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The Weight of Upper Limb Prostheses

Amber Henson
by Amber Henson
Jun 3, 2025

One of the common concerns that people have when they begin wearing an upper limb prosthesis is its weight, which can include a harness, frame, socket and the terminal device. Those who’ve previously been fit by a general prosthetist may have already experienced a heavy prosthesis and are reluctant to try again. These are valid worries! Wearing a prosthetic device can be intimidating, but with the right tools, the right prosthetic care and the right support, nearly everyone with a limb difference can find a prosthesis that works for them and is not too heavy.

The best place to start is with the right clinical team. Not just the right prosthetist, but the right occupational therapist too. This is why each of our centers has a dedicated occupational therapist on-site, who is there for each visit. The prosthetist, and their assistant/technician, creates the device, doing their best to balance the weight of the terminal device. Our prosthetist Rob, from our Dallas, TX, center: “The socket is the foundation of the prosthesis. If the socket does not fit well, the prosthesis will feel heavy and cumbersome.”

Prosthetists who are not upper limb specialists may not consider an anatomical socket design important, which leads to prosthetic devices feeling heavy. Our upper limb specialists keep the balance of the frame and, when used, the harness on their mind. Getting the balance right can go a long way toward the perception of weight. Once a test socket and trial prosthesis have been created, the occupational therapist (OT) works with the patient on exercises and body mechanics, outcome measures and practicing some of their daily tasks with the device. This is the perfect time for the patient to discuss how the prosthesis is feeling and working for them. The OT collaborates and shares this information with the prosthetist, so they can fix whatever issues are coming up, including the feeling of excess weight or the balance being off. This is also usually when the prosthetist will switch from a thermoplastic test socket to a silicone socket. Silicone sockets have many benefits, and one of them is that they feel lighter. After that, adjustments are made, along with more exercises and tests, and this process repeats until the patient feels confident and the definitive, aka take-home, prosthesis is created. Prosthetist Rob, again: “The materials we use to fabricate a prosthesis, and the technical skill needed to create an extremely lightweight device are critical to achieve the desired results of a light yet durable prosthesis. If the wrong materials are utilized or the technician fabricating the device is not versed in upper limb prosthetic fabrication, then a device can be unnecessarily heavy.”

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Rob showing a finished socket to his patient Joe

Once our patient is home, now it’s up to them to follow the directions that are given to them by the clinical team. There are four main directives: follow the suggested wear schedule, take breaks, know that frustration is a part of the process, and please call us with ANY issues. The suggested wear schedule isn’t just important to give the residual limb skin a chance to get used to your device — it also gives your muscles time to build up so they can support your prosthesis. While we have published a suggested wear schedule on our site, our OTs will give personalized ones to each of our patients.

Speaking of building up muscles, this is something that can help a lot. For many adults with congenital limb differences, they have gone through their life mostly using their sound side. For adults with acquired amputations, the muscles in their arm may have atrophied during their recovery. For both types of individuals, our OTs can practice strengthening exercises with their patient that they can do at home. Our patient JJ’s residual limb muscles began to atrophy after his accident. He had a long recovery time after losing both his hands when he was electrocuted at work. When he was ready to wear a prosthesis, he wanted the most rugged, body-powered device out there. But because of his injuries, his body wasn’t ready for a harness yet. He started with an ETD, which did not need a harness. JJ found a gym that catered to people with different types of disabilities, built up his muscles over time and goes bowling weekly, using a body-powered device.

Our centers often welcome patients who have been seen by a different prosthetic care center and were not satisfied with the results. Our patient Dakota needed a functional, comfortable shoulder-level prosthesis so he could continue working on his pig farm. He had been fit with a device by another provider, but it was simply too heavy for him to get anything done. He came to our Dallas location to see if we could provide something lighter and that fit him better. We did! Another patient of ours found that their device, again made by a different provider, was too heavy and was causing them pain. Our Portland location decided the best thing to do was to remove the elbow joint of the prosthesis. This still allowed the patient to be functional without the prohibitive weight of the joint. This is something we’ve done for other patients too, including Wendi and Marissa in the photos below — not only does it make the device lighter, but it allows our patients to use a device that they feel works best for them:

Wendi69
Wendi
Marissa at Sink Washing Prosthesis
Marissa

The end goal of each prosthesis is function. Sometimes that means making compromises. Our patient Karen, who has a congenital amputation, is a great example of this. Karen didn’t wear a prosthesis for most of her life. She eventually decided to be fit with an iLimb, which is one of the most advanced multi-articulating hands out there. Because it has a battery pack, though, it isn’t as lightweight as a body-powered device. But what Karen likes about it is the function. When she uses it, for instance, to fold laundry, it may take her longer than it would if she took off her device. But her back and sound side won’t hurt the next day, like they do when she tries to do the job one-handed. For Karen, the function and pain-free life that her device offers her outweighs (ha!) the downside of a slightly heavier device.

So, yes, an upper limb prosthesis can add weight. But a sound hand is also a weighty object! The key here is balance — our prosthetists put in the work to balance the socket and frame of a prosthesis as best they can, meaning that while the terminal device weighs what it weighs, a balanced socket can make sure that device still only feels like it weighs around 1.3 pounds, instead of 20 pounds if a poorly fit socket is used. Additionally, there’s also balance to how much a prosthesis is going to allow our patient to function and let them get back to their life. Communication can make all the difference — our prosthetists aren’t going to rest until they find a solution that will work for our patients and their unique bodies. Our occupational therapists are there every step, working with our patients and their body-mechanics to make sure it’s not just about function but also comfort.

If this sounds like the kind of prosthetic care you, or someone you know, would like to experience, please contact us. If you would like to leave a comment regarding this article, please do so below.

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