Understand how to choose between walkers and crutches for non-weight-bearing situations.
You might have noticed the abbreviation “NWB” on the doctor’s sheet if you have recently undergone surgery. NWB stands for “non-weight bearing,” and you may be unfamiliar with what it means.
In simple words, the lower portion of the body is considered as the weight-bearing section, specifically the limbs. In situations like surgery and casts for fractures, it is advised not to put any stress or pressure on the affected limb.
Post-intervention recovery is crucial for proper healing of the bones; however, movement is also necessary for faster healing. That is why the question of choosing walkers or crutches for non-weight-bearing situations is often confusing.
While crutches and walkers have their advantages and restrictions, choosing the best option can be difficult for most. This is why I decided to analyze in-depth the scenarios of postoperative mobility during rehabilitation and give a detailed picture to help readers choose the right equipment.
Types of Weight Bearing
First, let us understand the four types of weight-bearing, depending on the extent of damage and how much recovery is required:
Partial weight-bearing allows one to place pressure on the limbs that are 40 to 50% of the total body weight. You can get additional support by using walking sticks, crutches, and walkers.
Toe touch weight-bearing
Toe touch weight bearing allows one to put a slight amount of pressure on the toes of the affected limbs to maintain balance and stabilize the body during movements.
When you can exert absolute pressure on the affected limbs without causing any strain or misalignment of the bones, your physician will indicate full weight-bearing.
In situations where absolutely no pressure should be allowed on the limb, the physician will prescribe non-weight-bearing. You need to keep your feet constantly folded upward to prevent them from touching the floor or any surface.
Understanding Non-Weight Bearing and Its Role in the Recovery
As mentioned before, Postoperative care and rehabilitation therapy are very crucial after any surgical reconstruction. That is why restriction of movements and the absolute absence of stress or pressure is essential.
As the bones heal and repair themselves, any misalignment caused due to weight or pressure on the affected limb can cause long-term irreversible damage. This damage is not just limited to the bones. Muscles and nerves also are affected.
Who needs non-weight-bearing assistance?
Non-weight bearing assistance is required for those specific users advised to strictly not put any pressure or stress on the operated limb. These additional devices keep the weight off the operated limb and act as the significant load bearer during movement.
In the majority of the cases, your mobility is not wholly restricted; the specialists and physical therapists prescribe additional assistance. Depending on the severity of the situation, physical rehabilitation can include crutches or canes, or walkers.
Common queries about Non-weight bearing situations
Many questions arise in one’s head when your physician prescribes non-weight-bearing assistance.
One of the main concerns about crutches and walkers as alternate assistance for movement is about their stability. Contrary to the popular myths about crutches and walkers, these appliances have a very ergonomic and safe design concept. They provide as much stability as viable without hindering the wellbeing of the affected limb.
The second primary concern is about the amount of weight the appliances can bear to handle. The framework of the crutches and walkers is composed of hardened metal alloys that can easily hold 150 to 200 lbs without breaking apart. There are crutches and walkers designed to bear loads above-average capacity of 200 lbs too.
Rehabilitation With Crutches for Non-Weight Bearing
Crutches are one of the most recommended walking aids. They are used as a single aid or as double aid. The primary function of the crutch is to act as the limbic support system in place of the operated leg. A Crutch bears the entire weight of the legs with the help of support from the upper arm of the affected side.
Types of Crutches for Non-weight bearing
Users who have lost mobility completely in the limb or have issues maintaining a proper balance can use crutches. There are mainly three types of Crutches available that are designed based on their usability. They are
- Forearm Crutch – Consisting of a single long limb, this crutch has a handlebar to hold and a forearm cuff for providing better stability.
- Underarm Crutch – Most commonly used, the Underarm Crutch has two frames that fuse towards the bottom to form a single limbic end. This crutch has an armpit rest and a handlebar to hold.
- Gutter Crutch – This crutch is only suitable for patients with partial load-bearing capacity.
