Non weight-bearing exercise is often prescribed after a serious fracture or severe muscle or tendon injury. Surgery can also precede a period of recommended non weight-bearing activity. Because your bones or soft tissue are in a precarious state, you are at increased risk for injury and permanent damage from weight-bearing. The exercises that you complete while weight-bearing and non weight-bearing are somewhat different and it is critical that you follow your physician's and therapist's recommendations to facilitate decreased recovery time and improved long term outcomes.
Full Non-Weight Bearing Restrictions
In most cases, if you have non weight-bearing restrictions you will not even be allowed to move your affected arm or leg. Many physicians recommend a brace or cast to prevent you from inadvertently moving your affected extremity. During this phase of your recovery, your exercises will focus on strengthening your other non-restricted limbs. Your therapist will instruct you on weighted exercises for your unaffected limbs because you will require increased strength when you are allowed to bear weight so that you can ambulate and ease your affected extremity back into functional activities.
Range of Motion
Once your physician allows your therapist to move your affected extremity, you will begin progressive range of motion. Your therapist will assist you to move your limb through all aspects of its range of motion at first. Once you are able to reach approximately normal range with full assistance, your therapist will transition you to assisted range of motion and finally progress you to full active range of motion. Modalities may be used at this point to reduce pain and scar tissue and facilitate increased range of motion.
Initial Weight Bearing
When you finally receive the clearance to use full your limb with full weight bearing, which often takes at least six weeks, your therapist will begin to strengthen your affected limb. By applying a weighted cuff to your leg or using dumbbells in your hands, your therapist will instruct you to move your arm throughout your entire range of motion to strengthen your weakened limb and prepare it for functional tasks.
Transition to Function
Your weight-bearing phase may involve several different levels. Toe touch weight bearing allows you to only place your toes on the floor for light balance, without placing any significant weight on your foot. Partial weight bearing allows 30- to 50-percent weight on the foot and full weight bearing allows 100-percent weight on the foot. Regardless of your current weight-bearing status, your therapist will begin to aggressively target your ability to use your affected limb in functional exercise activities such as bathing, dressing, ambulation and stair negotiation. You will increase the amount of time and decrease the level of assistance required as you practice these tasks and as your limb continues to heal and strengthen.
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