Weight-Bearing Restrictions and Activity After Surgery

After lower extremity surgery, your orthopedic doctor may limit the amount of weight you can place on your operated leg. This restriction is necessary to provide adequate time for proper bone or tissue healing to occur. It also allows for any hardware that was placed during the surgical procedure to remain in the proper position.

Understanding the different weight-bearing restriction types, as well as how to perform them, is often confusing. So what are weight-bearing restrictions, and how do you navigate from non-weight-bearing to full weight-bearing after injury or surgery?

It is a good idea to check with your doctor or physical therapist to understand your specific weight-bearing restrictions and how to maintain them properly. Studies have shown that compliance with these restrictions is low, but can have serious consequences. 

Non-weight-bearing means that no weight can be placed on the operated leg. This is the most restrictive of all weight-bearing limitations. Since you are not able to bear any weight on the leg, an assistive device, such as a walker or crutches, will be necessary for you to walk.

When walking with your walker or crutches, keep your affected knee bent and keep your toes off the floor. No weight means no weight; even the slightest bit of pressure on your leg can cause problems.

Toe-touch weight-bearing means that only the toes on your operated leg should contact the ground. This is for balance only, however, and thus no significant amount of weight should be placed on your toes. As a result, an assistive device such as a walker or crutches will again be necessary for you to walk. Your toes are only used for slight balance and steadiness.

Partial weight-bearing allows you to place half of your weight on the operated extremity. Begin by using a scale to see how much pressure is on your affected leg when half of your weight is placed on it. Use your assistive device to stand with slight pressure on your leg.

Your physical therapist can help you with progressive partial weight-bearing. Sometimes your doctor may give specifics when prescribing partial weight-bearing. He or she may prescribe 25% weight-bearing, 50% weight-bearing, or 75% weight-bearing. Your PT can help you get a feel for how much weight should be placed on your leg.

Make a mental note of this, and limit the pressure placed on your operated leg during walking to this restriction. As full weight-bearing is still not allowed, crutches, a cane, or walker can help you walk without losing your balance.

Full weight-bearing allows you to place all of your weight on the operated extremity. There are no restrictions in regards to the amount of weight placed on the leg, therefore assistive devices are usually not necessary.

If you have been walking with a cane or crutches, you may not want to simply throw those things away, as you may need them to progress from partial to full weight-bearing. Sometimes progressing from partial to full weight-bearing can make your muscles a little sore, so expect this. Your PT can help you safely progress from partial to full weight-bearing.

If you fail to appropriately maintain your weight-bearing status, you could risk causing further injury or jeopardizing the success of your surgery. Of course, if you accidentally place your foot on the floor when you are supposed to be non-weight-bearing, you most likely have done no damage. Simply assess your situation, and return to your previous weight-bearing status.

Signs that you need to see your doctor if you accidentally break your weight-bearing status may include:

• Increased pain in your injured or operated leg
• An increase in redness or swelling in your leg
• Difficulty moving around that causes more pain

If you have broken weight-bearing precautions after an injury or surgery, it's best to err on the side of caution. Give your doctor a call and explain what has happened.

After injury or surgery, your doctor may limit your weight-bearing as things are healing. Take a moment to learn about different weight-bearing restrictions, and work closely with your physical therapist to properly progress your weight-bearing status as directed by your doctor.