For people with lower-limb prosthetics, winter can magnify balance issues and demands additional attention towards amputee fall prevention. Falling or tripping is always a hazard for amputees; in the colder months, this increases dramatically. However, it’s not all doom and gloom.
As an amputee, there are specific measures you can put in place to increase your safety and confidence. Below are some safety tips for fall prevention for patients with below-knee amputations, as well as info on how to choose the right shoes and fall recovery methods.
Why Are Amputees More at Risk of Injury in Winter?
During colder months, it’s important to keep your winter prosthetic leg and the rest of your body warm and insulated. Falling is always a hazard for an amputee, especially during winter months when a combination of balance issues and walking on slippery snow or hardened ice with little traction may cause you to trip and fall.
Cold Weather Challenges and Solutions for Amputees
Besides obvious safety issues for an amputee like slipping or falling, there are other mental and physical challenges that lower-limb amputees face in cold weather:
- Walking safely: snow, water, and ice make even the most trusted paths unpredictable. We recommend wearing shoes or boots that have a rubber or neoprene composite sole. Both offer better traction than leather and plastic when walking.
- Painful joints: cold weather causes muscle and joint stiffness, making it harder to move. Taking prescribed supplements and medication can ease the pain of prosthetic wearers who have arthritis. For those who don’t have arthritis but whose joints still become aggravated, we recommend doing mild exercise routines to get the blood flowing. Stretching, swimming, and walking on a treadmill are excellent options.
- Depression: those who suffer from depression know it can worsen during winter as the weather limits outdoor activities. Mitigating emotional highs and lows are paramount to maintaining general well-being, which often entails having a strong support structure and seeking professional medical guidance.
- Seasonal Affective Disorder (SAD): also known as “winter depression,” SAD is a mood disorder thought to occur due to a lack of light during the winter months, which causes serotonin levels to drop. If you experience mood changes, withdrawal from activities that are usually enjoyable, and general fatigue, then you might want to consider getting professional help, as well as exploring light therapy options.
- Social isolation and loneliness: during winter, shorter, darker days and more time spent indoors induce prolonged feelings of loneliness. Whether it’s an art class, exercise session, book club, or other group activity, we’d encourage you to join a club or class. This automatically exposes you to a group of people who already share some of your interests.
11 Tips for Staying Safe in Winter for Lower-Limb Amputees
Following these tips will help you navigate winter with greater ease, confidence, and safety.
#1 Invest in Shoes with Good-Traction
As we previously mentioned, investing in high-traction prosthetic shoes that provide a good grip will get you around safely. Rubber-soled amputee shoes or a variation thereof are best. We recommend selecting a size that fits your prosthetic leg comfortably but still has enough room for socks and foot warmers. If you live in a particularly cold state, you can also add gel liners for additional warmth.
#2 Stay Warm at All Times
When your body is in a cold environment, it redistributes blood to your torso to protect and maintain the heat of your vital organs. Consequently, it becomes more challenging to maintain a normal body temperature, and your limbs become colder. Therefore, it's crucial to keep yourself warm and insulated.
Wearing multiple layers of wool, fleece, thermal garments, and waterproof outer clothing is a must. Keeping your whole body warm decreases stiffness and potential joint pain and makes it easier to go about your daily activities.
#3 Take Care When Walking
Fall prevention for an amputee starts with environmental awareness. Some of the most dangerous surfaces in winter are stairways, wheelchair ramps, balconies, porches, parking lots, and sidewalks. Try not to walk on or rush through slippery areas without stabilizing yourself.
On that note, you also want to make sure your prosthetic limb is working properly. If something feels wrong, or you begin experiencing sudden pain or complications, make an appointment with your prosthetist rather than try to fix it yourself. It’s also important to learn how to get up after a fall. Amputees do occasionally fall. If you do, don’t panic. Check your residual stump and seek appropriate medical attention.
#4 Don’t Shy Away from Support
Another amputee fall prevention strategy is to use a walker, a cane, or a pair of crutches for slippery surfaces. What you choose depends on particular conditions, like knowing whether you need rubber or spiked tips. Some cane and crutch tips are interchangeable, so it's good to shop around. As always, the best option is to avoid potentially dangerous walkways, although this isn’t always possible.
#5 Search for Specialized Prosthetic Technology
Today’s cutting-edge prosthetic technology offers greater safety and comfort. From heat regulation to bionic ankles that bend, there are many prosthetic leg options designed to make life easier. The more clued-up you are about what’s out there, the better you can plan for all winter conditions. Consult your therapist for recommendations based on your personal needs.
#6 Charge the Phone
Keep a charged phone on you at all times. That way, if you do fall and can’t get back up, you can easily call for help.
