D&D Disability – the mechanics of lost limbs

This is part of the series on representing disability in D&D.

It’s time to put some crunch behind Domenech’s Ability Restorers. What are the mechanics? What are the effects of lost limbs, and how do the Ability Restorers mitigate them?

Let’s start with a review of the official sources.

Previous editions

The BECMI boxed sets, unsurprisingly, have nothing. They don’t even really have diseases.

What about AD&D? Gary Gygax had tables for everything. Surely he had tables for disabilities?


The closest thing he has are a page of diseases.

These are classified into mild, severe and terminal, where mild prevents strenuous activity, severe lowers hit points by 50% and has the character disabled for 1-2 weeks, followed by 1-2 weeks of mild illness during recovery, and terminal disease causes death or loss of the afflicted body part. Chronic diseases recur.

Many of the symptoms here do resemble the mechanics of some of the conditions on D&D Disability, with the potential to lose Strength, Constitution, Dexterity and/or Charisma depending on the affliction, possibly on a ongoing basis, and with varying chances of this being permanent (again depending on the affliction). But there are no mechanics for loss of body parts, or even really for loss of an eye or an ear other than to say terminal illnesses result in hearing loss in one ear or blindness in one eye – it doesn’t say what mechanical effect this has.

Fourth edition? Again, the closest thing this edition has are the diseases, although these are much more simplistic than Gary’s AD&D and don’t really replicate disabilities.

Fifth edition

The fifth edition DMG finally does have something resembling physical disabilities with the Lingering Injuries in Chapter 9: Dungeon Master’s Workshop (DMG p272). It lists:

Artwork from Fat Goblin Games
  • Loss of eye – disadvantage on Perception checks relying on sight and on ranged attack rolls, plus blinded if both eyes are lost. Needs regenerate to restore.
  • Loss of arm or hand – cannot hold anything two-handed and can only hold one thing at a time. Needs regenerate to restore.
  • Loss of foot or leg – half speed on foot, and must use a cane or crutch or wear a prosthesis. Fall prone after dashing and have disadvantage on Dexterity checks made to balance. Needs regenerate to restore.
  • Limp – speed on foot reduced by 5’ and must make a DC10 Dexterity save after dashing or fall prone. Magical healing restores.
  • Internal injury/broken ribs – make a Con save when attempting an action in combat or lose action and reactions until your next turn. Heals with 10 days doing nothing but resting, or with magical healing.
  • Horrible scar – disadvantage on Persuasion, but advantage on Intimidation. Needs high-level healing (level 6+) to remove.
  • Minor scar – no mechanical impact. Needs high-level healing (level 6+) to remove.
  • Festering wound – hp maximum drops by 1 point per 24 hours until healed. 10 successful Medicine checks (at one per day) can heal, as well as magical healing.

They also have some example diseases (DMG p257).

  • Sewer Plague basically causes exhaustion and impairs natural healing
  • Sight Rot induces vision penalties – -1 to attack rolls and ability checks which rely on sight, worsening by 1 every day until either cured (using multiple applications of eyebright ointment) or reaching -5 at which point the victim is blinded and can only be restored with lesser restoration or higher healing magic.

Some of the entries in the madness tables (DMG pp259-260) also resemble some of the disabilities in D&D Disability and Limitless Heroics, such as:

  • Compelled to repeat a specific activity repeatedly
  • Extreme paranoia; disadvantage on Wisdom and Charisma checks
  • Uncontrollable tremors or tics; disadvantage on attack rolls, ability checks and saving throws which involve Strength or Dexterity
  • When the character takes damage, they must succeed on a DC15 Wisdom saving throw or become confused for a minute

There’s more here than I expected, particularly once the diseases are brought in (which I wouldn’t have thought of if I hadn’t done the research into the earlier editions). However, I think there is scope for more. Thinking of Meurtle and the Domenechs, I’m going to look at lost limbs in more detail.

Based on artwork from Fat Goblin Games

Lost feet and legs

Disclaimer – my knowledge of this is from watching the Paralympics and The Last Leg (with Adam Hills and Alex Brooker who were both born with deformed feet; Alex also has deformed hands), watching Stef Reid on Dancing on Ice, and reading Cormoran Strike. So this is very much not from personal experience. If you have personal experience, please help me get this right!

The official rules for lost feet and legs say:

  • Loss of foot or leg – half speed on foot, and must use a cane or crutch or wear a prosthesis. Fall prone after dashing and have disadvantage on Dexterity checks made to balance. Needs regenerate to restore.

That doesn’t seem to quite cover it to me.

It feels like there is a significant difference depending on how much of the leg is missing.

Missing foot

I disagree with the official rules here. This feels like a bit more than a limp, but not as much as the loss of part or all of a leg.

