You can neither feel nor move a foot (IE 1), a leg (IE 2), both feet (IE 3), or both legs (IE 4). In the case of 1 foot or leg, your speed on foot is halved, and you must use a cane or crutch to move without a mobility aid. You must succeed on a DC 10 + (IE) Dexterity saving throw to avoid falling prone after using the Dash action. You have a −(IE) penalty on Dexterity checks made to balance. In the case of two paralyzed feet or legs, you can use your hands to move one fourth your speed for a number of minutes equal to your Constitution score before needing to rest. You need to move frequently and protect your legs to avoid sores and injuries.

Real-world Examples

Cerebral Palsy, Hereditary Spastic Paraplegia, Friedreich’s Ataxia, Muscular Dystrophy, Amyotrophic Lateral Sclerosis, Parkinson’s Disease

Assistive Options

Leg braces and crutches can reduce the movement penalty by 1 IE, but they take 1 minute to put on and cannot be worn while sleeping. Wheelchairs and other mobility aids provide additional options.

You experience chronic pain in your legs and/or feet. Any action that requires concentration (e.g., maintaining a spell) requires a successful DC 10 + (IE) Constitution saving throw per round to maintain concentration. Your daily walking distance is reduced by (IE) × 20 percent. In addition to the usual Frequency, any round when you exert your legs (e.g., running, combat, jumping), you must succeed on a DC (IE) × 2 + 8 Constitution saving throw or experience one level of exhaustion, cumulative each round of exertion, requiring 5d20 × (IE) per level of exhaustion to recover afterward. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.

Real-world Examples

Subungual Exostosis, Arthritis, Tendinitis, Bursitis, Osgood-Schlatter Disease, Paget’s Disease of Bone, Patellofemoral Pain Syndrome, Neuropathy, Sciatica, Varicose Veins, Muscle Spasticity, Complex Regional Pain Syndrome

Assistive Options

Applying ice for 10 minutes or a compression bandage can reduce the pain by 1 IE for 10d6 minutes. Wheelchairs or other mobility devices can help with mobility to reduce your need to walk everywhere.

Magical Assistance

A healing spell can target the legs and reduce the IE by 2 for 1 hour instead of regaining hp.

You walk with a noticeable limp due to inability to control your leg muscles with precision. Your movement speed is reduced by 20 percent × (IE), and you have a −(IE) penalty on all Dexterity (Acrobatics) checks and Strength (Athletics) checks involving legs.

Real-world Examples

Multiple Sclerosis, Ménière’s Disease, Parkinson’s Disease, Chiari malformation (CM), Guillain-Barré Syndrome, Cerebral Palsy, Muscular Dystrophy

Assistive Options

Leg braces, crutches, walkers, rollators, and canes can reduce the movement penalty by 1 IE, but braces take 1 minute to put on and cannot be worn while sleeping, and the others, unless designed for use as weapons, require one hand to be used for balance. Wheelchairs eliminate the movement penalty and add fifty percent to your dash movement unless on rough terrain, but many actions such as jumping are impossible while sitting in a typical wheelchair.

You are missing a foot (IE 1), a leg (IE 2), both feet (IE 3), or both legs (IE 4). In the case of 1 foot or leg, your speed on foot is halved, and you must use a cane or crutch to move at full speed without a mobility aid. You must succeed on a DC 10 + (IE) Dexterity saving throw to avoid falling prone after using the Dash action. You have disadvantage on Dexterity checks made to balance. In the case of two feet or legs missing, you can use your hands to move one fourth your speed for a number of minutes equal to your Constitution score before needing to rest.

Real-world Examples

Amputation, Dysmelia

Assistive Options

A prosthetic leg or foot can eliminate the disadvantage on one missing limb except Dexterity (Acrobatics) checks, but multiple prostheses may be necessary for different uses, such as distance walking vs. running. It must also be adjusted or replaced annually or when you experience any major physical changes, or it gets damaged.

Your feet are more sensitive than most people’s, giving advantage on Wisdom (Perception) checks involving touch with your feet, but any given set of footwear may be unbearably uncomfortable. What feels uncomfortable can change from day to day. (Roll 1d20 each morning. A 1 results in the footwear worn the day before being unbearable until another 1 is rolled on 1d20 another day.) The GM may require Constitution checks for other foot sensitivity-related situations.

Real-world Examples

Sensory Processing Disorder (does not improve senses in real life)

Assistive Options

The solution to this requires keeping a few tolerable pairs of footwear to switch if needed and hope they continue to be tolerable.

Your feet don’t fit within the range of shapes typical for your ancestry. Choose or roll on the following table. These are usually permanent conditions without an IE.

• Arch Irregularity. The arch in your foot is either too high or too flat (player’s choice). This causes foot and back pain when walking long distances, reducing your travel distance when walking by 20 percent.
• Claw Heel. Your toes fan out more than usual, and your big toe replaces your heel. This gives you advantage on Dexterity (Acrobatics) checks to balance on unstable surfaces, but you can’t wear most footwear, and you can’t walk long distances, reducing your walking travel distance by 20 percent.
• Clubfoot. Your foot is twisted vertically or even upside-down. This causes a limp and reduces your movement speed by 5 feet.
• Hooves. Your feet are hooves, giving you a −1 penalty on Dexterity checks related to balance since the rest of your frame is not designed for hooves, but your hooves cause 2 (1d4) plus your Strength modifier bludgeoning damage.
• Prehensile Feet. Your feet look like hands (without opposable thumbs, so unable to use melee weapons) and give you advantage on Dexterity (Acrobatics) checks, but you can’t wear most footwear, and you can’t walk long distances, reducing your walking travel distance by 20 percent.
• Toe Walking. While not deformed, you’ve walked on your toes since infancy, and your leg muscles have adapted themselves accordingly. You have difficulty retaining your balance while standing still. You have a −1 penalty on Dexterity checks related to balance, and your walking travel distance is reduced by 10 percent.

