When my patients got their first prosthesis, they usually didn’t get to take it home right away. I know, crazy concept. But hear me out.
I had a pretty unique setup because the PT clinic and prosthetic clinic were in the same building, so after the patient got fit for their first prosthesis, it often came straight over to our therapy gym and stayed there until the prosthetist and I felt like they were ready to take it home.
Sometimes that was a couple visits. Sometimes it was a couple weeks. There were definitely times it stayed in our gym for a month or two.
It wasn’t based on some arbitrary timeline. I wanted those early experiences with the prosthesis to happen in a controlled environment where I could help them learn what they should and shouldn’t be feeling, how to put it on and take it off, some basic volume management, and a few foundational movement skills.
I wanted to know that when they finally took it home, they were safe and had a good idea of what they should and shouldn’t be practicing.
Because one of the hardest situations was when someone already had the prosthesis at home and had spent several days reinforcing a bad habit.
Then guess what we were doing in therapy?
Undoing it.
Instead of building on what we had already worked on, we were backing up and trying to break something they had practiced over and over at home.
Some people picked it up really quickly and were more than ready to take it home.
Other people were the complete opposite. They were so intimidated by the prosthesis that eventually I was basically trying to force them to take their own leg home.
You know when somebody tries to slip you cash for doing them a favor and you keep pushing it away while they’re trying to shove it back into your hand or pocket?
Yeah, try doing that with a prosthetic leg.
So no, this wasn’t some rigid rule.
The bigger point was that getting the prosthesis didn’t automatically mean someone was ready to use it independently. Quite the opposite, actually.
Obviously, not everyone has the luxury of working in the same building as the prosthetist, and I’m not suggesting you start confiscating prostheses from your patients...or am I?
But if you have a good relationship with the prosthetist and can coordinate this expectation from the beginning, it might be easier to implement than you think.
On the surface, keeping the prosthesis in therapy for a little while can feel like you’re slowing the patient down. They finally have the thing they’ve been waiting for, and now you’re limiting how much they can use it.
But sometimes slowing things down at the beginning is what helps speed things up later.
A little more structure early on can mean fewer bad habits to undo, fewer setbacks, and much more intentional practice once they’re on their own.
The goal was never to keep the prosthesis away from them.
It was to make sure that when they took it home, they were actually set up to succeed with it.