I imagine it would be possible to walk if all you were missing was your foot or part of a foot – certainly Adam and Alex seem perfectly capable of hobbling about when they remove their prosthetics. You would have enough of a leg that you could use your stump for support without becoming too badly uneven.

The foot is used to balance, so you would be less stable, and you would probably be slower. The rules for “with a prosthesis” feel like they would be appropriate here:

  • Half speed on foot
  • Disadvantage on Dexterity checks made to balance

Fall prone after dashing seems a bit harsh. I would suggest a Dexterity (Acrobatics) check to avoid falling prone. I did consider a simple Dexterity saving throw isntead, but it feels like proficiency in Acrobatics would help: “Your Dexterity (Acrobatics) check covers your attempt to stay on your feet in a tricky situation.”

In this case, I imagine either a cane or a prosthetic limb which gave you a foot would help, particularly with the balance. Maybe the Dexterity checks made to balance have a -2 penalty on the roll in this case, or are completely normal if you have both (though of course a cane takes up a hand). I’d also suggest a prosthetic foot allows you to move faster than half speed – maybe your base speed is reduced by 5’ as per the rules for a limp?

Missing both feet

Missing both feet feels significantly different from just missing one foot. The foot is used for stability, so without any feet you would be much less stable. In this case, maybe it is reasonable to fall prone after dashing.

It also feels like there should be some sort of penalty to combat and other situations where quick movement is required. My instinct is to require a Dexterity (Acrobatics) check on every round where the character either makes an attack or is attacked, but that also feels like a lot of bookkeeping and a significant penalty. And maybe someone who has lived without legs would learn how to manage their stability better than that. So here are some alternatives. Make a Dexterity (Acrobatics) check, falling prone on a failed check…

  • …whenever you make an attack
  • …whenever you miss an attack
  • …whenever you miss an attack by more than 5
  • …whenever you miss an attack by more than 10
  • …whenever you roll a 1 on an attack
  • …on the first time either you attack or you are attacked on a turn
  • …on the first time either you attack or an attack hits you on a turn
  • …whenever an attack hits you
  • …whenever an attack hits you, succeeding by more than 5
  • …whenever an attack hits you, succeeding by more than 10
  • …whenever you are hit with a critical success

Thoughts? Where is the right point of balance here between verisimilitude and a usable character?

In this case I imagine a single prosthetic foot makes it similar to a single missing foot, and two prosthetic feet puts you on a similar basis to the single missing foot plus prosthetic above.

Missing lower leg

Once you’ve lost a significant portion of your leg, moving around on both legs becomes harder because you are unbalanced (literally) – your legs are different lengths so don’t both naturally meet the ground together (unless you have a similar amount missing from both legs). This means that movement without some sort of aid is restricted to either hopping or crawling.

Crawling is half speed (see PHB p182), and the character is prone.

Hopping is slow and hard work. I’d suggest reducing to a base movement speed of 10’, and they start to risk exhaustion after quite a short time. Maybe they can hop for up to 5 minutes before they risk exhaustion. For every minute past this limit they need to make a Constitution Saving Throw with DC 10 + the number of minutes past the limit or gain a level of exhaustion. After hopping, they need to rest for at least half the time they hopped to recover.

I’d suggest Dexterity checks made to balance have a penalty of -10 on the roll. We have already established that wearing a prosthetic leaves you with disadvantage on such checks, which in practice works out to roughly a -5 penalty, but making the check automatically fail feels a bit too harsh.

Photo by ShotPot from Pexels

Also the same combat checks from the no feet case should apply, but this time with disadvantage on the roll.

Adding a prosthetic? We already have rules here for “with a prosthesis”:

  • Half speed on foot
  • Disadvantage on Dexterity checks made to balance

I do feel that automatically falling prone after dashing is a bit harsh if you have a reasonably fitted prosthesis. Maybe it depends on the prosthesis – a peg leg would give much less benefit than a moulded leg with foot.

But this post has already taken long enough to write – I’ll leave the subject of different prostheses to another post.

What do you think?

As I said, my knowledge of living with missing limbs is from watching the Paralympics and The Last Leg, watching Stef Reid on Dancing on Ice, and reading the Cormoran Strike books.

So this is very much not from personal experience, and a lot of it is conjecture combined with speculation about the physics and mechanics of the different situations.

I’d really welcome your thoughts on these rules, particularly if you have personal experience. Let me know if you try them out, and how they work for you. You can either comment on the post or email me at melestrua@melestrua.net .

In the next post we’ll come back to Meurtle and his visit to Domenech’s emporium, and start to look at different legs and feet which might give different benefits, plus start to consider the disadvantages of living with a prosthesis.

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