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Q&A with Australian Health Practitioners
How much weight should i place through my injury when using crutches?
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Miss Loretta O'Sullivan-Pippia
Physiotherapist
I am a specialist sports physiotherapist with a sub-speciality in adolescents in sport (as awarded bu the Australian College of Physiotherapists in 2007). In addition … View Profile
How much weight you put through your injuried leg when using crutches really depends on your injury/surgery and also your stage of recovery - your physiotherapist and/or orthopaedic surgeon will be best placed to give you individual advice.
Generally in healthcare we talk about non-weight bearing (NWB), touch weight bearing (TWB), partial weight bearing (PWB), full weight bearing (FWB) as tolerated and full weight bearing. Sometimes we will give a percentage of your body weight as part of the PWB prescription.
NWB means no weight at all through your injuried leg.
TWB means just touching the ground, only a slight amount of weight through the injured leg.
PWB means you can put some, but not all weight through your injured leg - this is usually given as a percentage - 10%, 25%, 50%, 75% and so forth. 50% is the amount you would have through each leg if you were standing evenly on both legs, you can use this to work out what percentage wt you can put through. Another way to calculate how much wt you are putting through you leg is to weigh your self on bathroom scales so you know your full wt and then put some magazines/phone book beside the bathroom scales so that they are level and then stand with your uninjured foot on the magazines/phonebook and the injured foot on the scales and gently transfer weight to your injured leg until the scales show the correct percentage of wt.
FWB as tolerated means that you have the ok to go from PWB to FWB and that pain your pain decreases and your gait techinque improves you can be FWB and go with out crutches.
FWB means all your weight - and therefore no crutches.
As you progress from NWB to FWB you can also go from 2 crutches to 1 crutch and then no crutches.
How much weight you can put through your crutches is not the only thing to consider, but also how you use your crutches and in particular how your move or don't move your injured part. Whenever possible, we encourage patients to go through the actions of a normal walking style, even if they are NWB or TWB. We call this a shadow gait - essentially you mime the walking action either without touching the ground (NWB) or just lightly allowing your heel and then forefoot touch the ground (TWB). Be doing this, is becomes very easy to transition from NWB, through TWB, PWB and finally FWB as you are using the same pattern all the time, it is just how much weight you put through that changes. Also, by doing the shadow gait you reduce the risk of muscles shortening and becoming contracted from holding your hip and knee bent all the time (I have seen people after 6 wks on crutches who can't straighten their knee the muscles have become so tight!). You also don't have to relearn how to walk again when you come off crutches because you have already been doing it.
It is really important that if you are using crutches that you see first see your physiotherapist or doctor to ensure you have the correct diagnosis and that you do need crutches - lots of people just go to the pharmacy themselves and buy crutches without any assessment from a health professional, when they do not actually need crutches - this can lead to all sorts of other issues. If you do need crutches, than you should see a physiotherapist as soon as possible so you can be shown how to use crutches properly - lots of people who have been given crutches by their doctor have not been taught how to use them and use them incorrectly. It seems like a pretty simple thing, but so many people get it wrong, a lot of the time, and it does cause complications and often means additional physiotherapy sessions later to correct these complication. An appointment with your physiotherapist as soon as your get your crutches will get you on the right track from the outset, prevent the complications and reduce the number of treatments you will need later.
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