Hey, everybody. This is Christina the Amputee OT. In this video, I will be talking about
desensitization and end bearing exercises for amputees.
*machinery and welding sounds*
A lot of new amputees find that their residual limb tends to develop areas which are very
hypersensitive to the touch and this can be a problem because
if you have areas that are hypersensitive to the touch, not only is that uncomfortable,
but it can make it difficult to fit you for a prosthesis.
In addition because you will be bearing some of the weight of your body on the end of your residual limb when you're wearing a
prosthesis, it's good to be able to tolerate some weight being borne on the end of your residual limb and for that
you will have end-weight bearing exercises. Quick disclaimer, although I am an occupational therapist,
I'm not your occupational therapist
and so you may want to consult your physician, your physiatrist, your occupational therapist, or your physical therapist or your prosthetist
before doing any of these exercises. All these techniques are used to prepare your residual limb for prosthetic training.
Even before your sutures are removed,
you can massage your limb as long as you do it with clean hands. And this helps you to develop a tolerance to
both touch and pressure.
Basically for this you want to use one or two hands massage your entire limb and
massage it as much as you are able to tolerate with it being comfortable. It's going to be pretty tender at first,
but as you massage more and more and as your limb heals you'll be able to
give your residual limb a pretty deep massage.
And you'll want to do this for about five minutes three to four times a day if
You still have your stitches in just be very careful over this area so that you don't hurt that area. People tend to develop
hypersensitivity over their suture area so one thing you can do to reduce that
hypersensitivity is via tapping and you can do that before the sutures are removed, you just have to be careful.
And you'll want to do tapping for one to two minutes three to four times a day or more often if it helps.
And you want to be sure you don't tap with your fingernails, you tap it with your hand.
And over time you can increase it to gentle slapping.
*slap sounds*
If your limb is especially sensitive to touch you can start out using something as simple as a cotton ball.
You can rub the cotton ball on the very sensitive area.
Once you're able to tolerate soft materials. You can move on to Rougher materials such as a paper towel
or a rough towel.
And you'll want to do this two or three minutes for about twice a day.
And you want to do this until you can tolerate
rubbing from your terry cloth towel a lot of times people have issues with the scar on the surface
adhering to some of the deeper tissues and so to reduce that you can use a technique called "scar
mobilization." For that you'll place two fingers over the bony portion of your residual limb and while you're pressing firmly
move your fingers in a circular motion for about one minute.
Now, what you're not doing is sliding your fingers or
massaging, you're actually moving the skin to make the skin loose over your residual limb
You can see I definitely do not have any problem with my scars adhering to any other part.
My scars are pretty floppy.
If you're doing this before your incision has healed you won't want to do it directly on the incision, instead
you'll do it near the incision like this.
If you do all these exercises couple of times a day, you will be well on your way to getting fitted for a prosthesis.
For end-bearing exercises, which increases the amount of weight your residual limb is able to tolerate at the end of your residual limb,
you will need a towel and also you have to be at least four weeks post-op for an ertl amputation and
six weeks post-op for a regular amputation. Fold your towel in half.
Put the towel over the end of your residual limb from the side to side and pull gently until it smarts and hold for five seconds
You don't want this exercise to hurt. You want it to just sort of smart a little bit after five seconds release slowly.
Don't take the towel completely off and then do it again for another five seconds.
You can do this about twenty five times and then go the opposite way
So instead of side to side do front to back and do the same thing
pull for five seconds. One Mississippi, two Mississippi, three Mississippi, four Mississippi, five Mississippi
Relax.
And then pull again. When you're able to pull on the towel
comfortably with all of your strength, then you're ready to move on to end bearing exercises with a scale.
Which should actually take a couple of weeks before you can get to this point.
For end-weight bearing exercises you'll want to get a scale and
using the scale press your residual limb in to the scale until it smarts. Hold it for five seconds. One
Mississippi two, Mississippi, three Mississippi, four Mississippi, five Mississippi.
Relax a little bit.
Do it for another five seconds one Mississippi, two Mississippi, three Mississippi, four Mississippi, five Mississippi.
Until you
have done this twenty five times and you also want to note the amount of weight you can bear on the end of the scale.
If you look down in the description of this video there will be printouts of these instructions.
Be sure to note that each person is different. For example,
I did not have to do any scar mobilization or desensitization exercises with my residual limb because I did have any issues with
hypersensitivity and I also didn't have any issues with scar adhesions or anything. However,
I do have issues with end-weight bearing and I actually am not able to tolerate much end-weight bearing. Only like
40 pounds or so and probably 20 pounds comfortably when really I should be able to tolerate like
40% of my weight on the end of my residual limb.
Hopefully these exercises are helpful to you if you're a new amputee or even if you're a seasoned amputee.
Okay, everybody that's all for now. I hope you enjoyed this video. If you have any questions,
you can leave them in the comments section below. You can subscribe if you like. I put out new videos every Wednesday.
You can follow me on Facebook at facebook.com slash amputee ot, and
See you later. Bye!