Liner Socks –
When it comes to socks, there are two different combinations that I use and alternate between for comfort and performance. For a first layer over the skin, I use the French DawFlo sheath; they are expensive but comfortable to the skin and durable after repeated wash and use. They are very thin and don’t wrinkle during wear— wrinkling is a bad thing, as it can be painful. Alternatively, I use Silipos BK Silosheath gel socks; they are made of a thin layer of gel against the skin with a thin layer of sheath backing on the outside. They are very comfortable to wear, especially when having uncomfortable spots on your residual. The only drawback is the usual sweating part, like any other gel wear (see pictures below). For a second layer, I use The Royal Flush Prosthetic Socks; they are available in different thicknesses (2, 3, 4, 6, 8 ply). They are made of great materials that were invented to make veterans’ socks. They don’t wrinkle, keep dry, repel sweat, and are very durable after repeated wash and use (see pictures below).
Please note that you always need these two layers of socks at all times for sure, and you can add a third layer in case of loose fitting. In general, I use either DawFlo and 3-ply or 5-ply Royal Flush combination, or Silipos and 3-ply or 5-ply Royal Flush combination. These two combinations sometimes feel like you have two different prostheses for alternation. By adding a second liner as described before, you now have different combinations and alternatives to shift around and help provide relief to your hard-working residuals. Please note that all of these sock options come in different sizes and different lengths to fit your needs.
Juzo sleeves –
Juzo sleeve is what I wear 90% of the time to help keep the prosthesis on (see picture above). They offer a good combination of grip, flexibility, and comfort, and are light enough to wear all day. They have 2 strips of gel bumps on the inside, one on each side, that help keep grip so that the prosthesis stays attached. Their only drawback is that they don’t last as long and require pull-up adjustment here and there. Another drawback will be if you have a glossy finish socket, they will not work as well because they will slip off. In this case, ask the prosthetist to use a rough finish or sand rough the glossy part of the prosthesis that is covered by the Juzo sleeve, and that will fix the problem (see picture above).
Gel sleeves –
Before gel sleeves, swimming was complicated, and trying to keep the liner dry had ruined the fun of it, not to mention ruining components. With today’s gel sleeves, you easily throw one on before hitting the shower, or going to the beach. There are several types. I have always tried the latest and newest, and usually keep the top three performers handy. Gel sleeves keep the water away from the liner, they also hold the prosthesis on tight, but with less knee bending flexibility. So, they are good for hard activities, like jet skiing, kayaking, and rough gardening projects, etc. (see picture above).
Shoes –
Selecting the right shoes is truly important and serves like the icing on the cake. When you are BK-Short, every little bit will help, and a good pair of sporty shoes opens up the possibilities. It sounds weird when describing a pair of shoes that way, but they add to the stability of the walk, including the foot roll from heel to toes, and the balance from side to side, not to mention the spring and cushiony comfort. In recent years, I have been addicted to the NB-860 line; they are light, well balanced, have a smooth roll, and have a nice wide grip. There are obviously many good options out there, just make sure that they have a good combination of comfort, soft sporty action, and a wide sole and toe grip. In casual to semi-dressy footwear, Sketchers and Clarks have really provided a variety of options. Remember, get your choice of function and form, but do not go cheap with shoes. Whatever you do, stay away from any shoes with a narrow profile sole, like Puma, or a big heel that is more than 3/4 inch. You are trying to be less wobbly, so make a good choice in shoes. Also, future shoe selection should follow a similar sole and heel ratio, which is the sole size difference between the front and back of the shoes. By the way, don’t forget to take your shoes with you during your alignment, as alignment is done with particular shoes, and it will make a difference.
Shoe insert –
Regardless of the quality of the prosthesis you have put together, BK-Short will use their good foot in unique ways that will add much stress, including twists, turns, and maneuvering. So, let’s be proactive and protect that good foot, as it is now doing 150% of the usual work. To do so, replace the regular insert of the non-prosthesis shoe with a better insert to keep your foot aligned and supported properly. I have been using “PowerStep” brand, which is a good insert that provides excellent foot support, arch support, and the plus version includes metatarsal protection if needed. This insert is awesome and will save you potential trouble later in life, not to mention frequent trips to a podiatrist. Also, on the prosthesis foot, ask the prosthetist for a cork insole; they will help the prosthesis shoe last longer. Finally, it is advised that you replace your sports shoes on a regular basis, 3-6 months, as they become less comfortable and effective in time with material fatigue.
Residual care –
It is important for all amputees to properly care for their residual skin, especially BK-Short. Your feet were designed to carry your body weight with each step, but now your residual skin is doing hard work. So, here are some things that you can do to help with care and maintenance. Wash your residual with warm water and soft soap before bedtime, and use some moisturizing lotion after drying. This will help you prepare for the activities of the next day. Don’t get your residual wet in the morning during shower, as the hot water will expand hair follicles, and the trapped moisture and bacteria throughout the day could start a small pimple or infection. This is a moot point if you use a gel sleeve cover for morning showers. When you have an irritated spot on your residual, you can use any thin silicone nipple cover for a few days to prevent further irritation. If you notice the start of a small pimple or infection, and you cannot stay off your feet, use Dr. Scholl’s Corn Cushions. They come in small and large sizes. Place the cushion where the pimple is in the center hole, and put a dab of Neosporin cream in the donut holes to help with the healing and prevent further infection. Stop and rest if the infection becomes worse and painful, and remember, you can increase your chances of another amputation if you don’t.