Customization of the crutch for non-weight bearing
It is important to note that not every individual can use the same crutch. The height, gait, and weight are all necessary determining factors to consider while getting a crutch. You should get proper measurements and adjust the crutches accordingly.
- You need to stand erect with your shoes on. In the case of non-weight-bearing, the usable feet are placed flat and firm on the ground.
- Place the crutch under your armpit, and loosely place the hands on the sides.
- There should be a 2-inch gap between the armpit and the crutch rest at the top.
- The handlebar should be precisely at the level of the wrists.
- When you hold the handlebar, you should slightly bend the elbows at an angle of roughly 30 degrees.
Here is an instructive video of how to use a crutch for non-weight-bearing situations:
Rehabilitation With Walker for Non-Weight Bearing
Walkers traditionally are more stable than crutches. In addition to non-weight-bearing situations, walkers are often a vital necessity for Geriatric individuals with restrictive movement abilities. The causes of restrictive movements are not just limited to surgery or fracture casts. Degenerative bone conditions weakened limbs and muscles, and fluctuating gait are also situations where your doctor may advise you to use a walker.
So, what is a walker?
It is a simple device designed with four limbic ends to assist in movement. The majority of the weight is supported by the walker’s legs and the user’s upper body.
Types of Walkers for Non-weight bearing
There are many types of Walkers available in the market. Depending on the situation, age, and movement restrictions, walkers assigned to individuals may vary. Some of the most common types of walkers include
Walkers with wheels are known as Rollators. The wheels allow better and unrestricted movements, minus the strain of manual pushing. Depending on the frame design, rollators can consist of 3 wheels or four wheels. The brakes attached to the handlebar allow the user to control their movements and prevent skidding or slipping.
Designed specifically for users who are larger and bulkier than usual, these are robust. Created with reinforced metal, they can easily bear a weight load of 300 to 650 lbs. These walkers also have a larger than standard seat base for additional comfort of the user.
They are designed specifically for taller individuals who have restrictions of movement and posture. The even weight distribution between the upper arms and the walker frame allows more comfortable movements. These walkers are perfectly suitable for users with weak knees and wrists.
A fusion of a walking stick and a walker, Hemi-walker also has four supporting limbs. However, they need single-arm support. Hemi walkers are challenging to use unless someone provides additional assistance.
The traditional wheel-less walking frame is one of the most commonly used walkers. Very safe and sturdy, the Walking frame does not have a wheel or seat. Primarily advised for postoperative rehabilitation, walking frames require one to manually lift and move the walker from point A to B.
Compact and lightweight, these walkers are foldable and easy to carry around. Suitable for travelers with restrictive mobility, these walkers are made of aluminum alloy and are often easy to transport via cars and airlines.
Customization of the Walker for non-weight bearing
Similar to crutches, walkers also need to be adjusted to a specific height for comfortable usability.
- For the correct measurement, the user needs to stand erect with the shoes on.
- The upper limbs should be at a relaxed position hanging downwards
- You should take the exact measurement from the level of the wrist to the floor.
- The position of the wrist is where you will place the handlebar of the walker.
This video explains how to use a walker for non-weight bearing situations:
Choosing Between Walker and Crutch for Non-Weight Bearing
Crutches and walkers both have their advantages as well as disadvantages.
- Crutches exert constant pressure on the upper limbs, causing muscle soreness and bone ache.
- Walkers can be challenging to maneuver, especially in situations like a total non-weight bearing.
The extent of the time frame needed for recovery also is one of the keynote factors to consider while choosing between a walker and crutch.
The purpose of this article was to give a better explanation about crutches and walkers. Whether to choose between a walker or crutch for Non-weight bearing can be confusing if one has minimal knowledge about either of these walking aids. Crutches and walkers are both excellent aides for rehabilitation and recovery.
Hopefully, you would be less confused about your choices after reading this deep-dive into both these aides and their usability factors. Though the physical therapist primarily decides the best aid to be prescribed to a user, knowing about both can help one understand their working mechanism.