Following Your Surgeon's Weight-Bearing Status Prescription

Following Your Surgeon's Weight-Bearing Status Prescription

 

 

Following ankle injury or surgery, your doctor/surgeon may place weight bearing precautions on the affected leg upon allowing you to walk.  There are a few common weight bearing statuses such as:

 

FWB which is Full Weight Bearing (no restrictions)

WBAT means Weight Bearing As Tolerated (still no precautions, but use pain as the guide)

PWB is Partial Weight Bearing (see below)

TTWB stands for Toe Touch Weight Bearing  (practically non weight bearing) which means you can only touch the floor gently with the toes on the affected leg just for balance, not for weight bearing)

NWB is Non Weight Bearing

 

PWB can be specified as a percentage or an actual weight amount.  Your doctor/surgeon may request 25% PWB, 50%, 75%, etc... Or the surgeon may state you can place up to 25 pounds, 50 pounds, etc... on the affected leg.  Most people have no clue what 50 pounds of weight on one leg feels like, and most are discharged home from the hospital without being educated on this.  Usually, it is a matter of simply feeling what the required weight on one leg feels like in order to consistently adhere to the weight bearing status. 

 

I take a dial scale to my client's home in order to provide this education.  I use a dial scale because it allows you to see exactly how much weight you are placing on it, and you can adjust the amount as needed by either shifting more weight onto the scale (and the affected leg) or off the scale onto the unaffected leg.  Most clients already know their total body weight.  So if they weigh 160 pounds, and the doctor places them on 25% PWB, that means they can only place 40 pounds on their affected leg.  I place the scale on the floor and assist the client into standing.  Their stronger, unaffected foot is placed on the floor next to the scale.  They try to stand as close to their usual standing posture as possible (upright, shoulders back, with their feet/ base of support either shoulder or pelvic width apart).  Then they place the affected side's foot on the scale and slowly shift their weight onto the scale until the prescribed weight is reached.  They repeat this a few times until they are comfortable maintaining this weight bearing status.  Then I have them walk while adhering to the weight bearing status.  After walking, I have them go back to the scale and ask them to again place the appropriate weight on the affected leg.  However, this time I do not allow them to look at the scale while doing this.  They must adjust by feel, without the visual feedback of watching the changing scale numbers.  I repeat this process until they are consistently placing the proper weight on their leg.  

First you must know your client's total body weight



Have them add or remove body weight from the scale using the affected leg