Ankle boot
Many of us know someone who has suffered trauma to the ankle or foot (fractures, surgeries etc.) that requires the usage of a giant, cumbersome immobilization boot. Ankle boots are a necessary evil: They protect the joints and bones of the lower leg and allow for bones and soft tissues to heal.
The problem that I have with ankle boots has to do with how the patient is forced to stand and walk. To illustrate this concept, take a look at the photo of the pair of shoes a couple paragraphs below.
Can I convince you to walk in these shoes for six weeks? (A woman actually walked into our clinic wearing these shoes this year and had no idea as to why she was having lower back pain.) Wearing a surgical boot has the same effect on the body as wearing these shoes. The booted side will be considerably higher.
Many people will encounter secondary problems when forced to stand and walk in a non-symmetrical alignment that the boot causes. The lower back in particular can easily become irritated from unequal weight bearing and elevation of the pelvis on one side.
The simple solution is to build up the height of the unaffected side so that you are standing as level as possible. Some patients use a shoe with a thick sole. This can be effective, but one problem with this is that you must wear the same thick-soled shoe all of the time.
Here is a great way to add a lift to the non-booted side. We have gotten some great feedback from patients here at PhysioDC in regards to this product!
A more practical solution is to use a temporary heel lift on the short side. A heel lift can be transferred from shoe to shoe without difficulty. Heel lifts can be purchased quite easily online from medical supply catalogues or from a healthcare professional’s office. Drugstores also have comfortable, cushioned inserts that can be placed into the shoe on the short side.
As a final note: make sure that you check out your alignment in a mirror to see if your pelvis is level once the lift is in place. If you cannot figure this out for yourself, have someone look at you from behind and see how the pelvis rests when you are standing.
The sad truth is that most doctors do not take the time to address this issue; thankfully, it can be dealt with easily!
The heel lift pictured on the right can be purchased on Amazon here.
We also recommend the Airex Balance Pad, which is great for ankle stabilization training. Use it for single leg balance, air squats, or as a way to cushion your knees while performing exercises in a kneeling position. The Airex Balance Pad can be purchased on Amazon here.
Continue reading with Ankle Sprains and Hip Strength.
I had to wear a surgical shoe for three weeks because I was having pain in my foot. I was told I had a stress fracture and placed in a soft cast for a week while they waited for an x-ray, only to find out that my foot was not fractured in the beginning. But I wasn’t told that until after three weeks of wearing that shoe. However, I did wear a tennis shoe to balance out the uneven height, but my lower back began to hurt. When I complained about that pain that is when I was told not to wear it anymore. My question now is how do I deal with the pain in my lower back and the fact that I still have the pain in my foot?
Please help.
Rebecca
I would go and see a physical therapist, there may be a few different things going on here. It sounds like you have tendonitis in your foot / ankle in addition to a slight alignment issue in your lower back and pelvis. Many females who have a lot of flexibility will develop these problems when their bodies are put out of balance, even if it is for only a few weeks like in your scenario.
I was in an orthopedic boot for 12 weeks. Now I cannot bend to the side. What exercises can I do to fix this? Will kickboxing make it worse?
I am not sure what you meant by “bend to the side”? What I would recommend that you do is see a PT. I think that one session of PT should shed some light on what you need to do.
You hit the nail on the head because I’m in that exact position right now . I just was placed into a boot today after ankle surgery and I am now a new extra for “The Walking Dead.” I got an extra wedge for my other shoe for my good leg. I tried placing the wedge in. It works but there is also no room for my foot inside the shoe now, so it technically doesn’t work. I imagine a heel lift lifts the inside of the shoe to allow room for the foot when walking ? If not this would be a lucrative invention , inventing a shoe solely for the purpose of people with walking boots for the unaffected foot, since Dr’s don’t take this into consideration.
I feel your pain Marcus. I shattered my ankle a few years back and was in the same boat. Patterson Medical makes heel lifts that are not too obtrusive. Your other option would be to wear a work-boot or other type of shoe that already has a thick sole.
I am a 65 year old woman in excellent health, and not overweight. I’m a regular roller skater and had skated 6 months before surgery. I had bunion surgery and correction for a hammertoe, all on my right foot on Nov. 27, 2013 (the day before Thanksgiving). I was put into the big black boot, weighing 2.2 lbs during the month long recovery. Since I had had previous back surgery 9 years ago on a ruptured disc I expressed concern about the boot. The podiatrist expressed no concern at all and said I had no options, and blew me off. I brought this up on at least two occasions in his office, but he still wasn’t concerned. I had bunion surgery 30 years ago and was placed in a lightweight, very user-friendly Reese shoe…so why the heavy boot now??
