Limb Loss and Amputation Care

At Sheltering Arms Institute, we treat a wide range of amputations. 

Lower Limb Amputation

• Above the knee, in which a portion of the leg is removed from above the knee joint
• Through the knee, or knee disarticulation, in which the lower leg is amputated along with the knee joint
• Below the knee, in which the lower leg is amputated with the knee joint staying intact
• Hip disarticulation, in which the entire leg is removed with some variations that leaves the upper portion of the femur to help with posture while sitting
• Hemipelvectomy, in which the entire leg and sections of the pelvis are removed
• Ankle disarticulation, in which the foot is removed with removal through the ankle joint
• Partial foot and toe amputations, in which parts of the foot or toes are amputated

Upper Limb Amputation

• Partial hand, potentially including the removal of parts of the finger or the entire digit itself
• Metacarpal, or hand amputation, without the removal of the wrist joint
• Wrist disarticulation, or hand amputation that includes the removal of the wrist joint
• Below elbow, in which the hand and part of the forearm are removed
• Elbow disarticulation, in which the forearm is removed where it meets the elbow 
• Above elbow, in which the arm is amputated above the elbow
• Shoulder disarticulation, or forequarter amputation, in which the shoulder, shoulder blade, and/or collar bone are removed

At Sheltering Arms Institute, patients with limb loss spend an average of 15 days in the inpatient setting. This is typically followed by home healthcare, outpatient, and community support care.

Program-specific therapies at Sheltering Arms Institute seek to improve: 

• Patient nutrition
• Residual limb care
• Pain management
• Medical oversight for post-operative care
• Increasing physical functioning
• Pre-prosthetic education
• Peer visitor services
• Psychosocial and emotional well-being
• Improving independence with activities of daily living
• Optimizing speech, swallowing, and cognitive functioning as needed

While the following schedule is a sample and for illustrative purposes only, inpatient rehabilitation patients can expect an average of 3 hours of therapy each day. Individual schedules vary based on each patient’s care plan and level of injury.

7-9 a.m. – Physician Rounds

7:30 a.m. – Occupational Therapy to Practice Activities of Daily Living such as Bathing

8:30-9 a.m. – Breakfast

9 a.m.-12:30 p.m. – Physical / Occupational / Recreation / Therapy

11 a.m.-12 p.m. – Group Education Class

12:30-1 p.m. – Lunch

1-4 p.m. – More Therapy

4-5 p.m. – Therapeutic Recreation Groups

5:30-6 p.m. – Dinner

7-8 p.m. – Medications and Bedtime Preparations

Patients will receive their prosthetic limb once the incision on their residual limb is healed and swelling has stabilized, typically 6-8 weeks after your amputation. Individuals will transition from a preliminary limb to your permanent limb with the assistance of a prosthetist, physician, and therapists. This is due to changes in residual limb shape, as well as function in the first year, post-surgery.

Staples are typically removed during a person’s inpatient rehabilitation stay once the incision no longer has drainage and is healing well, typically about two weeks post-surgery. Patients then receive a shrinker from their prosthetist, which will further shape the residual limb in preparation for the first prosthetic limb.

There are two types of pain experienced after an amputation. The first is incisional pain. This is the pain that improves as the incision heals. The second pain is phantom limb pain, or pain that feels like it’s coming from the part of the body that is no longer there. This pain improves 80 percent of the time. In instances in which it lingers or prolongs, healthcare providers can recommend medication or additional therapy.

Most amputees, specifically lower limb amputees, will require a wheelchair and a rolling walker. For individuals requiring a ramp to ascend small sets of stairs at home RAMPS, a Sheltering Arms Institute community partner, helps fund and assemble ramps that are often not covered by insurance.

Sheltering Arms Institute offers a robust medical psychology department that specializes in providing coping strategies; one-to-one mentorship with other individuals who have been through similar situations; and monthly support groups with individuals who are at different points in their recovery.

Sheltering Arms Institute’s recreational therapists work with patients to identify community engagement opportunities that can support rehabilitation and recovery. 

We partner with the Amputee Coalition, the nation’s leading organization on limb loss, dedicated to enhancing the quality of life for amputees and their families, improving patient care, and preventing limb loss. 

We also partner with Sportable, the only adaptive sports club in Central Virginia offering a variety of competitive and recreational adaptive sports programs.

Sheltering Arms Institute also provides peer mentor opportunities for current patients to meet and converse with others who have experienced limb loss.

You will need to wear your semi-rigid dressing until you obtain your prosthetic limb, typically 6-8 weeks after your amputation, meaning you will still need to wear it upon discharge from Sheltering Arms Institute.

Your physical therapist will help get you set up with a prosthetist during your stay at Sheltering Arms Institute.

After inpatient rehabilitation, patients typically transition home and receive home health therapies. Once the residual limb incision has completely healed and a physician has provided clearance, individuals are fitted for their initial prosthetic limb in the prosthetist’s office. Outpatient physical rehabilitation begins thereafter.

Yes! Families and/or spouses can attend Sheltering Arms Institute’s limb loss education classes offered every Tuesday and Thursday. Family members are also welcomed to attend our Amputee Support Group offered the first Wednesday of every month and other group education classes. Prior to discharge, patients and families will meet with the care team for family training to ensure a safe transition home.

Yes! You can find more information about our Limb Loss Support Group here.