The art of the socket
Boulder graduate takes ‘artisanal’ approach to making prosthetics
When an 11-year-old llama named Bella broke her right hind leg in a gopher hole in 2010, her owners, Chuck Robuck and Trish Brandt-Robuck of Newcastle, Calif., chose to amputate rather than euthanize her.
But curious Bella loved wandering the couple’s ranch, and, unable to live the life she had known, fell into a depression. That’s when they called in University of Colorado Boulder graduate Michael Carlson (‘02KINE), a certified prosthetist, orthotist and “medical artist” who crafts prosthetic sockets.
As Will Rogers once noted, “The best doctor in the world is the veterinarian. He can't ask his patients what is the matter—he's got to just know.” Carlson, 39, faced the same dilemma with Bella, and for the next three and a half months, he struggled to get her prosthetic interface—the part between the skin and artificial limb—just right.
“There were huge setbacks,” he says, “including a real communication barrier.”
But after three tries, Carlson succeeded, and Bella has worn her leather-and-metal prosthetic leg for eight to 10 hours a day ever since.
“In her case, this was a life-saving procedure,” he says.
This case was unique for Carlson, though, in an important way: Most of Carlson’s patients are humans.
“I really shine when someone walks well,” he says, referring to his chosen profession as “artistry at the socket.”
And not just walk. Among his most gratifying experiences are helping a man who lost his leg in a BASE jumping accident, who then made a successful jump from the bridge where the accident occurred, and the time he went snowboarding with a veteran for whom he’d created a sports prosthesis.
Carlson gives partial credit for his success to his early exposure to craftsmanship in his father’s woodworking shop, especially learning how to use a sewing machine, and his long love affair with ceramic wheel-throwing—aka pottery.
“I’ve described what I do to people as a medical art,” he says. “It’s kind of an old profession, and the reality is that not much has changed with the interface between the device and the patient. My specialty is the design and fitting of the socket.”
Carlson grew up in Grand Junction and decided to study kinesiology at Boulder, with a possible eye toward the health care field. He worked with Rodger Kram, professor of integrative physiology, and began focusing on prosthetics toward the end of his time in school.
Carlson, like many of his peers, got his start with , which has created devices for many famous clients, including a tail for Winter the dolphin, star of the movie “Dolphin Tale.” While working for the company, he graduated from various prosthetics and orthotics certificate programs, including a prosthetics and orthotics residency in New York City. In 2016 he left the company to start his own practice.
“My career path,” Carlson notes, “has been linear.”
A prosthetics practice, he says, is similar to a dentist’s office. He is the clinician who designs and implements a treatment plan and follows up. But where many clinics have technicians to do the actual fabrication, Carlson is involved with all phases of the process.
It all starts with a patient’s healing after amputation, which can take six weeks to 12 months. When the patient is ready with a “healed and cylindrical limb,” Carlson takes a cast and creates a prototype. Once he’s got the fit right, he creates a carbon laminate shell to fit the limb that attaches to prosthetic components.
Carlson has chosen to stick with a hands-on, “artisanal” approach, despite the advent of such time-saving technologies as prefabricated sockets and 3D printing.
“I believe haste makes waste,” he says. “It takes a long time. It’s an intimate procedure. I really get to know my patients, and it’s so gratifying when I get to see them walk.”
Going to school at , with its mountain backdrop and countless recreational opportunities, helped point Carlson toward his unconventional career—all told, there are only about 2,000 people in the field in the United States, he says.
“I felt lucky to be there, and I felt an obligation to make an impact or strive toward significance and give back,” he says. “I invested in my education and wanted to use it; I wanted to use my degree in my work and keep building on my
education. My job is all about helping people”—and, it must be noted, the occasional grateful llama.