Exercises for Leg Amputees: Tips on Working Out with Prosthetics

Losing a limb doesn't mean giving up on your fitness goals. Exercise is vital for amputees as it boosts physical function, confidence, and overall health. Whether you're a new amputee or an experienced athlete, a regular exercise routine tailored to your prosthetic limb can improve your strength, stamina, balance, and quality of life.

At PrimeCare, our team of expert prosthetists and physical therapists specializing in upper and lower limb prosthetics understands the unique challenges that amputees face. In this guide, we'll share our knowledge, exploring various exercises for lower limb amputees to help you build a workout program that's safe, challenging, and empowering.

Why Should I Work Out as an Amputee: Benefits of Exercising with a Limb Difference

Beyond the usual fitness benefits, exercise is crucial for amputees for several reasons:

• Improved function and mobility: Regular exercise builds strength and endurance, making it easier to walk with your prosthetic leg, perform daily tasks, and maintain independence.
• Reduced pain and phantom limb discomfort: Exercise can help manage chronic pain and reduce phantom sensations in your residual limb.
• Balance and fall prevention: Targeted exercises strengthen your muscles, improving balance and decreasing your fall risk.
• Psychological well-being: Exercise combats depression, promotes self-esteem, and builds confidence in your abilities.
• Prevention of secondary conditions: Exercise reduces the risk of heart disease, diabetes, and other health problems associated with inactivity.

How to Start Exercising as an Amputee: First Steps

If you’re not sure where to begin, here's a beginner's guide to starting your exercise journey as an amputee:

1. Consult your doctor: First and foremost, always get clearance from your healthcare team before beginning a new exercise plan.
2. Work with a physical therapist (PT): A PT can design a customized workout program and teach you proper exercise forms for safe and effective training.
3. Set realistic goals: Aim for short, achievable goals at first. Gradually increase the intensity and duration of your workouts as you get stronger.
4. Listen to your body: Pain is a warning sign, so stop and rest if something hurts.
5. Ensure proper prosthetic fit: A well-fitting above-the-knee and below-the-knee prosthetics are essential for comfortable and safe exercises. Consult your prosthetist regularly for adjustments.

Strength Exercises for People with Lower Limb Difference

Building strong muscles is the foundation for good balance, mobility, and overall function with a prosthetic leg. Amputees often experience muscle weakness and loss in the residual limb and surrounding areas. Strength training exercises target these muscles, helping you control your prosthesis more effectively and move more confidently.

Squats

Strengthen the quadriceps, hamstrings, and core muscles crucial for stability and walking with a prosthesis.

• Stand with feet hip-width apart, toes slightly outwards. If needed, use a stable chair for support.
• Keep your back straight, bend your knees, and lower your buttocks like you're sitting in a chair.
• Push through your heels to return to the starting position. Focus on using your leg muscles and core.

Lunges

Improved leg strength and coordination are essential for staying safe on uneven terrain and stairs.

• Stand with feet hip-width apart. Take a large step forward with your strong side foot and lower your body until both knees form a 90-degree angle.
• Push with your front heel to return to the starting position. Alternate legs for each repetition.

Wall Seats

Target the quadriceps and core muscles to enhance stability and endurance for standing for longer periods.

• Position your back against a wall with your feet shoulder-width apart in front.
• Slide down the wall until your knees are at a 90-degree angle. Hold the position for 30 seconds and feel your leg muscles working.

Push-Ups

Strengthen upper body muscles to help with balance and overall function, especially during activities like reaching or lifting objects.

• Start in a modified plank position on your knees and forearms. Keep your body straight from head to knees.
• If strong enough, modify to a full plank position on your toes.
• Lower your chest towards the floor, bending your elbows.
• Press back up, focusing on engaging your core muscles.

Single-Leg Deadlift

Single-leg deadlifts strengthen the hamstrings, core, and gluteal muscles, improving stability for single-leg activities like walking with a prosthesis.

• Stand with your feet hip-width apart. Hinge forward at your hips, keeping a straight back, and lift your prosthetic leg behind you.
• Return to the starting position, focusing on control and using your core muscles for stability.
• Repeat with the other leg.

