Exercises for Above Knee Amputation
Exercises after undergoing an above knee, or trans-femoral amputation are primarily designed to prepare you for using a prosthetic device. In order to use a prosthetic device, hip motion must be optimized and maintained through stretching and strengthening of the hip extensors and abductors. As a general rule, keep your leg moving as much as possible and change positions frequently. By keeping your hip moving and active, these exercises will help prevent complications from occurring.
Lying prone, or on your stomach, is an easy and effective way to stretch your hip flexors. Lie on your stomach for about 20 minutes, two or three times per day to keep the hip flexors limber. Hip flexors cross the front of the hip, and are prone to shortening after an above knee amputation. Shortening of these muscles can lead to contracture formation, which will make prosthesis use extremely difficult. To intensify this stretch, add a rolled towel under your amputated limb.
Hip extensions can also be done from the prone position. This exercise targets the large gluteal muscles of the buttocks, which are especially important for activities such as walking and standing. While prone, slowly lift your amputated limb straight up. Hold for a count of three against gravity, and slowly lower the leg. If this is too difficult, this exercise can be done in the side-lying position.
In the sidelying position with your amputated limb on top and hips straight, slowly lift your top leg straight up towards the ceiling. Again, hold this exercise for a three count against gravity, and then slowly lower the leg. This exercise works the abductors of the hip, another important muscle group for walking. Repeat this exercise with the non-amputated leg as well.
One of the most common contractures with above knee amputations occurs in the adductor, or inner thigh muscles. These muscles should be stretched often to prevent contracture formation. Sitting with your back against a wall, bring both legs out to your side, bend your non-amputated knee slightly. Push down on both thighs with your hands, taking care to keep your buttocks on the floor. This stretch should be felt on the inside part of the thigh. Hold each stretch for at least 20 seconds, repeating three to five times.
Tyler Shultz is a third-year doctor of physical therapy student at the Medical College of Georgia in Augusta, Ga. His articles have appeared in numerous physical therapy blogs since 2009, including PT ThinkTank and AAOMPT-sSIG blog. Tyler graduated from the University of Georgia with a Bachelor of Science in health promotion in 2007.