Below-knee & Van Nes Rotation Amputees 

• The limb may need a special alignment to give it a slight forward tilt, similar to skiing.
• A tilt can be given to a standard artificial limb by inserting a small "shim" or "wedge" into the heel of the skate on the artificial leg.
• Having an adjustable ankle (or a foot that has an adjustable heel height option) makes it easy to make the necessary ankle/foot adjustment.
• Adjusting the blade of the skate to turn slightly inwards can help achieve a better grip on the ice.
• Support around the knee can be provided by a knee brace.

• The same adjustments as for below-knee amputees apply.
• In addition, above-knee amputees will need adjustments made to their artificial knee. Skating requires faster leg movements, so the flexion (the degree the knee can bend back) of the artificial knee will need to be limited in order to allow the knee to swing the lower leg forward quickly for the next stroke. This can be done with a special knee, a joint stop inserted into the regular knee, or simply an elastic strap fixed around the front of the artificial leg.