Hip Bridges

Hip bridges strengthen the gluteal muscles, which are essential for core stability and power during walking, stair climbing, and other activities.

• Lie on your back with knees bent and feet flat on the floor. Squeeze your buttocks and lift your hips off the floor until your body forms a straight line from shoulders to knees.
• Hold for a few seconds, then lower down slowly.

Bird Dog

Bird dogs improve coordination, which is essential for safe and efficient walking with a prosthesis.

• Start on your hands and knees. Extend your opposite arm and leg, keeping your core engaged and your back flat.
• Hold for a few seconds, then slowly return to the starting position. Repeat on the other side.

Standing Hip Abduction

This strengthens the outer hip muscles.

• Stand with your feet shoulder-width apart. Loop a resistance band around your thighs, just above the knees. Keeping your legs straight, lift your sound leg to the side as high as is comfortable.

Stretching Exercises for Lower Limb Amputation

Maintaining flexibility is crucial for comfortable prosthetic use and overall well-being. Amputation can lead to tightness in the residual limb and surrounding muscles, limiting your range of motion. Regular stretching helps improve flexibility and makes it easier to walk with your prosthesis and reduces your risk of injury.

Hamstring Stretch

Improves flexibility in the back of the thigh, which is essential for a full range of motion during walking and other activities.

• Sit on the floor with your sound side leg extended. Bend your prosthetic side leg, placing the sole of your foot against your inner thigh.
• Keeping your back straight, reach gently towards the toes of your extended leg until a stretch is felt in the back of your thigh. Hold for 30 seconds and repeat 3 times on each side.

Quadriceps Stretch

Increases flexibility in the front of the thigh, enhancing comfort and reducing strain while walking with a prosthesis.

• Stand upright, holding onto a chair for balance if needed.
• Bend your prosthetic knee, bringing your heel towards your buttocks. Use your hand to gently pull your heel for a deeper stretch in the front of your thigh. Hold for 30 seconds and repeat 3 times on each side.

Calf Stretch

Improves flexibility in the calf muscle, which plays an important role in pushing off the ground during walking and maintaining balance.

• Stand facing a wall, placing your sound side foot forward and prosthetic foot a step behind.
• Lean towards the wall, keeping your prosthetic leg straight, until you feel a stretch in your calf muscle. Hold for 30 seconds, repeat 3 times on each side.

IT Band Stretch

IT band stretches improve flexibility in the outer thigh, reducing tightness that can contribute to pain and discomfort with a prosthesis.

• Stand with feet hip-width apart, then cross your prosthetic leg behind your sound side leg.
• Keeping your back straight, gently lean towards your sound side until you feel a stretch along the outside of your prosthetic side hip and thigh. Hold for 30 seconds, and repeat 3 times on each side.

Shoulder Stretch

Shoulder stretches improve flexibility and range of motion in the upper body, which can help improve posture and overall balance.

• Reach one arm across your body, holding it at the elbow with your opposite arm.
• Gently pull your arm towards your chest until you feel a stretch on the back of your shoulder. Hold for 30 seconds, repeat 3 times on each side.

Standing Side Stretch

Standing side stretches improve flexibility in the torso and core muscles, enhancing stability and range of motion for everyday activities.

• Stand with your feet hip-width apart and arms above your head, hands interlocked.
• Gently lean to one side, keeping your hips straight and core engaged. Hold the stretch for 30 seconds, then repeat on the opposite side.

Balance Exercises for Lower Limb Amputees

Good balance is essential for safe and efficient walking with prosthetics. Amputees often experience stability challenges due to changes in weight distribution and body mechanics. Balance exercises help improve your body awareness and distribute weight evenly, reducing your fall risk and enhancing your confidence during daily activities.

Single-leg Stance

Single-leg stance directly challenges your ability to maintain equilibrium on your prosthetic leg. This exercise strengthens the stabilizing muscles in your residual limb, ankle, and core, helping you walk with greater stability and reducing your risk of falling. This directly challenges the ability to maintain balance on the remaining leg and prosthetic knees.

• Stand with your feet hip-width apart and lift your sound side foot off the floor.
• Maintain balance on your prosthetic leg, focusing on a fixed point in front of you. Hold for as long as possible, aiming to increase your time with practice.

