One of the biggest challenges for new prosthetic wearers is getting the sock fit just right. Many of these patients experience pain, discomfort, or rotation of the prosthesis. I see a lot of patients due to discomfort from improper sock fit.

Most prostheses utilize some type of prosthetic sock to manage volume changes of your limb. Prosthetic socks can be used by upper or lower extremity amputees to provide a more comfortable fit, reduce friction and absorb perspiration by “wicking” moisture away from the skin. Reducing perspiration on the skin can dramatically reduce bacterial infections and common skin complaints.

Some amputees wear socks in combination with sheaths or with liners to get the best possible fit, while others wear liners without socks. For amputees that are using socks in conjunction with pin lock type liners, it is vital that the pin is free of sock ply when applying the prosthesis. Regardless of the type of prosthesis you are wearing, the prosthetic socks must be pulled completely up on the residual limb and free of wrinkles. Wrinkles will increase pressure on the residual limb.

One of the most common challenges of using a prosthesis is determining proper sock ply fit. The size of the residual limb can change for a number of reasons, including volume loss and weight loss. Our bodies are comprised of about 75% water. When you factor in activity level, medical complications such as circulation problems or diabetes, the residual limb can reduce in size quickly. A new amputee or prosthetic user will often experience rapid reduction in the size of the residual limb.

The prosthetic socket will not change size, it remains a constant in prosthetic use. Compare wearing prosthesis to a wedding band or class ring. For most people it was a tight, snug fit when they began to wear it. Over time it became less tight, even loose. A residual limb fitting into a prosthetic socket is the same concept. Different ply of socks are used to compensate for volume lost or gained. If pressure is felt at the bottom of your limb, it may mean that you have lost fluid volume and need to add a sock to compensate for that lost fluid. Socks fabricated now are machine washable and usually lay flat to dry for normal use and care.

A common question that your prosthetist will ask you is “How many ply of socks are you wearing”? The “Ply” refers to the numbers of strands used in the sock- if two (2) strands are used the sock is a (2) Ply. The higher the number of ply, the thicker the sock. The “Ply” can differ between materials – so if you are changing from one material to a new one of a different material you may need a different ply. Three (3) ply and five (5) ply are the most common sock thicknesses.

If you find that you cannot achieve a comfortable fit by adding or reducing sock ply, it is vital that you contact your prosthetist for an appointment.