Non Weight Bearing Implementation
How exactly did people with successful recoveries implement NWB?
I am halfway through a 6 week NWB phase. I have been able to avoid putting my foot down to bear my body weight (no falls, accidents, etc). However, I just saw some clinical articles that define NWB as absolutely NEVER putting the foot on the floor. When sitting, I gently rest my heel on the floor with my toes pointed up - especially at work. Your experience?
I’m not quite to a successful recovery yet, however, during the first two weeks I kept completely off the affected foot (no toe touch). I propped my foot up on my desk at work and pretty much elevated it whenever I was moving around. During week three I started to toe touch and gradually added a little more than toe touch weight. I was put in a boot at the end of week three and told that I could walk whenever I felt comfortable.
Hang in there. I don’t think I could have made it through six weeks on NWB. Did you need extensive grafting on your repair or was your tendon tissue in poor condition? I wonder why your surgeon considered your rupture so severe that earlier weight bearing was out the question. A lot of the non-op people are early weight bearing and they don’t have the added help of any suture material hold the tendon ends together. I would be very tempted to be a non-compliant patient for the week and a half.
Yes, 6 wks NWB sounds like torture to me, and I haven’t seen any evidence that it helps. I think having your cast bear the weight of your lower leg is usually considered compliant with NWB — though most post-op patients feel more comfortable with their leg elevated. But it’s still resting on something — i.e., NWB doesn’t mean you have to hold it up in the air all night…
I went through 6 weeks NWB in a hard cast, too.
I was also told to NEVER put weight on the foot, other than resting the foot on the heel with toes up. For the first four weeks, I had the foot elevated above my heart 23 hours a day or so because of the swelling, then gradually went back to lowering the leg, while still resting on the heel. I didn’t put pressure on the toes until the cast came off, except to gently test it out a couple times around week 5. It was tough.
I definitely fell a couple times (three to be exact), and landed hard on the heel of my bad leg twice, but luckily didn’t get re-hurt.
Having a knee scooter was an absolute godsend. That new walking crutch thing looks pretty cool too, but I don’t remember it being available last year.
Good luck; half way through is most of the way done!
I was 6 weeks NWB in a cast as well. I kept my leg elevated as much as possible because of the swelling. When I did have to sit at a desk or stand at a counter, I would rest the heel on the floor, but didn’t really put any weight on it. I think “never putting the foot on the floor” is unrealistic - if you are in a cast, your achilles is pretty well protected, and just resting it on the floor with no real weight on it worked fine for me. I’m now in week 10 and hopefully about to get the walking boot off. It does get better. Hang in there.
Thank you all for the feedback. I am not going to fret about the “foot on the floor” and focus on avoiding the big pitfall for the rest of the way - falling and slamming my foot on the floor! That seems to be the biggest risk.
@Derek: I am embarrassed to say that I don’t know exactly why the surgeon put me on 6 weeks of NWB beyond his statement that the severity of my rupture requires it. I asked for my medical records and I really can’t tell from it either (there was no grafting required). But, I now have 4 of 6 weeks of NWB behind me. So, I am just going to stick with it the rest of the way!
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