Putting weight on a non-weight bearing foot or leg can lead to serious complications and should be avoided. If your doctor has instructed you to not put weight on a foot or leg, it is crucial to follow their directions closely.
Why Would a Foot or Leg Be Non-Weight Bearing?
There are a few key reasons why a doctor may instruct a patient to not put weight on a foot or leg:
- Surgery – After many foot and ankle surgeries, doctors will instruct patients to not put weight on the foot until it has had time to heal. This avoids complications like bones shifting out of place, screws or hardware coming loose, and wound ruptures.
- Fracture – Foot and ankle fractures need time to heal and stabilize. Putting weight on a fractured bone too soon can displace the fracture fragments and prevent proper healing.
- Sprain – Severe sprains and ligament tears in the foot and ankle also require a period of non-weight bearing to allow the ligaments to mend.
- Ulcer/Wound – Diabetic foot ulcers and wounds on the foot need offloading to encourage healing and prevent further damage.
- Infection – Osteomyelitis and other infections of the foot bones and joints make the area vulnerable and unable to handle weight bearing.
The amount of time a patient is made non-weight bearing depends on the specific injury and procedure performed. It could range from a few weeks to several months. The timing is crucial and will be specified by the treating doctor or surgeon.
Consequences of Putting Weight on a Non-Weight Bearing Foot
Putting full or even partial weight on a foot that should be non-weight bearing can undo the healing process and cause significant setbacks. Some specific consequences include:
- Displaced fracture – The bones in the foot have many small fracture fragments that need to knit back together. Weight bearing too soon can cause these bone fragments to shift out of alignment. This may require additional surgery to re-align the bones.
- Ligament re-tear – Sprained or torn ligaments in the foot and ankle need time to mend and strengthen. Too much weight too soon could re-tear the damaged ligaments.
- Loss of fixation – After foot and ankle surgery, screws, plates, and other hardware are used to hold everything in place while the bones heal. Weight bearing early on can cause this hardware to loosen or fail.
- Joint dislocation – It is possible for joints, such as in the midfoot and hindfoot, to dislocate if weight bearing occurs when the joint capsule and ligaments are still healing.
- Slowed healing – Weight bearing on an unhealed fracture, sprain, or post-surgical foot can significantly slow down the healing timeline. It causes excess strain and inflammation that delays the healing process.
- Infection – For open wounds or after surgery, weight bearing can introduce bacteria into the area and increase infection risk. Infections in the foot and ankle bones can become severe.
- Ulcers – In diabetics, weight bearing on an area with an active ulcer can enlarge the wound and lead to further complications.
Depending on the specific circumstances, complications from early weight bearing may require additional treatment such as repeat imaging, immobilization, antibiotics, wound care, surgery, or even amputation in severe infections.
How to Keep Weight Off Your Foot
If your foot is temporarily non-weight bearing, it is essential to strictly limit any weight being placed through that foot. Here are some tips to protect your foot:
- Use crutches or a walker for stability when standing or moving around. Keep your weight between your hands and your other foot.
- A knee scooter is a good option to stay off the foot while still remaining mobile.
- Wear a boot or rigid shoe when up with crutches to remind you not to put weight down.
- Use a wheelchair or stay off your feet as much as possible.
- Keep the foot well elevated above heart level as much as you can to reduce swelling.
- Consider a bone growth stimulator to help speed up fracture healing since no weight bearing will slow the process.
- Take supplements such as vitamin D, calcium, and vitamin C to optimize bone healing.
- Do toe wiggles and other light foot range of motion exercises to prevent stiffness while remaining non-weight bearing.
Your doctor may order repeat x-rays at intervals to monitor healing before allowing you to begin putting weight on the foot. Don’t try to speed up recovery by putting weight down early – this will only delay the process further. Strictly limit weight as instructed for the fastest recovery.
Transitioning Back to Weight Bearing
Once your doctor gives the all-clear to start putting weight on your foot again, it is important to transition slowly and carefully back to full weight bearing. Sudden overloading can still cause problems. Here are some tips for a gradual transition:
- Use a walker or crutches to lightly touch down at first, putting just a small amount of weight through the healing foot.
- Progress from there to putting about 25% of your weight on the foot, then 50%, increasing by 25% increments at a comfortable pace over days to weeks.
- If you feel any sudden pain, instability, or other warning signs, slow down the progression.
- Consider a course of physical therapy to help you gradually restore normal gait, strength, and function in the foot and ankle.
- Wear a brace or supportive shoe as instructed to provide stability as you transition back to normal activity.
- Closely monitor the skin for any signs of breakdown or ulcers and limit activities that cause rubbing on the foot.
Expect some residual swelling, stiffness, weakness and soreness as you being walking on the foot again. This should steadily improve. Avoid high impact activities too soon. With a slow and gradual return to weight bearing, you can get back to all your normal activities over time.
When to See Your Doctor
Consult your doctor right away if you experience:
- Sudden increase in pain and swelling in the foot
- Sounds or sensations of popping, tearing, or instability in the foot and ankle
- Inability to bear any weight even after the allowed healing period
- Signs of wound opening, drainage or infection
- Unusual bruising, redness, or warmth in the foot and ankle
- Prolonged numbness or tingling in the foot
Ongoing complications can signify problems with the healing process that need medical attention. Don’t try to “tough it out” if your foot does not seem to be improving as expected. Connect with your doctor promptly for proper evaluation.
