what is the definition of PWB and FWB???

Hello everybody– hope everyone continues to be positive and shares with everyone else.  I really appreciate reading everyone’s stories.  I would like to understand what is meant by non-weightbearing, partial weightbearing and full weightbearing??  Today, I am 18 days post op—I had ordered one of those vaco-ped boots (see vacoped.com) and received it on Friday.  I tried it on yesterday, Saturday–10/10/09 and it really felt amazing.  My Doctor has not yet authorized this and is still believing conservatively that I need a few more weeks NWB in order to avoid re-rupture.  When I am in the vacoped boot 30 degrees equinas I am able to be PWB and maybe even FWB?? I am not in pain–it does not hurt at all and I am wondering if this constitutes PWB and FWB by definition??? or is PWB and FWB based on 2 bare feet being on the ground next to each other????  your comments are greatly appreciated–Larry

22 Responses to “what is the definition of PWB and FWB???”

  1. Larry- I ruminated over the definitions as well. I was ordered to be strict NWB for the first two weeks (during which time I was in a splint) and then allowed to be PWB to FWB as I tolerated. To me, PWB started when I was allowed to let my injured foot touch the ground and FWB started when I didn’t need the crutches anymore. Hope that helps. Cheers, Ron

  2. NWB - nonweight bearing
    PWB - partial weight bearing
    FWB - full weight bearing

    I think…..

  3. Larry,
    I’d agree with Ron’s (ultidad) and alex’s definitions. If your doc has said NWB for the time being then I’m not sure you should just buy a boot and ignore him! Admittedly plenty of people on this site are PWB in a boot at 18 days but that’s usually after the doc has given them the go-ahead. Your doc is the only one who has stared your AT in the face and seen the extent of the damage. If you do rerupture it is harder to fix second time around (or so my surgeon told me) because there is less ‘good’ tendon to work with and you have a greater chance of ending up with a shortened tendon. If I were you I’d speak to the doc before heading off to the disco in my funky boot.
    Smoley

  4. Are you in Britain by any chance? It seems that the orthopods there are generally a lot more conservative, on average, than in the US. My doctor’s plan for me was sutures out 2 weeks after surgery, begin PT and PWB at that point, FWB 4 weeks after surgery and 2 shoes as soon thereafter as I could get them on. That got disrupted by several infections but that is his usual plan. There have been numerous studies that show no difference in recovery between the conservative and aggressive approaches, in fact it shows a slightly increased risk of re-injury following the conservative approach. The longer your leg is immobile the more muscle mass you lose and the longer your recovery will take. Push back on your doctor.

  5. NWB means nonweight bearing
    FWB means full weight bearing
    PWB means partial weight bearing

  6. I think everyone here knows that PWB means “Partial Weight Bearing” but I too would like to know what is the definition of “Partial Weight Bearing”? Right now I am 12 days post-OP and for the last couple of days I am able to sit down and let my injured foot rest on the ground for 30 minutes or so…does this mean I am already PWB? (I doubt it…PWB probably means you can step down on your injured foot with partial body weight while wearing a boot?). Tomorrow I will get my stitches removed and will ask the doctor.
    Thanks,
    Brian

  7. Hi Brian, Best of luck tomorrow! Yes that’s right on for PWB. I think you are in a temporary soft splint cast now? Everyone is different on their recovery. I feel we all know our body best over the surgeon. But listen to their advice and do what you can. I had a soft cast for 2 1/2 weeks. Fiberglass cast after that with toes pointed down for another 4 1/2 weeks. So I had roughly 7 total weeks in a cast. Mine was a complete ruture. I could have shortened that cast time by 1 week but I was out of town. I went to the boot with NWB using cruthes at week 7 1/2 then graduated to PWB with crutches at week 8 1/2. I was FWB with boot in 5 days after that just short of 9 weeks. Ahh it felt good. Waking up all those little bones , nerves etc. I never have had any pain this entire time. I took my first real walk un-assisted with boot on day 65. It all came fast for me. I did use a crutch or cane for I’d say another week on and off when I got tired. At day 76 I went to cross fit but I did modify. At day 100 I realized my recovery will be more towards the 1 year mark for 100%. I’m OK with that. There is more than I can do than what I can’t do and everyday I see micro gains. Still dealing with a small open wound at the incision but my PT and daily activities are pretty normal. Again good luck tomorrow and happy healing.