Side Steps

Side steps improve lateral balance and stability while requiring you to engage the muscles around your hips. They can help you better handle situations where you need to shift your weight or step to the side while walking.

• Using a stable chair or wall for support, step sideways with your prosthesis first, followed by your sound side leg.
• Repeat in the opposite direction. Focus on smooth movements and maintaining balance throughout.

Standing on Uneven Surfaces

Standing on uneven surfaces challenges you to use your core muscles and prosthesis in tandem to maintain stability in real-world environments. Practicing this helps you navigate challenging surfaces like gravel, grass, or cobblestone paths with greater ease and confidence.

• Place a balance board or small pillow on the floor. Carefully step onto it with your prosthetic foot while maintaining your stability.
• Practice standing on the uneven surface for increasing lengths of time. As you feel ready, gradually challenge yourself by closing your eyes or shifting your weight.

Clock Reach

Clock reach improves core stability and challenges your balance in different directions, mimicking movements needed for everyday activities.

• Stand with your prosthetics on the ground, sound side foot slightly lifted. Imagine your foot is the center of a clock.
• Slowly reach your sound side foot forward (12 o'clock), then to the side (3 o'clock), then back (6 o'clock). Continue around the clock, focusing on maintaining your balance.

Heel-Toe Walk

Heel-toe walk enhances balance and coordination by requiring precise foot placement, similar to what's needed for smooth walking with a prosthesis.

• Place the heel of your sound side foot directly in front of the toes of your prosthetic foot.
• Walk in a straight line, carefully maintaining your balance. Focus on keeping your steps small and slow.

Tandem Stance

A tandem stance provider for strong core muscles and improves balance by challenging you to maintain a narrow base of support.

• Stand with your feet hip-width apart. Place your sound side foot directly in front of your prosthetic foot, heel to toe.
• Maintain this position, focusing on keeping your core engaged and body upright. Hold for as long as possible.

Agility Exercises for Lower Limb Amputees

Agility is the ability to change direction and move your body quickly and efficiently. As an amputee, improving your agility will make it easier to navigate obstacles, react to unexpected situations, and move around with confidence. Agility exercises also help enhance your coordination, benefitting overall function with your prosthesis. We’ve put together some agility exercises for you to try.

Braiding

Braiding exercises improve footwork, coordination, and the ability to change direction quickly, making it easier to navigate uneven surfaces and crowded environments. The focus on foot placement helps you develop more awareness of your legs and prosthetic foot.

• Place a few cones or markers in a curved line.
• Weave around the cones with quick side steps, crossing your feet in front of and behind each other.
• Focus on maintaining your speed and balance as you navigate the course.

Obstacle Stepping

Obstacle stepping improves lower limb strength, agility, and coordination. The act of stepping over objects of various heights and distances challenges your balance and forces you to quickly adapt your walking pattern, which is beneficial for handling everyday obstacles.

• Set up small obstacles like boxes or hurdles.
• Carefully step over each obstacle, alternating between leading with your prosthetic and sound side legs.
• Pay attention to foot placement and maintain an upright posture.

Figure-Eight Walk

The figure-eight walk enhances agility and coordination by requiring you to constantly change directions and maintain balance on a curved path. This exercise is beneficial for improving your ability to navigate tight spaces and turns with your prosthesis

• Place two cones a few feet apart. Walk in a figure-eight pattern around the cones.
• Start slowly, gradually increasing your speed as you feel more comfortable.

Lateral Shuffle

Lateral shuffles improve agility and footwork by requiring quick side-to-side movements which is beneficial for reacting quickly and changing direction during activities.

• Begin in an athletic stance with feet shoulder-width apart, knees slightly bent.
• Shuffle sideways, leading with your prosthesis for a few steps. Reverse direction, leading with your sound side leg. Focus on quick, controlled steps.

Carioca

Carioca exercises enhance coordination and agility while challenging balance with single-leg stance and footwork variations.

• Similar to grapevine, cross your prosthetic leg in front of your sound side leg and step to the side. Cross your sound side leg behind and continue steps sideways.
• Reverse the motion, crossing your sound side leg in front as you step.

