NWB to PWB To FWB Progression and Boot questions

Just want to throw a couple questions out to the group, especially those who are at FWB and beyond. My doc doesn’t offer a lot of details when she gives me instructions so I rely on the experts from here to get my info!!

Question 1:

I’ve been given the OK to begin PWB on Monday (3 and half weeks after surgery). I was told the standard, start with 2 crutches, move to 1 and then FWB as tolerated which I get, but then she mentioned “most people get to FWB in just a few days”  after I left the office I started questioning the speed of that progression because I have seen a lot of the posts and protocols that make it sound like that pregression is done over a week or two, not a couple of days. Does that seem right assuming I can tolerate it? canI really set aside my crutches after 3 days?

Question 2:

As far as the walking boot goes I know it has the rocker bottom and that you land heel first but just how much do you roll off the toes? When I was in the boot prior to surgery I remember a couple of times where I must have rolled off the toe to far and it hurt a little bit, and that was with no Achilles!! so I’m just wondering how close to the toe you go or do I just use the heel and go peg leg style?

Thanks for any advice

7 comments ↓

#1 crutchesintx on 11.16.12 at 2:13 pm

I had an Aircast for my boot. When I went from NWB to PWB to FWB, the doc told me to do it in a total of two weeks. But I did it in about 10 days, I was just done with crutches and needed to do it for a trip I was taking.

With my Aircast, the boot wouldn’t even let me get to my toes. When it rocked forward, it would pretty much stop me around the time where my toes would normally come into place in my normal walk.

#2 ryan on 11.16.12 at 3:01 pm

I went from basically NWB to FWB in about 4 days. That was right around 5 weeks though. Considering you are only 3 and 1/2 weeks out you may want to take it a little slower. With that being said, I think it’s most important to just listen to your body and stop when you start experiencing pain. In the boot you really can’t do much damage taking baby steps but feeling pain is a good indicator to take it easy!

#3 normofthenorth on 11.17.12 at 11:41 am

You should roll all the way forward, pushing your knee forward. Avoid peg-leg and knee hyperextension, both “easy” mistakes.

Early WB is generally good, but the best well-demonstrated results came from the schedule in bit.ly/UWOProtocol . That’s PWB from 2 weeks in to 4, then “FWB as tolerated” from 4, usually a few days to FWB (AKA “Where did I leave that cane?”).

#4 ryanb on 11.17.12 at 1:47 pm

Norm is right- roll all the way forward onto the toes. The trick is to trust the structure of the boot, driving your shin forward with a relaxed ankle and calf (don’t load the Achilles). It takes a little practice, but once you figure it out, you can walk quite normally, and fast.

The other big thing to remember is to drive your knee forward- don’t let it go back and hyper-extend. A while back, I posted a video on my blog where I attempted to demonstrate.

#5 kkirk on 11.17.12 at 2:27 pm

Thanks for the info this will be very helpful.

#6 soccergotme on 11.17.12 at 3:48 pm

Thanks for the info, I’ll look up the video
I think my plan is going to be to stay NWB until Thursday thanksgiving day. That will give me the full 4 weeks and then I’ll have a 5 day weekend to start the process around the house. Since I have no plans to go anywhere over the weekend I’ll be able to ease into and even if I wanted to (which I dont) I wouldn’t really be able to over do it.

#7 cheap nfl jerseys on 10.24.13 at 5:47 am

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