  8. PWB is usually a transition, using crutches, from gently letting your recovering foot “ride along” and “make believe” it’s walking, all the way to holding the crutches off the floor (tho’ that’s FWB). Some protocols specify pounds or % weight, but the key is to be gradual and keep progressing at a reasonable pace. The v. successful UWO study started PWB at 2 wks and went to “FWB As Tolerated” at 4. Many Docs go slower, with no evidence to support the added nuisance and risk of a crutch-fall.

  9. Thanks for the replies, doryt and norm, what you said makes sense. Doryt, I think my doctor has me on a similar recovery route as you. My splint should come off today at 13 days post-op. Last I heard, it will be another 3-4 weeks with hard cast. He thought ts might be closer to 4 weeks just because my full tear was higher up the Achilles than average (3 inches above where it connects to the heal bone), but we’ll see what he says this morning… I can already flex my calf by doing quick and gentle plantar flexing and am hoping this is a good sign that I am recovering quicker than expected (maybe because of the GraftJacket?)….

  10. What did you guys do to start PWB? I am just shy of 6 weeks post op and have been told to start PWB but at this point I don’t really know how to take the first step to do that? How light did you all start? At this point I have just been “ghost stepping” - placing my injured foot on the ground but not putting any weight through it. Is this how you all started? Did you have much stiffness or soreness transitioning from NWB to PWB? Thanks

  11. I’m assuming you are using crutches. While leaning on your crutches, place them in front of your injured foot. Then gently put a little weight on your injured foot moving up to the crutches. When you feel comfortable, then step through the crutches.

  12. Yes, my foot felt stiff as wood and very tender. But as you heal, the pain will continually decrease. Good luck!

  13. Yes I’m on crutches. How long did it take to be FWB once you started to PWB? Thanks for your help

  14. Hi Marissa
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  15. I started PWB at 5 weeks. It took me 3 weeks PWB to finally go without crutches to FWB. Such a huge feeling of triumph and freedom. At 7 weeks I could use one crutch on the opposite side from my booted foot to step giving me a FREE hand. I’m at 8 weeks and walk pretty slowly- rolling from the heel to the toe and have a 2″ wedged sandal on the good foot, so I’m balanced and don’t misalign my spine and hip. It’s really hard but it does get better.

  16. I started PWB at 5 weeks. It took me 3 weeks PWB to finally go without crutches to FWB. Such a huge feeling of triumph and freedom. At 7 weeks I could use one crutch on the opposite side from my booted foot to step giving me a FREE hand. I’m at 8 weeks and walk pretty slowly- rolling from the heel to the toe and have a 2″ wedged sandle on the good foot, so I’m balanced and don’t misalign my spine and hip. It’s really hard but it does get better.

  17. I tore mine 5/20 and had surgery 5/28. Was in a partial cast with sides open for 9 days. At 9 days stitches came out and I was put in a boot set at 20 degrees. Had that on for 2 weeks. Was able to rest it on the ground and did put some weight on it that way to see how it felt. Not sure I was supposed to but it didn’t hurt when I did. Went back to doc 2 days ago after 2 weeks at 20 degrees and he set it to where it now flexes from 0-20 degrees. He had me take a couple steps in office. Then told me to walk with the crutches and PWB until I felt balanced and comfortable. That didn’t take long. The next day I didn’t use the crutches at all. I was thrilled with all this bc originally doc had told me I would be NWB for 6 full weeks. He changed his mind bc everything looked good and I had 0 issues as far as swelling, pain, etc. so for those of you expecting the worst (as I was after reading many blogs) it can go smooth. I am 3.5 weeks post op and walk with the boot…not normally of course but both hands are free at least. I regularly flex the boot back and forth between 0-20 degrees to keep it from getting too stiff. Just wanted some of you to see there can be experiences that aren’t painful and terrible the whole time! Or for 3.5 weeks at least, don’t wanna jinx myself.

  18. Thanks debuff it’s nice to know not everyone picks it up within a couple of days I have still only been putting minimal weight on my injured leg (only my second day trying to put weight on it at all) it’s still quite stiff and a bit sore. I am supposed to be going on holidays in less than a week so on one hand I want to be FWB as soon as possible but on the other hand I don’t want to injure myself more than I already am!

  19. Listen to what your body is saying..I had planned to go to a national conference at 6 weeks. When I started packing I got dizzy and nauseous. So I realized that I wasn’t ready, so had to call and cancel at the last moment. So disappointing! But a different opportunity opened that I’m able to do now. I had long term chronic tendonitis , so I had two torn tendons. I have had to accept my body’s schedule for healing. Take care and best wishes for healing.

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