Recovery after surgery

Everybody recovers at a different rate after their surgery. Your recovery depends on your health condition and your own experience.

The following information is a guide to give you an idea of the physiotherapy you will have after your surgery.

Stage 1 - days 1 and 2 after surgery

Moving around

You will be seen by the therapy team to support you getting out of bed and into a wheelchair safely. The occupational therapy team will lend you a wheelchair while you are in hospital so you can start moving around again.

If you have had an amputation below the knee or through the knee, you will have a ‘stump board’ attached to your wheelchair. This will support your stump when you are sitting in your wheelchair. It also helps to reduce any swelling.

An occupational therapist will help you get into your wheelchair and position your stump on the stump board. You will be shown some simple exercises to keep the joints moving.

If you have had a below the knee amputation, please do not support your stump with pillows, or have the electric bed bent up under the knee. This can make your knee stiff. It is important that your knee can straighten fully if you will be walking with an artificial leg.

Pain 

You will be given pain medicine to keep you comfortable. Tell your nurse if you have any pain, including phantom pain.

You might not feel any pain when you are lying in bed. However, you will be doing exercises during your physiotherapy sessions, so it is important to take your pain medicine regularly so your pain is well controlled when you are resting and during movement.

Your wound

Your stump will be covered with a bandage. Do not remove the bandage yourself, as this could cause an infection.

Your physiotherapist will encourage you to look at your stump, and touch it on top of the bandage if you can. This is to stop your stump from becoming sensitive to normal sensations.

Stage 2 - around 3 to 5 days after surgery

The rehabilitation team will come to see you and talk to you about your treatment and progress.

If you can, lie as flat as you can for 1 hour each day. This means you can straighten your hip as much as possible, and lower the risk of your hip tightening. Doing this might make it easier to walk with a prosthesis.

As you start to feel better and have less pain, you will find that you can do more yourself. The occupational therapists, physiotherapists and nurses will help you to be as independent as you can be.

The peripheral nerve catheter will be removed and your pain relief changed to give you more freedom. It is important to let the medical team know if your pain is less well controlled when this change is made.

You will slowly be able to do more exercises as you gain strength and confidence. You might go to the gym in the physiotherapy department. If you do, please wear loose, comfortable clothing, such as shorts and a T-shirt. This will make it easier for you to move around. You can meet other people who have had an amputation at the gym sessions.

Stage 3 - around 6 to 10 days after surgery

The physiotherapists will aim to take you to the gym once a day.

You can start using a walking aid when your surgeon and physiotherapist feel your wound has healed enough. This is called an early walking aid trial.

You must have enough muscle strength, the ability to stand up in the parallel bars, and be able to stand for about 8 to 10 minutes to use the aid. Not everyone will be able to take part in a walking aid trial. Your physiotherapist will talk to you about this.

The walking aid you use will depend on the level of amputation you have had.

The pneumatic post-amputation mobility aid (PPAM aid, or pam aid) is an inflatable leg. The PPAM aid helps to reduce the swelling to your stump and helps you to walk again.

The Femurett is another type of walking aid. It is used by people who have had their leg amputated above the knee.

Stump shrinker compression sock

The compression sock is a tight, elastic bandage for your stump. It helps to control any swelling. Your physiotherapist will give you a sock and show you how to put it on.

It will be difficult to put it on yourself at first, as it is designed to be tight. Your physiotherapist or nurse will help you until you can do it yourself.

Start by wearing the sock for short periods and build up your tolerance. The aim is to wear it all day.

The sock should not be worn when you are asleep or overnight. Remove the sock if it is causing you pain, or if your wound becomes very sore. If this happens, tell your physiotherapist.

Keep your compression sock in a dry place at room temperature. Follow the washing instructions inside the sock, or in the information sheet that comes with the sock.

Do not wear the sock if it is damaged (if it has a ladder or a hole). The sock cannot be repaired, and you will need a new one. Ask your physiotherapist for a new one.

If this happens after you have left the hospital, contact your prosthetic centre.

Stage 4 - around 11 to 21 days after surgery

If your stitches are not dissolvable, your nurse will remove them.

You might be taken to our specialist amputee rehabilitation unit once your consultant is happy that your wound is healing well and a bed becomes available.

The unit provides amputee nursing, physiotherapy, occupational therapy, counselling, prosthetic provision and social care support.

There is a rehabilitation gym, a practice kitchen and bathroom, and outdoor space. The unit is at the Lambeth Community Care Centre in Kennington. It is a few minutes from St Thomas’ Hospital.

If you are able to manage safely, your doctors might be able to let you go home at this stage.

Using an artificial limb (prosthesis)

If you can have a prosthesis, and you have done the early walking aid trial, the prosthetist will visit you. 

The prosthetist will make a cast of your stump, and start making your prosthesis.

Some people might not be able to have a prosthesis. You will need a lot more energy to walk with a prosthesis. Some medical conditions can also limit your return to walking.

If you are not suitable for a prosthesis at this time, you can still learn to be very independent. Your physiotherapist and occupational therapist will help you to practise exercises and techniques until you are safe to move around on your own in a wheelchair.

You can always be considered for a prosthesis at a later stage. If you think you would like to be reconsidered for a prosthetic limb after you have left hospital, ask your GP for a referral to the local limb fitting centre.