#7 Wear Comfortable Clothes
Don’t wear restrictive clothing that inhibits movement or garments that can get caught on things. Moreover, make sure your pants are the right length, so don’t trip over them.
#8 Keep Your Hands Free
Another part of fall safety lower for limb amputees is keeping their hands as free as possible when walking. If you do slip, your hands will break your fall. Use a bag to store and carry valuable belongings like keys etc.
#9 Keep the Areas Around Your House Clear of Snow and Ice
A great fall safety tip for lower limb amputees is to keep your yard and driveway free of snow and ice. If you can’t do it yourself, then hire a snow control company to de-ice surfaces outside your home.
#10 Inspect Steps, Hills, and Ramps
Another tip for fall prevention for patients with below-knee amputations includes inspecting steps, hills, and ramps. Rather use alternative routes or ask for help if they look unsafe.
#11 Plan Your Getting Out
Colder seasons entail a little more planning. Allow enough time to get to where you are going, so you don’t rush. If possible, plan routes with the least amount of risk. For example, if you usually walk somewhere, but there’s a lot of snow, it might be safer to drive, even if it's a short distance away.
What Activities Should Amputees Avoid in Winter?
As a rule of thumb, you should always pay attention to surfaces before walking on them. Additionally, try to avoid the following:
- Walking on slippery surfaces without something to stabilize yourself, such as a walking aid or handrail.
- Running errands alone, like grocery shopping or going to the doctor.
- Proceed with caution on wheelchair ramps or sloped paths — only do so if there are handrails.
- Fixing your prosthetic device yourself if something feels wrong or broken.
- Taking shortcuts to get somewhere quicker can be dangerous. Stick to designated walkways as much as possible.
If your profession or lifestyle requires you to spend extended time walking outside, you should speak with your prosthetic team about the best options for fall prevention. Amputees can do a lot to improve their safety with the right prosthetic equipment.
How to Choose the Right Winter Boots for Prosthetic Legs?
The shoes that are best for you depend on several factors, such as your amputation level, artificial limb, and posture. Choosing shoes for prosthetic legs comes with the following considerations:
- Choose the right heel height: shoes with flat soles can make you feel like you’re falling backward and produce a suboptimal socket angle, putting too much pressure below the knee. That’s why many prosthetic feet are made with a modest heel of about one centimeter. As a lower-leg amputee, your prosthetist might also recommend wearing an insole in the shoe you wear on your prosthesis.
- Buy half a size bigger: this gives you space to add safety and comfort features around your prosthetic. Furthermore, if your residual limb ends in the area encompassed by your boot, and is sensitive to the cold, the extra bit of room provides space to wear thick socks or small pocket warmers.
- Get the right soles: the soles of your shoes should provide proper support. Rubber provides better traction than plastic. You can also add spikes or rubber attachments to your shoes’ undersides that can be removed once indoors.
- Use toe fillers: some prosthetic feet don’t come with toe moldings that are used to fill out the extra space in a shoe. Crumpling in the upper shoe and a lack of a solid foundation can lead to walking issues. Adding toe fillers preserves the shoe and the prosthetic leg because it reduces the chances of slippage.
How to Get Up After a Fall: Amputee Dos and Don’ts
When we fall, our natural reaction is to tense up. Ironically, this makes us more susceptible to injury. It seems counterintuitive, but you should try to relax your body completely. This allows different body parts to move independently in reaction to the collision and distributes the force of impact across more of your body. Bend your joints to remain flexible and try to protect the vulnerable parts of your body.
How to get up after a fall as an amputee:
- When you have a fall, you will most likely get a fright. Instead of rushing up, stay calm and first get your breath back. Take a moment to determine if you are injured and plan how you will get back up safely before trying to do it.
- If someone is waiting to help you, ask them to check for wounds or bleeding.
- When you are ready, roll onto your side, using your hands as support, and assume a side-sitting position. Then, rise with support from a person nearby.
- If you do not have help, crawl to the nearest sturdy surface (either on your stomach or shuffle on your bottom) and hoist yourself up into a standing or sitting position.
- Rest and alert your doctor if you have serious injuries.
- Improper help may worsen the situation if you think you have a dislocated joint. In this case, call for medical help.
- If necessary, contact your prosthetist, so your artificial limb can be checked.
- If you notice damage to your skin or pain in your joints, make an appointment to see your general practitioner.
- Contact your physiotherapist if your fall affects your walking in any way.
Lower-limb amputees don’t need to dread winter. As long as you’re prepared, you can avoid many season-related issues and go about daily life with minimal stress. With the right orthotic equipment and shoes, you’ll feel better and be more active. If you’re looking for winter prosthetic solutions, we can help. As a leading prosthetics provider in New Mexico, PrimeCare has a wide range of options to suit varied needs. Contact us today for a free consultation.