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Women face unique challenges when getting a prosthesis

Army Spc. Cherdale Allen shows off two of her prosthetic legs: one for walking and the other for high heels. Army Spc. Cherdale Allen shows off two of her prosthetic legs: one for walking and the other for high heels.

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Like many women, when she’s in her civilian clothes, Army Spc. Cherdale Allen likes to dress up in her high-heeled shoes. 

“My heels are like 4 inches and up,” said Allen with a laugh. “I like to feel beautiful.” 

That has been a little tougher for Allen, an active-duty soldier working in medical supply, than  most other women. She lost part of her left leg below the knee to cancer and is being fitted with a prosthesis at the Center for the Intrepid at Brooke Army Medical Center (BAMC) in San Antonio, Texas. This prosthesis will help her to dress fashionably once again. “I just wanted to be able to wear the heels I used to wear. That was on top of my list,” said Allen. 

It’s not just whether a prosthesis will be able to handle a high heel, said Andrea Ikeda, a research prosthetist with the Extremity Trauma and Amputation Center of Excellence at BAMC and the person who is helping Allen get a prosthesis that will work. Ikeda fitted Allen with three different artificial limbs: one for walking, one for running and one for use when she wants to dress in heels. The next step is to add a flesh-tone cover for the high-heel foot that will also look more natural. 

“For most women, body image and a more natural-looking prosthesis are more important than they are to men,” said Ikeda. “Many women want their prosthetic arm or leg to match their other side in shape, size, skin tone, etc., so it looks more natural and doesn’t stand out.” 

In Allen’s case, the fitting also had to consider not just how it fit her body, but how it fit her movement style. She has a tendency to strike her heel (as opposed to walking and running on her toes) and hyperextend when she walks. Allen has had the new prosthesis for four months now, and she said it’s working well. 

“I’ve got the foot I wanted. So far, so good,” said Allen. 

For upper-extremity amputations, Ikeda said the weight and size of the hand or hook can be more of a factor for smaller women than it is for men. Manufacturers of prosthetic hands recently have released some smaller sizes, which better match a typical woman’s hand. 

“A few months ago I was able to use an extra-small-sized hand, which had just come out on the market, for a woman with what I consider about an average female hand,” said Ikeda. “The size matched very well, and the patient was pleased.” 

Ikeda said the process of fitting a woman with an artificial limb is not really different than the process for a man. Each prosthetic socket, the part of the prosthesis that fits onto the residual limb, is individually custom-made for each limb. But there’s more to the process. “When fitting a woman, we sometimes have to think about other things, such as weight gain during pregnancy, which can affect socket fit.” 

Right now, as combat operations have wound down following the wars in Iraq and Afghanistan, there hasn’t been an increase in the number of combat amputations for women, or for men, for that matter. But as women fill more combat roles in the future, there is the potential for demand to become more of an issue. Ikeda believes that prosthetists, working with industry, will be able to meet their patients’ needs. 

“As we continue to ask manufacturers of prosthetic feet about more options in adjustable and high-heeled feet, hopefully more choices will come to the market,” she said. 

That’s music to the ears of Allen, who just wants to live normally and look her best. 

“I still want to feel like a woman, feel good about myself and dress up,” said Allen. “I want to continue to live like I used to.”

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