I got out of the boot on Dec. 28, 2013 and my back blew out on Dec. 30, 2013. Two herniated discs (L3/L4 and L4/L5). Very, very painful and scary, I couldn’t move! I had surgery on Jan. 28, 2014 to repair herniation and after excruciating pain and physical therapy I still have numbness in my left leg and foot along with drop foot. I have fallen 3 times and finally got an AFO (brace) to keep me from falling. All of these problems are because of wearing the heavy boot which caused me to walk uneven and throwing my back out of alignment, hence rupturing the discs.
Has this happened to anyone else?
My guess is that this happens fairly often Sharon. Sorry to hear about that. Boots are not fantastic, particularly for those of us who have underlying lower back issues.
I too have had bunion surgery and hammertoe and cross toe surgery. I had back surgery yesrs ago and have failed back syndrome. When I expressed this to my podiatrist she said it should be no problem.
When I could finally walk with the boot, I managed 3 steps before horrible paraspinal back spasms. I asked about a solution…she said “you will be fine “. Not good enough for me, so I researched and found on Amazon and Walmart this lift to put on your shoe. $16 at Walmart. I can say that I am now walking comfortably in the boot. I don’t understand the seeming dismissal of this problem. So sorry you had to have more back surgery. I pray the best for you!
I am dealing with hip issues after a stress fracture and tendon tear where I spent 3 months pre surgery in boot trying to let it heal and then again post surgery. Between the scooter and the boot and the inactivity I am paying the price heavily. I can sympathize. Physical therapy is needed WHILE we are wearing these things as well as after.
I had a triple arthodesis op 3 months ago on my right ankle I have now been put in a black boot but it gives me a lot of pain in my heel & outside of my ankle is this right as I don’t have pain when wearing my trainer shoe.
Regards Val
It is not ideal Val, but get out of that boot as soon as the doctor lets you.
The Even Up Shoe Leveler is a nice way to stay even while you’re in a boot. See EvenUp Corp for all the details, but order from Amazon; much cheaper and often with no S/H.
PhysioDC: Here is the link on Amazon for the Even Up Shoe Leveler
Have you ever heard of the Evenup shoelift device. Seems to address what you are talking about
I love that product! I just found out about it a few months ago. We are recommending them. Here is the link: Even Up Shoe Balancer
I am in Canada and can’t find any place where I can purchase the Evenup, which seems to be the only product anywhere for this problem. I couldn’t even get it from Amazon. I broke my ankle 9 weeks ago, have had a hip replacement due to polio and also my unaffected leg is weak with little balance, also from polio. My knee on that leg has been acting up in the past couple of years. So if I walk on this boot cast without something like Evenup, I will destroy my hip and my knee in very short order, therefore I am still stuck in a wheelchair. Does anyone have any idea how I can get one of these shoe balancers?
I am going to assume that Canada’s Amazon is different??? That is totally weird Marion. Did you try the link form our product page??? I am sure that Even-Up must have a website???
You could also in the mean time just wear a shoe with a thick sole, like a hiking boot or something along that line. I would also call a physio office in your neighborhood and ask them about the Even-Up.
I had been in a surgical boot for 16 months total, after 4 surgeries on my right foot(bunionectomy/hardware-hardware removal, than non-union/outer fixator, than removal of that. Since being out of boot, I’m having IMMENSE pain, like all the guts on my left side are making their way across my sternum..like they are swollen. My hubby noticed my stance one night. With my feet shoulder width apart, my torso points to the right. The more I move, the more pain I feel..as if my frame is rubbing on my organs..had 4 CT, 3 x-rays, all blood work is fine..went to orthopedic specialist yesterday and he said he will do MRI of spine and if he finds nothing..he’s passing me off AGAIN. I feel HOPELESS and ready to give up on life..my insurance doesn’t cover chiropractors and I’m wondering if there’s a diff route to go?? PLEASE LORD, Help me.. Out if 4 ER visits, I had ONE physical exam by dr..
Kenise you have been using a surgical boot for longer than anyone I have ever worked with. You body has probably changed quite a bit in response to wearing the boot, especially if you have been walking around with one side higher than the other (no lift in the other shoe).
You definitely should see a physical therapist, even if it is for just one session to get some ideas in terms of how to start doing the right things. Your spine and legs need to be assessed, and I can’t do that via email.
I forgot to mention I have severe thorocolumbar scoliosis..It was minor during childhood..just found out its severe..falling apart..I also have IBS, and no gallbladder.. Thank you for even reading this, I appreciate any time taken..
Where do I get a heel lift online? I’m in the SF Bay Area and neither my doc or PT know. HELP!!!
Janine I think that we have a link at the bottom of the article now that goes right to the heel lift???????????
