Full Non-Weight Bearing
Full weight-bearing is prescribed when your bones or ligaments are too weak to take any strain at all. Walking using the injured limb risks re-injury. This means that you cannot lean on your injured leg even when it is in a plaster.
In order to avoid putting any weight through your leg, it is best to avoid lowering your foot to the ground at all. Only in special cases will patients be allowed to touch their foot to the ground during weight-bearing - this is called 'touch' weight-bearing and is used when non-weight-bearing is too difficult.
Your physiotherapist will provide you with:
- Gait aids - this is usually crutches, however other aids may be used.
- Instructions on how to negotiate stairs, perform turns, ascend and descend slopes and any other necessary maneuvres.
At this point, your foot or ankle is probably immobilized in a plaster cast. A cast covering your ankle will not take your weight - even if you have a cast you should not put any weight on your foot.
When is full NWB used?
Full non-weight-bearing is required after serious knee, hip, ankle or foot injuries. It is also used after some surgeries.
Occasionally, moderately severe ligament injuries affecting joints in the leg require a few weeks of non-weight-bearing despite not requiring surgery.
What are the risks of weight-bearing too early?
The most serious risk is re-injury of the bone or ligament that was damaged.
Transition from Full Non-Weight-Bearing
The first time you put weight on your foot you will probably feel sore, weak and/or unstable. This will be especially noticeable when you've been non-weight-bearing for a prolonged period of time, ie weeks. This is a normal consequnce of disuse, and it is important you begin weight-bearing and movements as soon as it is safe to do so.
Most people find that they repaidly regain strength in their leg as they continue with rehabilitation and gradually increase their weight-bearing. It is however, a difficult period, and your physiotherapist will provide encouragement and support as you start to take your weight. They will also teach you exercises to improve the feeling and strength in your joints.
What are the risks of full non-weight-bearing for too long?
Your body is designed to move and carry your weight, so prolonged periods of non-weight-bearing will alter the strength of your bones and muscles. Some changes include:
- Ligaments can become less elastic
- Muscles can shorten and become weaker
- Loss of proprioception can increase the risk of losing balance.
- Softening of bone (osteoporosis) leading to increased risk of fractures.