don't know what to do.

the other monday, i got my "final socket". from the first moment i noticed nothing much has changed. it was still pealing off while sitting or when i sit on the edge on a chair to get ready for standing up :-(

he tried to show me how to use to rotation join, to avoid the "extreme movements" (his words) i do when i try to get out and in of the car . didn't help though.

thought i'll give it a shot anyway and started to get ready to leave, then it came off while i was standing on my "good" leg, holding my other leg in the air! i called him back and he replaced the valve which he thought was faulty. that seem to solve this matter but only for now...

got home and like nothing has changed. it was coming off everytime i was sitting on normal chairs.

yesterday evening, i went to a rock concert and stood up in the crowd for a couple of hours (nothing unusual) . after less than an hour, felt like the socket was cutting me..! to a point where i couldn't put full body weight on it and had to stand on the other leg much more ! even with the crutches i use, the pain was so bad i wasn't enjoying the music much anymore hrrrrrrgghh.

when i got home, hardly walking and in pain, i couldn't find any visual cut on the stump . which is good.

i don't know what to do now.

obviously the fit is not good (he keep mentioning all the time how perfect it is). i had to sign the receipt for the socket and liner so he could charge my insurance company. we're on holiday so i can't reach my lawyer and i doubt if he could help much on this.

thought about calling him , but i'm worried i'll loose my nerves on the phone which won't work for my benefit. on sunday i'm going to the rehab center and ask for advise there.

:angry::mad::sad:

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That is absolutely diabolical tomer... if he's got an ounce of respectability he will see you and fix the problem. It sounds like a pretty fundamental problem to me and totally unacceptable. Don't listen to people telling you techniques for getting round poorly fitting sockets. As for signing, you shouldn't do that until you are totally satisfied, even if it means going out for a walk and hanging around for an hour or more until you are happy with the fit.

The guy sounds like a pretty useless Prosthetist to me, letting you go with a socket like that.

I'd say give him a chance to put it right, if he won't play ball to your satisfaction (and be assertive), then report him, ditch him, find someone else.

Good luck!!

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Hey tomer, look at this pdf... page 14 (page 11 of the pdf)... reasons for poor fit on sitting... may help understnad what may be going on?

http://www.ot-forum.de/verlag_ot/otquarter...8_final_ger.pdf

thanks mate. i've written to Ossur on "Ask the Orthotic Expert" on this , hope I'll get an answer.

I'm going to read to him over the phone tomorrow the passage on "the patient reports of losing the prosthesis during strong hip flextion, e.g when sitting down"

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That is absolutely diabolical tomer... if he's got an ounce of respectability he will see you and fix the problem.

Have to agree with OBL there..I know that they "force" you to sign for the leg when you leave, but he really should make things right!

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I've called him yesterday and scheduled to come in on Friday .

After advising with another leg guy (who has just done a proper seal in socket for another guy) and my lawyer yesterday, I'm going to demand "nicely" for a complete new socket without any costs to my insurance company as they'll never agree to fund another socket (and liner , if we decide on different type of suspension)

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This will be interesting to follow.....let us know as you go along.

xxxxx

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