Following a life-changing electrical injury, years of severe neuropathic pain and significantly reduced mobility, Mr Knight made the difficult decision to undergo a transtibial amputation. His subsequent rehabilitation at Askham Rehab focused on rebuilding his physical strength, confidence and independence, with returning to family life at the centre of his goals.

Read more about Mr Knight’s rehabilitation journey and his return home.

Mr Knight’s story is one of significant physical and psychological change. What began with an electrical injury in 2023 led to multiple surgical interventions, persistent pain and increasing limitations on his everyday life. Eventually, amputation offered a new route forward.

Following surgery, Mr Knight came to Askham Rehab for an intensive period of specialist rehabilitation. Physiotherapy, occupational therapy, psychology and nursing support were brought together around his individual needs, while close collaboration with the wider professionals involved in his care helped plan each stage of his recovery and transition home.

Throughout his rehabilitation, progress was measured not only through clinical outcomes, but through what those improvements allowed Mr Knight to do again. One of his proudest achievements was something deeply personal: getting back into the garden and kicking a ball with his young son.

A life-changing electrical injury

Mr Knight, aged 40, sustained a life-changing electrical injury in June 2023. The electrical current entered through the palm of his right hand and exited through the sole of his right foot. He also sustained a mild traumatic brain injury, resulting in difficulties with concentration and memory.

Over the following years, Mr Knight underwent multiple orthopaedic interventions, including various debridements, extensive fasciotomies, Achilles tendon lengthening, toe fusion, big toe release and metalwork insertion. His recovery was complicated by infection and screw extrusion, alongside persistent and intractable neuropathic pain affecting his right side.

His final surgery before amputation involved debridement and a split-thickness skin graft (SSG) to the dorsum of his right foot, which was unsuccessful.

On most days, Mr Knight rated his pain between 4 and 8 out of 10, describing it as continuous crushing pressure alongside sharp neuropathic pain extending into his right foot.

His mobility had consequently become significantly limited. He required a walking aid due to foot drop and intermittent lower back pain, could walk approximately 20 metres and had a standing tolerance of around five minutes.

Nerve conduction studies performed in July 2024 confirmed absent peroneal and tibial motor signals and an absent right sural sensory signal. Mild to moderate denervation patterns were also reported in the tibialis anterior and tibialis posterior. An MRI in August 2024 showed metatarsal stress reactions in the fourth and fifth metatarsals.

The turning point

The impact extended far beyond Mr Knight’s physical health. His ability to participate in family life and return to hobbies he had previously enjoyed had been profoundly affected. In particular, being unable to play with his two young children became a significant source of frustration.

His sleep had also been severely affected, with bad dreams and flashbacks relating to the original incident.

When asked whether there was a particular point when he felt like giving up, and what helped him continue, Mr Knight said:

“There were a few times I felt like giving up like when I got an infection and it stopped me doing things. Then there were times when my family came up to see me for the weekend and when they left to go home, it made me upset and alone. What pushed me through it was having photos of my family around the place I stayed.”

In 2026, after living with persistent pain and significant functional limitations, Mr Knight made the difficult decision to undergo a transtibial amputation with the aim of improving his quality of life.

When asked about his initial emotions and physical challenges before making the decision, he said:

“Fear of how I would be perceived and the fear of what was ahead after surgery.”

Mr Knight underwent Targeted Muscle Reinnervation (TMR) to minimise post-operative phantom limb and neuroma pain. He also experienced psoriasis, which was effectively managed prior to his transtibial amputation.

The surgical process

Mr Knight’s surgical pathway involved:

• Two separate operations, a few days apart, during a single hospital admission
• A peripheral nerve block for pain management
• Targeted Muscle Reinnervation (TMR) to reduce phantom limb and neuroma pain
• A staged wound closure approach to reduce infection risk

Following surgery, the planned rehabilitation sequence included an initial 7–14-day period of post-operative recovery in hospital, followed by two weeks of non-weight bearing.

PPAM aids were introduced after approximately two weeks, with prosthetic fitting planned for around six weeks post-surgery.

This was followed by a three-month period of specialist rehabilitation at Askham Rehab before transitioning to Proactive rehabilitation, alongside a combination of private hydrotherapy and community physiotherapy.

A multidisciplinary approach to amputee rehabilitation

Mr Knight’s post-operative rehabilitation at Askham Rehab brought together three core therapy disciplines: physiotherapy, occupational therapy and psychology. They worked alongside our nursing team, who supported his wound management and the removal of sutures and staples.

Following an extended period of pain and restricted mobility, global deconditioning and reduced physical endurance were significant areas to address as part of his functional recovery.

