Learning to Walk After a Broken Leg: A 7-Step Guide

Do you have a broken leg (tibia, fibula, knee, ankle or femur fracture)?

As a physical therapist, I’ve designed a 7-step guide to help you regain your mobility and confidence in walking after a leg fracture. And a video demonstration!

Let’s embark recovery together 🙂!

Step 1: Identify leg fracture-specific do’s and don’ts

Identify what you are allowed and not allowed to do based on the type of fracture you have.

Normally, you’ve had an X-ray, an MRI, or a CT scan. This examination has determined the precise location and type of your fracture.

For example, is it a fracture that is:

• Closed and non-displaced:
• Closed but displaced:
• Open and displaced:

Based on this and your overall condition, your doctor or surgeon has likely provided you with specific recommendations regarding the type of walking allowed in the coming weeks.

I’ll now go into detail about the three possible walking types based on the type of fracture.

Situation 1: You haven’t been given any specific instructions about whether you are allowed to walk or not, or you’ve been told that you can walk normally

You can walk as much as you want. What should guide you? Your feelings during and after walking (in the hours and the night following).

Do you have significant pain? If so, try to do a little less the next day. You’ll gradually learn to balance it better.

Situation 2: You’ve been told that you are not allowed to put any weight on the injured leg for X weeks

In this case, you have two options:

• Either you don’t put any weight on the foot at all and walk on your toes. Or you move around in a wheelchair.
• Or you place your foot on the ground but without putting any weight on it. This is called touch-down weight-bearing.
  
  Your physical therapist can show you how it works if you’re not sure – you’ll get the hang of it quickly!

Situation 3: You’ve been informed that you are allowed some weight-bearing on the broken leg

In general, you will be told that you are allowed to apply, for example, 10 kg or 10-20% of your body weight.

It’s best to use scales to see how much that is when standing, and then try to replicate it while walking.

1. Take a scale
2. Place something next to the scale, like a dictionary, so that you can put one foot on the scale and the other on this other support, ensuring both feet are at the same height.
3. Step onto the scale and the support.
4. Shift more or less weight onto the fractured leg by tilting your pelvis to that side.

Demo:

Step 2: Assess current challenges that limit your walking abilities

Even if you are allowed to put weight on your broken leg, you may still encounter difficulties.

Try to identify why (your physical therapist can assist you):

• Is it simply apprehension?
• Is it the pain at the moment? Or precisely where (leg, foot, hip, arm)?
• Is it because of a lack of balance?
• Is it due to stiffness in the foot, knee, or hip?
• Is it that you can walk but get tired too quickly?

Step 3: Target these issues with exercises

Incorporate a specific exercise routine to address these associated issues.

For example, if you have a stiff knee, perform exercises to regain knee flexion (or extension).

If you experience pain, consider what you’re doing to alleviate and prevent it. And what else can you do:

• Apply cold more frequently during or after activity?
• Reduce weight-bearing on the broken leg by relying more on crutches?
• Take pain-relief medication shortly before your walking sessions?

If you find yourself getting tired too quickly, you can:

• Perform muscle maintenance exercises while sitting or lying down.
• Use an exercise bike (allowed if you have support, even partial).
• Practice standing for a little longer each day.

If you’re unable to figure out what to do on your own, seek advice from a physiotherapist or doctor!

Step 4: Choose a suitable walking aid

Choose a walking aid that suits your difficulties.

Here are the most commonly used walking aids by my patients who have just had a leg fracture:

1. Crutches: for additional support and help distribute the weight off the injured leg. They come in various designs, such as underarm or forearm crutches, to suit your needs.
2. Walking Sticks: they are often adjustable, offer balance and stability while walking. They are helpful when minimal support is required.
3. 4-Wheel Walker: it provides more stability and comes with a convenient seat for resting.
4. 2-Wheel Walker: more suitable for indoor use. Allows you to move and then have your hands free once you reach a location, and is more stable than a 4-wheel walker.
5. Walker frame: bulky but can be helpful in the beginning when you’re not stable enough with crutches.

Step 5: Find the walking style that works best for you

With crutches, there are two several ways to walk.

Here are written explanations along with diagrams. Plus, a video demonstration by me 🙂

Video demonstration of walking with and without crutches

Partial Weight-Bearing (Three-Point Gait)

This is the gait that people naturally adopt and it provides the most relief for the fractured leg.

Here’s how it works:

1. Advance both crutches together in front of you on the same line.
2. Place the foot of the fractured leg in the middle, making sure to put significant weight on the crutches to reduce pressure on the foot.
3. Then, move the uninjured leg a bit further forward.
4. Repeat the sequence: Both crutches together, fractured leg in the middle, good leg forward, both crutches together, and so on.

This is also how you walk if you’re not allowed to put any weight on your leg at all. Like in the diagram below:

See also: Walking after 6-weeks non weight bearing

“Military-Style” Walk (Four-Point Gait)

Once you are comfortable with the three-point gait, you can consider this type of walk, which is more natural and closer to regular walking.

In this case, you won’t be advancing both crutches simultaneously. Instead, you’ll advance one crutch along with the opposite leg.

For example:

• Advance the right leg and the left crutch.
• Then, the left leg and the right crutch.
• Repeat this pattern. Initially, it may be somewhat disjointed, but after a couple of days, you’ll get the hang of it, and it will become automatic.

As you progress, you can switch to using less support, such as forearm crutches or walking sticks. You can gradually increase your walking capacity beyond using a single cane.

Walking with one crutch

When walking with only one crutch, it’s better to place it on the side opposite your broken leg.

For example, if your left leg is fractured, use the crutch on your right side.

This prevents limping and allows you to put some weight on the crutch when placing the injured leg.

Step 6: Gradually increase your walking

Gradually increase your daily walking regimen based on how you feel!

• Remember to increment your walking parameters one step at a time. Start by adding more duration, then pace, and frequency.
• Assess how your body reacts the following day and make any necessary adjustments.
• Set reasonable goals, and progress steadily over the weeks, increasing your outdoor walking time little by little.

Step 7: Stay motivated, most recover fully after a broken leg!

Stay motivated and remember that the majority of people recover without long-term consequences after a leg fracture!

What seems impossible today will be completely achievable in just a few weeks. As you navigate through my website, you’ll find numerous statistical data from studies on recovery after various types of leg fractures.

You’ll see that in the vast majority of cases:

1. People return to their sports activities at the same level as before.
2. Most people also resume their professional activities.
3. Driving is often possible a few weeks after a fracture.
4. Swelling and edema can sometimes last for several months (or even years), but they are not always associated with pain or discomfort.
5. Complications and permanent restrictions are the exception rather than the rule.

Right after an accident, these timelines may seem endless. But it’s also incredibly satisfying to see your progress week by week.

Wishing you a very successful recovery, and I look forward to connecting with you in the comments if you’d like to share your experience or have any questions 🙂!

You may also like:

• How to walk after broken tibia and fibula
• How to walk after an ankle fracture
• How to walk after a plateau tibial fracture

 📚 SOURCES

Anderson TB, Duong H. Weight Bearing. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551573/

Images :

Fitting and Using Crutches – Partial Weight Bearing and Weight Bearing as Tolerated. https://www.health.act.gov.au/

Walking aids. Meghan Phutane. Followphysiotherapist at Assistant Professor, College of Physiotherapy, WH, MMC, Miraj (here)