Long-Term Effects of Early Weight Bearing
If complications arise from putting too much weight on your foot too soon, you may end up with chronic long-term effects such as:
- Arthritis from improperly healed fractures impacting joints
- Instability or deformity due to ligament damage
- Chronic pain and swelling
- Gait abnormalities
- Increased risk of foot ulcers and infections
- Potential need for additional surgery
These problems can significantly impact your mobility, function, and quality of life. Some may lead to the eventual need for surgical fusion procedures to stabilize damaged joints.
Keeping Your Foot Properly Immobilized
In addition to avoiding weight bearing, keeping your foot stabilized and immobilized is also critical during the healing period. A foot that is allowed to excessively move around before injuries are healed can also cause complications. Here are some key tips:
- Wear any boot, cast or brace as directed by your doctor and avoid removing it.
- Use crutches or a knee scooter to keep your foot elevated and avoid putting it on the ground.
- Limit any activities where your foot is dangling freely without support.
- Sleep with your foot immobilized in the boot and elevated.
- Take sponge baths and use a shower chair to avoid getting the cast or boot wet.
- Do gentle range of motion exercises within any bracing to prevent stiffness.
- Keep an eye out for any rubbing or pressure areas on your skin and discuss with your doctor.
Improperly immobilizing your foot can also result in misaligned bones, loosening of surgical hardware, damage to vulnerable tissues, and other healing complications. Stay compliant with all instructions.
How Long Does It Take for an Injury to Heal While Non-Weight Bearing?
The healing timeline for injuries to the foot and ankle that require a period of non-weight bearing include:
- Ankle sprain – mild, 2-3 weeks; moderate, 4-6 weeks; severe, 8-12 weeks
- Ankle fracture – 6-12 weeks depending on fracture location and complexity
- Foot fracture – 4-8 weeks for an uncomplicated fracture
- Achilles tendon rupture – 6-8 weeks immobilization
- Plantar fascia tear – 4-6 weeks in boot
- Turf toe – 4-8 weeks in stiff sole shoe
- Lisfranc injury – 8-12 weeks protected weight bearing
- Metatarsal fracture – 6-10 weeks
- Great toe fracture – 4-6 weeks
- Jones fracture – 6-10 weeks
These timeframes are general estimates and vary based on the specifics of the injury. Your doctor will monitor your healing with imaging and exams to clear you for weight bearing when it is safe. Patience is required as forcing weight bearing too soon will only prolong recovery.
Preventing Injury That Requires Non-Weight Bearing
While accidents happen, there are some ways you can help prevent foot and ankle injuries that require keeping weight off:
- Wear supportive and stable footwear during sports and exercise.
- Take rest and recovery days between strenuous workouts.
- Tape or brace vulnerable ankles for activities requiring cutting, jumping, and changing directions.
- Stretch and strengthen the muscles supporting the foot and ankle.
- Stay hydrated and fuel up properly before sports.
- Listen to pain signals and avoid “playing through” anything more than mild discomfort.
- Get timely treatment for minor sprains before they become major injuries.
- Allow overuse injuries like stress fractures time to fully heal.
- Consider custom orthotics or shoe inserts if you have poor arch support or alignment that puts you at risk.
While not all foot and ankle injuries can be prevented, many can be avoided with proper self-care, training regimen adjustments, and early intervention when problems arise.
Maintaining Cardio Fitness While Non-Weight Bearing
A period of non-weight bearing can result in cardiovascular fitness losses if you are unable to do your normal exercise routine. However, all is not lost. Here are some good ways to maintain cardio conditioning as much as possible:
- Upper body ergometer – Use an arm bike to get in cardio while keeping your foot elevated.
- Seated aerobics – Do chair aerobics moves to elevate your heart rate without foot impact.
- Seated strength training – Work on upper body and core strength while seated.
- Eat well – Don’t use the inactivity as an excuse for poor nutrition that could result in weight gain.
- Get outdoors– enjoy fresh air on your knee scooter or wheelchair outdoors if possible.
- Swimming – Pool exercises and swimming can get your cardio going without foot impact.
- Anti-gravity treadmill – Provides special harnesses that can enable walking without full weight bearing.
It requires some creativity and commitment to maintaining fitness, but with modifications, you can avoid large losses until you can use your foot fully again.
Precautions for Daily Activities When Non-Weight Bearing
Day-to-day life requires some adjustments and precautions when a foot is temporarily non-weight bearing. Here are some tips to stay safe:
- Install railing and ramps if you have stairs to your entryway.
- Remove loose rugs and clutter that could cause tripping.
- Reorganize your kitchen so things you use often are within reach.
- Set up a bedside commode and shower chair for easier bathroom access.
- Stock up on prepared meals and easy snacks you can eat with one hand.
- Align furniture to give you clear paths between rooms.
- Lower your work surfaces or sit at a table.
- Ask for help from family and friends as needed.
Planning ahead and making modifications can help you perform daily tasks while remaining strictly non-weight bearing until your doctor allows it. Don’t push yourself in ways that could compromise your recovery.
Conclusion
Having to keep all weight off of a foot or ankle for a period of time is certainly inconvenient. However, it is vital for proper healing of many different injuries and post-surgical procedures. Complications ranging from inadequate bone healing to infections and ulcers can occur if you put too much weight through the area before your doctor gives the go-ahead. Use crutches, knee scooters, wheelchairs, and boots as needed to avoid any weight bearing. Transition slowly back to walking under medical guidance. With patience and commitment to keeping weight off the foot, you will be back on your feet when the time is right!