Prosthetic Foot

What is a prosthetic foot?

A prosthetic foot, or foot prosthesis, is an artificial replacement for part or all of your natural foot. Prosthetics substitute for body parts that you don’t have or that don’t work as they should. A prosthetic foot is primarily a mobility aid. It can enable you to walk on two feet when you couldn’t otherwise.

Who might use a prosthetic foot?

You might use a prosthetic foot if you’ve had a lower extremity or foot amputation. Common reasons for lower extremity amputations include tumors, trauma, infection and peripheral arterial disease. Diabetes-related foot conditions are the most common reason for foot amputations, specifically.

What are the different types of prosthetic feet?

Different types of prosthetic feet offer different levels of functionality. Some are more rigid, and others move in different ways. Some offer more stability, and others more flexibility. Some accommodate more active lifestyles. Your prosthetist will help you select the right prosthesis for your needs and goals.

Types include:

Solid ankle cushioned heel (SACH) prosthetic foot

The SACH foot is the simplest type of prosthetic foot, and often the first type you’ll use. For most people, it’s not a permanent solution but a temporary one that you’ll wear until your permanent foot is ready. It has a rigid keel (center), with foam molded in the shape of a foot around it, and a rigid ankle.

The keel is the weight-bearing center of the foot that mimics the function of your foot’s arch. It provides support and shock absorption when you walk. A flexible keel stores and transfers energy as you walk by bending a little when you put weight on it. A rigid keel doesn’t do this, so walking is a bit clunkier.

Flexible keel prosthetic foot

An elastic keel or flexible keel foot is similar to a SACH foot, except that the keel gives a little when you walk. This helps the foot accommodate uneven terrain a little better. Everything else in the foot is rigid, making it very stable and easy to control. This foot can be helpful for limited walking if your leg is weak.

Axial prosthetic foot

Axial feet have mechanical ankle joints that mimic the movement of a natural ankle. There are two types: single-axis and multi-axis. A single-axis ankle moves up and down to help the foot accommodate an incline or decline. A multi-axis ankle also moves side to side, which helps with uneven surfaces. 

Axial feet allow limited walkers to walk in more places. They’re heavier than the simpler models, but they’re durable and offer good stability, especially for those with weak or unstable knees. The moveable ankles help to absorb some of the stress of walking that might otherwise transfer to your leg.

Hydraulic ankle-foot

A hydraulic ankle-foot uses compressed fluid, such as water or oil, to provide a smooth, rocking motion at the ankle, heel and ball of the foot. This imitates the movement of a natural foot in different walking phases. Hydraulics provide good shock absorption and reduce pressure on the prosthesis socket.

Dynamic-response prosthetic toot

A dynamic response foot provides more flexibility for more physically active users. It’s a contoured foot made with strong but flexible materials, like carbon fiber and foam, that spring back when you push off it. This helps to recycle some of the force you generate by walking, so it takes less energy to walk.

Dynamic response feet are also called energy-storage-and-return (ESAR) feet. They walk for longer distances with more comfort and with a more natural gait than simpler models. They can change speed or direction with ease, making them versatile for many uses. Most sports feet are ESAR models.

Microprocessor prosthetic foot

A microprocessor foot has computer chips and sensors that detect how you’re using the foot and what the terrain is like and make automatic adjustments. This improves overall mobility and relieves stress and strain when walking. Because it uses advanced technology, it’s sometimes called a bionic foot.

Microprocessor feet are battery-powered and require charging at night. They’re more expensive and less durable than other models, and you can’t let them get too wet or dirty. They’re also heavier, although some models use their electric power to help propel the foot, doing some of the work for you.

Specialty prosthetic feet

You might use an alternate prosthetic foot for certain sports or activities. Some of these include:

• Running.
• Swimming.
• Showering.
• Rock climbing.
• Skiing.
• Golf.

Partial foot prostheses

If you have a partial foot amputation, you might benefit from a partial foot prosthesis. Options include:

• Shoe inserts. A custom orthotic shoe insert can fill in the missing part of your foot.
• Ankle-foot orthosis. An ankle foot orthosis (AFO) is a combined foot plate and ankle brace that straps onto your existing foot and shin. It can be modified to fill in the missing part of your foot.
• Silicone partial foot prosthesis. Silicone prostheses are both flexible and lifelike. A prosthetist will carefully model the prosthesis to look just like your natural foot and fit precisely to it.
• Toe-length carbon fiber footplate. This partial foot prosthesis is a flexible carbon fiber insole that extends all the way to the end of where your toes would be, providing a springlike action.

What are the advantages of using a prosthetic foot?

A prosthetic foot can restore your mobility, independence and quality of life after a foot amputation. It can be difficult (or impossible) to walk if you don’t have a whole foot. Some people develop abnormal ways of walking that throw their musculoskeletal alignment off. A prosthetic foot can help you walk more safely and comfortably for your body and avoid injuries.

What are the possible complications of using a prosthetic foot?

Different types of prosthetic feet can cause different complications, like balance problems, muscle strains or mechanical failures. Some complications can happen with any type of prosthesis, including pressure sores or skin irritation from sweat. Your prosthetist can help you troubleshoot these issues.

How long does it take to get a prosthetic foot?

Acquiring a prosthetic foot from a certified prosthetist is a structured process that takes several months. You’ll have several appointments with your prosthetist to discuss your needs and goals, take measurements and make molds of your limb. After that, your prosthesis is made to order over several weeks.

How long does it take to get used to a prosthetic foot?

It may take several months to get used to using your new prosthetic foot. Your prosthetist will teach you how to use it, clean it and care for it, and troubleshoot any issues you might have. An occupational therapist or physical therapist can help you adapt your everyday life and activities to your new foot.

Can you walk with a prosthetic foot?

A prosthetic foot from a certified prosthetist is an assistive device designed to help you walk. Some prosthetic feet can help you to run or swim, too. What you can do with your prosthetic foot will depend on your overall physical condition and the type of prosthesis you have.

Can you drive with a prosthetic foot?

You can drive with a prosthetic foot, though you might need to learn new ways to drive safely. If you’re not comfortable using the pedals with your prosthetic foot, you can modify your car with hand controls.

Can you sleep with a prosthetic foot?

You shouldn’t sleep with a prosthetic limb on. Changing positions when you sleep with your prosthesis on may cause injuries. Also, your limb and skin need a break from wearing the prosthesis and liner.

How long can you wear a prosthetic foot?

Most prosthetic feet last three to five years, depending on how much you use them. Your prosthetist might need to adjust the fit before that. Your natural limb may change its shape and size over time.

How does a prosthetic foot attach?

A prosthetic foot attaches to a custom socket that fits precisely onto your existing limb. Different types of suspension systems hold the prosthesis in the socket, including vacuum suction and pin-lock systems.

A note from Cleveland Clinic

While transitioning to a prosthetic foot is a physical process, there’s also an emotional component. Most people who are considering a prosthetic foot are planning or recovering from an amputation. This is a major life event. Consider consulting a counselor or support group to help you through this transition.