Optimal recovery could not be achieved through any one discipline in isolation. Instead, his rehabilitation required a coordinated multidisciplinary approach, with the different teams working towards shared goals for his mobility, independence, confidence and eventual transition home.

Physiotherapy: rebuilding strength and endurance

Physiotherapy focused initially on restoring global muscle strength.

Following three years of pain, limited mobility and physical compensation, Mr Knight had developed significant weakness in his quadratus lumborum, erector spinae and core muscles, alongside his right gluteal muscles, hamstrings and quadriceps.

His programme included twice-daily functional strength and conditioning exercises using light weights and hydrotherapy. Loading tolerance was developed through regular use of PPAM aids, while cardiovascular and muscular endurance were addressed through self-propelling techniques and boxing.

Flexibility, joint mobility, single-leg balance and dynamic control were also incorporated into his rehabilitation to support his progression with PPAM aids and preparation for prosthetic rehabilitation.

During two episodes of infection, the nursing and physiotherapy teams worked closely together to ensure Mr Knight received the appropriate medical care alongside his ongoing rehabilitation, with the infections treated using antibiotics.

Occupational therapy: returning to everyday life

Askham Rehab’s occupational therapy team worked with Mr Knight on functional activities of daily living and rebuilding his independence.

As he progressed, the focus developed towards improving muscular endurance and wheelchair self-propulsion within the community.

Mr Knight also completed a bus journey as part of his rehabilitation, providing an opportunity to experience and navigate some of the real-world challenges of community mobility as a wheelchair user.

Experiences outside the rehabilitation environment allowed him to encounter everyday situations in public and develop the practical skills and confidence needed to support his transition back into the community following discharge.

Psychology: adjusting to life as an amputee

Mr Knight described one of his biggest emotional hurdles when beginning rehabilitation as:

“Being seen as an amputee and getting around in a wheelchair.”

Psychological support therefore formed an important part of his overall rehabilitation.

Askham Rehab’s psychology team completed cognitive assessments and explored coping strategies for pain management, sleep hygiene, memory and concentration.

Sessions also focused on mental resilience, adjusting to changes in body image and self-esteem. Cognitive Behavioural Therapy (CBT) techniques were used to challenge negative thoughts and anxiety.

His rehabilitation recognised that adapting following a life-changing injury and amputation involves psychological recovery alongside physical progress.

Working together to plan the next stage

Mr Knight’s rehabilitation involved close collaboration between the professionals supporting him both within and beyond Askham Rehab.

Together with Mr Knight’s surgeon, Dr Tania Cubison; case manager, Declan Egan; solicitor, Lise FinchWest; prosthetist, Jamie Gillespie; Proactive physiotherapist, Ezgi Tarhan; Elly Mendis; Dr F Anwar; and the Askham Rehab multidisciplinary team, virtual meetings were held to review his progress and plan the next stages of his rehabilitation.

Within Askham Rehab, weekly multidisciplinary team meetings brought the three therapy disciplines together to discuss Mr Knight’s individual goals and progress.

This collaborative approach helped maintain continuity throughout his rehabilitation and supported a smooth transition from inpatient rehabilitation back to his home and community.

Returning home and reclaiming independence

Following intensive rehabilitation at Askham Rehab, Mr Knight successfully transitioned back to his primary residence, demonstrating increased functional mobility and greater independence within the community.

When asked which everyday tasks he was most proud of reclaiming, he said:

“To walk again, not be in pain and struggling to do things. I managed to go in the garden with my little boy and kick a ball around with him – something I never got to do before my accident, and I’ve got that proud moment back with him.”

For Mr Knight, progress was not simply measured through strength, endurance, walking or other clinical outcomes. It was also about returning to the everyday experiences that mattered to him and his family.

Progress beyond the clinical milestones

Mr Knight’s rehabilitation journey required considerable physical and psychological adjustment. From rebuilding strength and endurance to developing community independence and adapting to life following amputation, each stage contributed towards his wider goal of returning home and participating more fully in family life.

His commitment and positive attitude also had an impact beyond his own rehabilitation. Throughout his time at Askham, he supported and encouraged other residents, bringing warmth and positivity to those around him.

His journey demonstrates why successful rehabilitation is not defined by one major milestone. Progress can be found in improved strength, greater confidence, another step towards independence or an everyday experience that once felt out of reach.

For Mr Knight, one of those experiences was being back in the garden and kicking a ball with his son.

The small victories can be every bit as meaningful as the big ones, because each one represents progress towards greater independence and the life a person wants to return to.

If you would like to learn more about rehabilitation at Askham Rehab or discuss a referral, please contact our team on 01354 740269 or email info@askhamrehab.com.