Real-world Examples

Clubfoot, Pes Cavus, Pes Planus, Autism

Assistive Options

Custom boots, costing an additional 50−100 percent, can assist with some of these. The cobbler must succeed on a DC 8 Proficiency check. Failure ruins the pair, and the cobbler must start over, requiring you to pay for time and materials regardless for each attempt. The boots will look noticeably different (DC 8 Wisdom (Perception) check).

The shape of your toes is outside the range of those typically expected for your ancestry. Choose or roll on the following table. This trait is typically permanent.

The traits in this book were designed primarily based on humans, so some traits may not make sense for characters of other ancestries. Talons on an avian would be expected, but hooves would not, whereas hooves on a minotaur or tiefling are typical. Polydactyly on a satyr might mean having feet like a human. By exploring fantasy combinations, we gain insight into real-world experiences of having an atypical mind or body.

• Atypically shaped. 1d10 of your toes bend in odd directions, curving sideways or even backwards. (Roll 1d10 for the number of toes, then 1d10 for each to determine which toe.) Depending how many toes are atypically shaped from each foot, you have penalties to Dexterity ability checks and saving throws requiring balance equal to −1 per (number of atypically shaped toes) ÷2.
• Missing Toes. You are missing 1d10 toes. (Roll 1d10 for the number of toes, then 1d10 for each to determine which toe.) Depending how many toes are missing from each foot, you have penalties to Dexterity ability checks and saving throws requiring balance equal to −1 per (number of missing toes) ÷2.
• Overgrowth. 1d10 of your toes are longer than expected for your ancestry. This has no immediate game mechanic but will lead to confusion, fear, or other social effects, depending on the situation. Boots and other footwear need to be custom made and cost 50−100 percent more than usual.
• Polydactyly. You have (IE) extra toes on your foot (/feet). This has no immediate game mechanic but will lead to confusion, fear, or other social effects, depending on the situation. Boots and other footwear need to be custom made and cost 50−100 percent more than usual.
• Syndactyly. 1 + (IE) of your toes are fused together. Depending how many toes are fused, you have penalties to Dexterity ability checks and saving throws requiring balance equal to −1 per (number of fused toes) ÷2.
• Talons. Your toes end in claws or talons. This allows you to make an unarmed strength attack that does 2 (1d4) slashing damage if barefoot. Boots and other footwear need to be custom made and cost 50−100 percent more than usual.
• Undergrowth. 1d10 of your toes are smaller and weaker than expected. (Roll 1d10 for the number of toes, then 1d10 for each to determine which toe.) Depending how many toes are undergrown from each foot, you have penalties to Dexterity ability checks and saving throws requiring balance equal to −1 per (number of undergrown toes) ÷2.
• Webbed. Your toes are webbed and give you +5 feet on your swimming speed. Boots and other footwear need to be custom made and cost 50−100 percent more than usual.

In the real world, human webbed digits do not give swimmers any noticeable benefits.

Real-world Examples

Hammer Toe, Anvil Toe, Curly Toe, Claw Toe, Adductovarus Toe, Syndactyly, Polydactyly, Arthritis

Assistive Options

As described in the above listings, custom boots are necessary for many of these but do not change game mechanics.

Magical Assistance

Boots of Striding and Springing can assist with Dexterity penalties relative to malformed toes at the expense of the jumping benefit.

Your hands and/or arms (Roll 1d6: 1–2 Hands, 3–4 Arms, 5–6 Both) get weak due to muscle tone or neurological failure. All Strength attack rolls, ability checks and saving throws have a −(IE) penalty to hit, and all damage is divided by (1 + (IE)), rounding up.

Real-world Examples

Arthritis, Myopathy, Tendinitis, Amyotrophic Lateral Sclerosis, Carpal Tunnel Syndrome, Cerebral Palsy, Multiple Sclerosis, Down Syndrome

Assistive Options

Devices or weapons that strap onto the forearm can assist with hand weakness, as can a device that provides leverage to reduce the strength needed for operation by substituting distance. Be creative!

Magical Assistance

Magic items that increase strength like Gauntlets of Ogre Power or the Belt of Giant Strength items can assist with this but cause excruciating pain if used more than an hour per day, requiring a Constitution check equal to the magical Strength − 5 or take one level of exhaustion per minute after. An item that increases Strength by a specific amount should consider your initial strength to be 7 − (IE).

You experience tremors in your hands and arms. You have a −(IE) penalty on all Strength and Dexterity checks and saving throws that require fine motor control, including ranged and finesse attack rolls.

Real-world Examples

Amyotrophic Lateral Sclerosis, Ataxia, Multiple Sclerosis, Parkinson’s Disease, Hyperreflexia

Assistive Options

Devices that can absorb the vibrations to some degree can help handle utensils. An additional sponge-like grip on handles can help with finger issues. Specialized utensils with long handles or cups with lids can help with eating. Be creative.