Below knee artificial leg, built around the stump you have

How long until you walk on it?

Most people can be assessed six to eight weeks after surgery, once the wound has healed and the stump is no longer swollen. After a diabetic amputation healing often takes longer, and we would rather wait a few weeks than fit a socket over fragile skin.

From the first assessment to the final fitting usually takes one to three weeks, depending on how quickly the test socket settles and how often you can come in. Walking well takes longer. Expect a few weeks of daily practice before you stop thinking about each step, and a few months before long walks feel normal.

While you wait, a shrinker sock and simple exercises make a real difference. Our guide to the first weeks after amputation shows what to do.

The socket matters more than the foot

Families often ask first about imported feet. We understand why, but the socket decides whether you will wear the leg at all. A beautiful carbon fibre foot on a socket that pinches will sit in a cupboard; a simple foot on a socket that fits well will walk for years.

There are two main socket designs. A patellar tendon bearing (PTB) socket puts more weight on the tendon below the kneecap and on the sides of the shin. A total surface bearing (TSB) socket, worn with a silicone liner, spreads the load over the whole stump. Both work well; the shape, length and skin of your stump decide which suits you.

Every leg we make goes through a clear test socket first. You stand and walk in it while we look through the plastic at the skin. Any white or red patch shows pressure, and we correct it before the final socket is made.

Living with a below knee leg in Pakistan

Shoes. The foot is set for one heel height. If you switch between chappals, joggers and formal shoes, the leg leans forward or back. Tell us what you wear most days and bring those shoes to the fitting.

Sitting on the floor. Kneeling and sitting cross-legged are possible with a below knee leg, but the back of the socket presses behind the knee. Many users take the leg off for long gatherings, and we can trim the socket to make floor sitting easier.

Heat. A Pakistani summer means sweat inside the liner. Take the liner off at midday, dry the skin and the liner, and carry a small towel. A sweating stump slides in the socket and rubs.

Motorbikes and rickshaws. Riding again is a common goal. On most motorbikes in Pakistan the gear change is under the left foot, so a left below knee user needs to practise gear changes with the artificial foot or have the lever adapted. Tell us at the assessment.

Namaz. Most users pray standing with the leg on and decide for themselves about sajda. Our namaz and wudu guide covers the options.

Caring for the leg and the stump

• Check the stump every night with a mirror for redness, blisters or broken skin.
• Wash the liner inside every day with mild soap and let it dry fully.
• Add or remove sock layers as the stump changes during the day.
• Keep an ordinary leg out of water; for wudu or the shower, take it off or ask about a waterproof leg.
• Do not let anyone else loosen or tighten the bolts. Small alignment changes make a big difference to the knee and back.

When the socket stops fitting

The stump keeps shrinking for a year or more after surgery. At first you add sock layers; when you need many layers, or the leg starts to rock or pinch, the socket needs replacing. A replacement socket starts from Rs 40,000 and keeps the rest of the leg, so the second year usually costs much less than the first.