Is It a Prosthetic Issue or a Patient Issue?
One of the most common questions I hear from therapists working with amputees is this:
“Is this a prosthetic problem or a patient problem?”
You see a gait deviation. Or something looks off. Or the patient describes a sensation that makes you pause. And suddenly you're trying to sort through the possibilities. Is this strength. Is this motor control. Is this alignment. Is this the componentry. Is this simply their unique anatomy in motion.
Early in your amputee rehab journey, that question can feel stressful and maybe intimidating. But over time it becomes one of the most interesting parts of the work. Every session turns into a real time puzzle that forces you to slow down, pay closer attention, and sharpen your clinical instincts. And honestly, that’s part of what makes this specialty so satisfying. Knowing the answer every time would get boring.
That’s really the heart of amputee rehab. You're constantly observing movement, listening to what the patient feels, and deciding what deserves a second look. Sometimes that means taking a video and reviewing it later. Sometimes it means asking a coworker to watch with you. And sometimes it means calling the prosthetist to talk through alignment or the patient’s report.
This is where your pattern recognition develops. You start to notice which sensations relate to volume or fit, which compensations come from mobility or strength deficits, and which deviations tend to show up with alignment issues. But even with experience, the answer is rarely clean or obvious. It’s almost never entirely mechanical or entirely patient driven. More often it’s an interaction between the two, influenced by the task, the environment, and how the patient is feeling that day.
That’s why collaboration matters. Listening. Observing. Asking better questions. Sharing information with the prosthetist. Being honest about which parts are training and which parts are hardware. If you find yourself asking, “Is this a prosthetic issue or a patient issue,” that doesn’t mean you’re lost. It means you’re paying attention. And that’s where clinicians grow the most.
Announcing the 2026 ARS Certification Dates and Locations
For therapists who want more reps at this kind of clinical reasoning, I built the Amputee Rehabilitation Specialist Certification Course. It's a two day, live, hands on training that teaches a complete amputee rehab system, from [pre prosthetic care] through advanced [gait training] and functional mobility.
Here are the 2026 public course dates:
Atlanta: March 21 and 22
Chicago: May 30 and 31
Hartford: September 19 and 20
Denver: November 14 and 15
Each course is capped to keep the labs hands on and high quality.
If you want to reserve a spot for yourself or your team, all the details are below.