Hello,
I have a foot injury and I am trying to find a solution to my problem. I fell and injured my left foot Nov 19 and was in a walking boot for 2.5 months. I’m still not quite sure what the injury is called. 1st they said it was a fracture. The main problem is I have an unstable joint between my big toe and the toe nest to it.. so anytime dorsiflex my foot it’s painful. I am in nursing school and trying to finish the last semester problem is I have to be on my feet 16 hrs a week .. my doctor is recommending surgery to do a fusion but he said I can hold it off to finish..I spent 150.00$ on shoes and of course walking on carpet makes it easy but when I walk on non carpet floors my arch hurts like I’m walking on a rock.. (that type of pressure freaking ) I walk fine and have nor problems with walking on the foot with the walking boot because of the thickness of the walking boot maybe thing is I can’t wear the walking book for nursing school…since I have been on my feet much for 2.5 months I also have back pain when standing feels like even barefoot I’m uneven . What would u recommend for something that imitate the support and no pain that I get with the walking boot. I wonder if the heel lift will work.. help please… thank u
Essence it sounds like you have an unstable 1st ray??? Some of our patients here at PhysioDC really like having a custom made orthotic placed in the work shoes. I would recommend getting an orthotic that has extra support / stiffness in the big toe region of the foot. The best material for that is usually “graphite”.
A physical therapist can cast your feet and send the molds into a lab to have the orthotics made. Ask your doc for a prescription and find a good PT that casts for orthotics.
What are the primary considerations when transitioning from boot to shoe? I had a bone spur removed from top of foot and am 5 weeks post op, moving from 3 weeks in boot back to shoes. Are there special exercises I should do? No other foot issues except minor arthritis in top of foot. My toes are stiff and foot feels inflexible and sensitive.
Alison I would start with some basic exercises. Putting a towel under your foot and scrunching it with your toes until the underside of your foot is tired is not a bad idea.
I also think that doing some stretching would be a good idea, but you really should visit a PT to have the foot checked out. In terms of getting out of the boot, I would try to transition gradually over several days once the doc gives you the okay. For example, start wearing the shoe around the house and for short walks, while sticking with the boot for when you have to be on our feet for longer periods.
I have been in a wheelchair for almost 8 months due to a very bad break! All the bones that connected to my ankle were broken! Just had surgery the other day and they but me in a walking boot but they said to not walk on it! What is the point of wearing the boot?
Kelly I am so sorry that you have endured so long in a wheel chair. I shattered my fibula back in the day and I was jumping out of my skin at six weeks without weight bearing.
My only guess from this end is that they don’t want anybody stepping on your foot or you catching your foot on the wheelchair. The doc does not want you ruining his wonderful work.
Hello… I broke my right ankle July 20th and had ORIF surgery August 12th, on Sept 9 I was given a boot and the okay to start walking on it and to leave the crutches whenever I felt comfortable to do so. My concern is that isn’t that to soon to start putting weight on my ankle? Also is there anything I can do to help strengthen my ankle?
Elma when I broke my ankle I started putting weight on it at about 6 weeks. I would transition off the crutches gradually: use them for longer distances initially.
There are plenty of exercises that you can start on. The most basic would be working on gathering a towel under your toes. Get a list from your doc, or ask a local PT for a progression of exercises to go through.
Due to pain in my left heel, I went to see a podiatrist. They found after a x-ray that I had a heel spur that broke off and fractured my left heel. The doctor put me in a boot for three weeks and ask me to get a shoe lift for the other foot. I thought wearing a shoe with a 2 inch heel on the good foot would be enough. After 3 weeks wearing the boot, I was able to take it off. The day after I quit wearing the boot on my left foot my right lower back and knee begin to hurt tremendously. I went to the orthopedic doctor and they gave me a cortisone shot in my knee, but it still hurts and I have noticed also that foot on that side looks swollen. My lower back on that side aches at times. When I did go to the orthopedic doctor they did see arthritis in my knees, but my knee and back did not hurt until I took the boot off. Do you have any suggestions?? I am 57 year old female and I am overweight.
I would see a physical therapist. I think that someone needs to take a good look at your alignment and see what needs adjusting.
I am going to be having a ankle boot in a like two months then a brace is their anything I should worry about will I get back pains? I am only young so I’m really scared because I’m having an operation then having a cast then a boot then a brace then physio! I’m really scared any advice it would really help!
I would get one of those “Even Up” lifts for your other shoe while you are wearing the boot. We don’t need you walking around as if you are using one stilt, that would not be good for your lower back.
Since you are young the physio should really be a breeze for you. You will probably like it. Don’t worry.
I had a stress fracture in my ankle. I’ve been in boot for 3 months along with scooter and crutches. Just recently starting walking without the boot and my back is in pain and my knee is swollen. Actually my entire right leg is slightly swollen compared to the left. Any advise.
