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I enjoy the privilege of working with people recovering from a wide variety of medical conditions. Many of these conditions can directly affect activities of daily living, particularly, the ability to drive safely: orthopedic and sports injuries, fractures, sprains and strains, joint replacements, hip fractures, shoulder and elbow surgeries and spinal fusions. Despite the many different types of problems, there is one question that is invariably asked, “When can I return to driving?” Unfortunately, the answer is not as simple as the question because it depends on many factors. Furthermore, the implications, such as a serious accident causing further damage to the injury or surgical site or harm to someone else, are significant and possibly critical. So, the next time you ask your physician this question, please follow instructions and be patient…remember, it could be your child or grandchild running into traffic to chase a ball and you would want the driver to be at optimal function to apply the brakes!

Impact of Not Driving

In our culture, the inability to drive has a significant impact on lifestyle and livelihood. A study published in the Journal of Bone and Joint Surgery, found that 74% of those unable to drive due to injury or surgery are dependent on family and most of the remainder depend on friends. 4% of those unable to drive have no help at all and more than 25% suffer major financial hardship.

The report also found that family physicians, orthopedic surgeons, podiatrists, and physical therapists are keenly aware of this dilemma but often fail to communicate effectively to patients about driving. Most medical professionals express serious concerns about liability regarding return to driving following an injury or surgery. They feel that there is a lack of data to support decisions and inadequate communication among each other. They agree that they must do a better job communicating with patients and their families so they can better prepare for a period of time during their recovery in which they cannot drive.

Recent studies published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and the Journal of Foot and Ankle Surgery (JFAS),determined that there are two significant components in the decision of safely returning to driving after an injury or surgery; the time required for healing and the time required for a return of function. Additionally, it was found that those wearing a surgical shoe or walking boot demonstrated a significantly slower braking response time even in healthy/non-injured individuals wearing the shoe/boot.

Time for Adequate Healing

During the time required for healing, in addition to the fear of an additional trauma from a motor vehicle accident to the healing body part, there is a general concern about the potential damage that may come from over using the body part to drive before it is adequately healed. For example, a healing fracture in the right lower leg might be compromised or delayed if one must suddenly and forcefully apply the brakes. Also, during this time, it is not unusual for post-injury or post-surgery patients to use pain medications, including narcotics. This will also compromise judgment and reaction time while driving.  

Time for Adequate Function

Most orthopedic conditions heal in 6 to 8 weeks. However, as many of you may fully know, once a cast or splint is removed, you are not ready to run or jump. Depending on the severity of the injury, it may take many weeks of aggressive physical therapy to regain strength, range-of-motion, agility and dexterity to function at a safe level for a full return to daily activities, including driving.

Driving Requires the Whole Body

The current research reinforces the fact that driving safely requires good function of the entire body. For example, just because you broke your shoulder bone but did not fracture your right leg does not mean that you are able to drive safely. Wearing a sling after arm surgery also compromises driving. First, you need a stabilized and healed injury prior to driving. Then, you must work in rehab to make modifications to return to safe driving. Apply the same scenario to injuries or surgery to the spine (neck and lower back).


Type of Surgery:

  1. Knee Arthroscopy
  2. Right Total Hip Replacement
  3. Right Total Knee Replacement
  4. Lower Leg Fracture
  5. Ankle Fracture
  6. Right Lower Leg Cast/Brace
  7. Ankle/Foot Tendonitis/Fasciitis (non-surgical)

Time Until Normal Braking*:

  1. 4 Weeks
  2. 4-6 Weeks
  3. 4-6 Weeks
  4. 6 Weeks after initial weight bearing
  5. 9 Weeks
  6. Full weight bearing after removal of cast/brace
  7. Surgical shoe/boot can be removed for 50-75% weight bearing

*Based on research using driving simulators


  1. You have physician’s approval that you are healed enough not to do any damage to the injury.
  2. You can use your arms to touch your forehead and opposite shoulder without significant pain.
  3. You can walk with minimal pain and minimal limp.
  4. You can put 50% of your total weight on the involved leg (especially the right).
  5. You have adequate range of motion at the hip and knee (bend the hip 70-90 degrees, extend your knee to -10/-5 degrees and bend your knee to 80-90 degrees without pain).
  6. You can drive in empty parking lot and practice without difficulty.
  7. You are wearing a surgical shoe or boot that does not involve surgery or fracture healing (tendonitis or plantar fasciitis) and with your physician or podiatrists approval, the device can be removed without causing pain upon seated weight-bearing and gas/brake simulation.

Remember, every case is unique and there is no substitute for communication with your orthopedic surgeon, podiatrist, family physician and physical therapist.

Visit your doctor regularly and listen to your body.     

Keep moving, eat healthy foods, exercise regularly, and live long and well!

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!