Endurance Exercises for People with Lower Limb Differences

Endurance, or cardiovascular, exercise boosts your heart health, stamina, and ability to perform daily activities without getting tired quickly. While building endurance is beneficial to everyone, it’s especially important for amputees, as walking with a prosthesis often requires more energy than natural walking. Regular cardio workouts will improve your ability to walk longer distances, handle stairs, and maintain an active lifestyle.

We encourage you to choose endurance exercises that are joint-friendly and enjoyable. Here are some excellent options for amputees:

Walking

Walking with prosthetics is an ideal endurance exercise that's accessible to most amputees. It sounds simple but it builds stamina, improves cardiovascular health, and directly translates to increased functional ability with your prosthetic. Aim for regular walks and increase distance and duration as you get stronger.

• Start with short walks and gradually increase distance and duration.
• Focus on a smooth gait pattern and engage your core muscles.
• Use walking poles or a treadmill for added stability, if needed.

Standing and walking are also considered weight-bearing exercises as your body, including your residual limb and prosthetic side, bears its own weight against gravity. While walking is a natural weight-bearing activity, starting with simple standing exercises, such as equal weight distribution and weight-shifting, can be a great way to gradually increase your tolerance for weight-bearing and build the confidence to progress to walking with your prosthesis.

Stationary Bike

A stationary bike offers a low-impact way to build cardiovascular fitness without putting excessive stress on your joints. This is especially beneficial for amputees who may be new to exercise or experience joint discomfort.

• A stationary bike provides a low-impact cardio workout.
• Start with short sessions at a comfortable resistance.
• Gradually increase the workout time and resistance level as you get fitter.

Swimming

Swimming with amputation offers a great full-body cardiovascular workout while minimizing pressure on your joints. It helps build muscle strength and endurance in a way that can be modified and customized for amputees of different levels.

• Water provides gentle resistance for strengthening muscles.
• Adjust your swimming style based on your amputation level, or consult a swim coach/physical therapist for guidance.

Elliptical Machine

The elliptical trainer provides a low-impact cardio workout that strengthens leg muscles and improves cardiovascular health without putting too much stress on the joints.

• The elliptical provides a low-impact cardio workout that is gentler on joints compared to running, although running for amputees is also possible.
• Place more weight on your sound side as needed. Be sure to pay attention to posture and avoid leaning on the handles.

Rowing Machine

Rowing strengthens the upper body and core muscles while providing a cardiovascular workout, improving overall fitness and posture for amputees.

• Rowing engages your upper body and core while providing cardio. Consult a therapist or trainer to ensure proper form and protect your residual limb.

Tips on Exercises with Lower Extremity Amputations

There’s no denying that living an active life with a limb loss takes dedication and practice. Here are some additional tips to help you safely and effectively incorporate exercise into your routine to improve your overall fitness and well-being:

• Warm up and cool down: Start each session with light cardio and gentle stretches to prepare your body and prevent injuries. End with static stretches to improve flexibility
• Proper form: Focus on the correct exercise form to maximize results and avoid injuries. If you’re unsure, consult a physical therapist.
• Gradual progression: Increase the intensity and duration of your workouts gradually over time.
• Hydration: Stay hydrated before, during, and after your workouts.
• Rest days: Allow time for rest and recovery.
• Upgrade for Performance: Consider investing in athletic prosthetics if you’re planning on exercising or doing sports regularly or on a competitive basis.

Conclusion

Living with limb loss presents unique challenges, but with dedication and the right support, you can achieve your fitness goals and enhance your quality of life. Remember, exercise is a journey, not a destination. It’s important to start slowly, listen to your body, seek guidance from your healthcare team, and celebrate every accomplishment along the way.

If you're looking for expert support in your exercise journey, PrimeCare, a top prosthetics center in New Mexico, is here to help. Our experienced prosthetists understand the specific needs of amputees, and we can provide personalized prosthetic care, tailored exercise programs, and ongoing support to help you build strength and confidence and achieve your full potential. Whether you're new to amputation or seeking to take your fitness to the next level, contact us today to learn how we can empower you on your journey.