Guide to Frequently Asked Questions on Prosthetics Part 4| Talk about swelling of the stump.
The phenomenon of swelling and pain in residual limbs is a major problem that has to be faced for a long time. The residual limb is often swollen, and the main reason for pain is poor blood circulation. The reasons are as follows:
1. Due to amputation, the limb muscles themselves begin to atrophy rapidly, resulting in poor limb muscle function and directly affecting the poor blood return to the limbs.
2. Due to the gravity of the human body itself, and the fact that the entire lower limb is squeezed and restrained by the prosthetic cavity, blood is less likely to return to the heart than in healthy people, making swelling worse.
Traditional Chinese medicine believes: "Blockage causes pain, and pain means blockage." Blood stasis, qi stagnation, cold coagulation, etc. can all lead to poor blood flow and blockage of meridians, manifesting as pain. Following this theory, our focus should naturally be on how to unblock the blood vessels as much as possible.
Mitigation methods:
——Hot water soaking method
Sitting position: The knee joints of the lower limbs are completely relaxed, that is, the knee socket is just placed on the edge of the basin for the best effect. (I usually place the water basin on a stool so that the water basin is at the same height as my buttocks, allowing my residual limbs to completely relax and soak.)
Water temperature: As high as possible, try to use as much heat as you can tolerate.
Time: The longer the better, at least 20 minutes.
Special reminder: Long-term soaking is only suitable for people who have had their limbs amputated for many years and whose scars at the broken end have completely healed and become strong. Otherwise, if soaked in hot water for a long time, the new scar and its surrounding area will easily soften and peel, which will inevitably make the skin layer more delicate and prone to problems. Therefore, the soaking time depends on the age of scar formation and whether the healing is strong.
People who wear prosthetics should develop a good habit of soaking their residual limbs in hot water every night before going to bed, but this is only possible if there are no wounds (such as abrasions, ulcers, etc.). But if you really need to wash it, use boiled light salt water (add a little salt before washing) and do not soak it for a long time to prevent the wound from becoming inflamed and difficult to heal; or after washing, wipe the wound surface with alcohol, iodine and other medical disinfection cotton balls. It should be noted that this "remedial" method will be very painful and the wound will not heal easily.
——Assisted hand-washing method
When soaking, use a towel with hot water to scrub vigorously from the bottom of the stump to the knee. Try to keep it in one direction (from bottom to top). This is equivalent to massage, in that the external force of the hands helps blood flow back to the residual limb and promotes blood circulation.
Soaking in hot water should be a "homework" that people wearing prosthetics must do before going to bed every night, just like brushing our teeth every day, it is essential. If you want quick results, you can do it multiple times a day if possible, and the best time is before going to bed. If you can insist on taking a hot bath every day, the swelling effect will be better.
The hot water immersion method has the benefits of "killing three birds with one stone":
A. Promotes blood circulation and removes blood stasis, and helps restore leg strength.
B. Clean the skin and prevent inflammation.
C. Eliminate fatigue and help sleep.
Special reminder:
Avoid washing and soaking in cold water, because cold water has the opposite effect to hot water. Not only can it not expand blood vessels and promote blood circulation, but it can constrict blood vessels and hinder it.
——"Dry cleaning" alternative method
If you are unable to soak in hot water for some reason, you can lie flat on the bed (it doesn’t matter if you use a pillow) and raise your lower limbs upright (the whole body is basically in a 90-degree position). Then, use your hands to circle and push hard from the highest point (the stump) to the lower knee.
Special reminder:
It should still be done in one direction. If the purpose is to reduce swelling, it is best not to do it back and forth in both directions, otherwise you will achieve half the result with twice the effort. This is the role of massage. You can control the time required by yourself. You can do it multiple times a day. The more the better.
Other tips
A. "Relaxation" method.
There is no need to leave the prosthetic leg with you all day long. When we don't have to wear a prosthetic limb to do things, we can take it off to "reduce the burden" on the residual limb in time.
In this regard, women have an inherent advantage over men. It is very convenient to wear a skirt to cover when taking off clothes.
B. Flat stretching method
When it is inconvenient to take off the prosthetic limb when going out, you can act on your own initiative and find an opportunity to stretch out the leg wearing the prosthetic limb. This method can relieve some of the pressure on the residual limb.
C. Elevation method
Whenever you lie down, regardless of whether you are wearing a prosthesis or not, you can use bedding, pillows, bedside and other objects to elevate your legs (single or both legs) to promote the return of blood in the lower limbs to the heart and reduce leg swelling. If the bed is placed against the wall, you can adapt to local conditions and raise your legs to rest against the wall. The effect is also quite good.
D. "Pedaling on the wheel" method
Before falling asleep, you can lie down on your back and raise your legs to do the "empty wheel pedaling" exercise, just like riding a bicycle, with your legs moving up and down alternately.
E. Patting, grinding and rubbing method
Also lie down, raise your legs high, and use your slightly bent calves (the sound legs and residual limbs can also cooperate) to slap each other or alternately rub each other. Its main purpose is not only to promote blood circulation, but also to prevent or slow down the abnormal sensations in the lower limbs that are prone to occur due to long-term wearing of prostheses, such as numbness and further muscle atrophy.
Everyone should consciously and appropriately strengthen the movement of their residual limbs. It is necessary to maintain normal exercise, that is, "active" exercise, but also pay attention to increasing the number of "passive" exercises. For example: regular tapping, massage, etc. can be performed. When carrying out these boring activities, if you listen to the radio or follow the beat of music, it will become boring and relaxed, which is undoubtedly beneficial to physical and mental health.
"Movement leads to success." "If there is blockage, there will be pain, and if there is pain, there will be blockage." This theory of traditional Chinese medicine is a truth that has been verified through thousands of years of practice. The characteristics of the various methods described in this article mainly lie in the word "dynamic", and their functions lie in the word "tong". Everyone can "follow their feelings" and get what they need. If you insist on using one method consistently or alternately in turn, it will be very effective.