Stage 1: Healing and Starting Physiotherapy

OVERVIEW
Following the amputation, there will be a healing phase – during which time the incision and surrounding tissue will recover. This timeframe can vary from a matter of weeks, to a couple of months or even more depending on the type of amputation, how much scar tissue may be involved and how the limb heals. In the hospital, the physiotherapist (PT) will teach exercises to improve muscle function and will show you how to get around on crutches or in a wheelchair (if it is required). The team will recommend any rehabilitation therapy that may be needed.

In the early days following the amputation, healing of the incision and the residual limb (the part of your limb remaining after surgery) is the main goal. Part of the healing process involves promoting shrinkage. Swelling is always an issue after surgery and bandaging the residual limb helps with this. The nurse and physiotherapist are the professionals you will deal with most frequently at the beginning of your rehabilitation, and may coordinate your care.

The nurse changes the bandages on your residual limb or checks your cast depending on the type of dressing you have. Be sure to tell the surgeon or nurse about any pressure points in the dressing, any pain you feel in your residual limb (stump), or if you are experiencing phantom limb sensations (the conscious sensation that the amputated limb is still there) or phantom pain.

Shortly after surgery, your physiotherapist will begin massaging and stretching the residual limb (or teach you to do so) a few times a day. The physiotherapist helps you gradually restore physical function and movement to the area around your amputation. As your strength improves, you will play a more active role in your physiotherapy, exercising a few times a day to increase circulation, strengthening muscle tone and the range of movement you can achieve with your residual limb (range of motion). The exercises also reduce swelling and the chance of developing contractures (muscles tightening around a joint). Lower-limb amputees may also do upper-body strength-training exercises if they will be using crutches or a walker.

If you are a lower-limb amputee, you will probably be moving around the hospital on crutches or using a wheelchair within a few days. Your physiotherapist will complete any training on walking aids before you leave the hospital if it is needed. If you are an upper-limb amputee, you will probably become mobile as soon as you recover from the effects of the anaesthetic.

On returning home, a post-operative dressing is applied to the residual limb. You may return to the hospital to have your bandage or cast changed/removed; alternatively, a local nurse or health care professional may be requested to handle this. After the sutures are removed, a compressive sock called a “shrinker sock” or a tensor bandage helps reduce swelling (edema), and molds and shapes the limb so the prosthesis will fit more comfortably.