Thank you
Have the doc check it out Rhonda. Weak muscles have a hard time pumping swelling out of the leg, but it might be something other than that.
I broke two toes and was in a boot for 7 weeks. I have severe pain in the back on my ankle when I stopped wearing the boot. I have tried stretching to see if that helps to no avail. Any idea what it could be
Your foot is probably stiff from the boot and now it is having a hard time accommodating to a normal shoe. Your foot is probably also weak. I would slowly phase back in to regular shoes, and keep the walking limited at first. It probably would also be a good idea to see a PT to get some strengthening and stretching ideas to transition you back to regular walking.
I suffered a bimaliolar fracture breaking my tibia & fibula, I had surgery where I was fitted with a plate around 11 weeks ago. I’m shortly about to finally get out of my boot but haven’t had very clear instructions on what type of shoe would be best. All they said was “probably some kind of trainer that is supportive”?? There are so many trainers I have no idea where to start. I am from Scotland so may not have the same shops as you but if you could give me a few pointers I’d really appreciate it.
I feel your pain, that happened to me not too long ago. I would say that a flexible athletic shoe is a good idea. You may even want to go a size larger to be accommodating for swelling if that is the case with your foot. I have found that some of the best companies out there include “Brooks” and “Asics”.
Another consideration is your foot type, which I obviously can’t be totally helpful to you because I am not looking at your feet. A few pointers though…….if your foot is “flat”, I would get a “motion control” type shoe. If your arches are high and you have stiffer feet, a “cushioned” type shoe with a “curved last” is a good idea. If you go to a reputable shoe store, they should be able to tell you what type of foot you have.
Thank you so much for your help, I really appreciate it. I will definatly keep your advice in mind when I go to purchase my new shoes. ?
I am being treated for a problem with my right foot. It had swelled up on the right side and I ended up walking on the side of my foot for nearly 4 years never realizing I was doing it. My doctor gave me an injection in it two different times and said it was a build up of cartilage. All of the swelling went down He also put me in an air boot and I have been using it for nearly 3 weeks. My foot is so much better and I’m so thankful for that however now my other foot is starting to bother me. It is hurting on the top towards the outside of my foot. Could this be caused from wearing the boot? If so, is there anything I can do to stop it? It is very painful and sometimes I have to make myself put weight on it.
Thank you so much for your help.
You are probably not standing evenly because of the boot. It sounds like you need an “Even Up” Shoe balancer, we have a link to them an Amazon through our blog article. It is under the ankle tab, the link is here: https://www.physiodc.com/post-surgical-ankle-boot-please-get-a-lift-for-your-other-shoe/
I have just had bunion surgery and am encountering knee pain from the shoe. I am going to try and find a higher shoe for the other foot right now! I was aware of this as my mum recently had the same operation and had hip pain from the different heights and when i told the nurse about this before my op and requested 2 post op shoes to solve this problem, she looked at me like i was crazy and shrugged it off and said ‘no we only give one shoe’!! Sometimes health professionals fail to see the obvious! Then again, I’m in the UK and the NHS are very stretched so I guess giving away 2 shoes would be an unnecessary expense so I will just get a higher shoe myself :)
p.s. any tips for getting back to running again once it’s healed? I’ve been told no impact sports for 12 weeks which is going to be hard! I can do gym/cycling/swimming apparently though. I don’t want to make it worse though so any tips gratefully received!
Everything needs to be incremental. Start with the cycling and some gym activity. I love the pool, especially walking in the water. that would be a great transition into full weight bearing on a treadmill. When you do start with more impact, do a short jog on the treadmill (maybe 1 km) and stop, even if it feels great. I would slowly build from that while allowing at least 2-3 days of rest in between jogs.
It blows my mind Hannah. If no other option exists, I think that getting another surgical shoe is not a bad idea.
I dislocated my ankle and fractured my fibula. They corrected the dislocation and did surgery to stablize my ankle and fibula with pins. Surgery was Sept 6, 2016. I started off with Cast then boot. I started having hip pain so I purchased the even ups to go on my other shoe. It helped a great deal. Now I’m given a lace up brace to wear instead of boot. I have started physical therapy. They say I have no motion from stiffness so this is going to take time to correct. I’m having terrible pain with the brace when wearing my tennis shoes so much so that I prefer to wear the boot. I have noticed a lot more swelling since I have tried returning to work in last 2 weeks. It’s a desk job so only thing I can think of is not having it elevated as much. It hurt so bad this morning I removed the shoe and wore the brace inside boot. Which was probably a mistake. I don’t know if it’s the socks, brace or shoe but I need to change something. It was so swelled the leg looked quite deformed from the indentation. So I have the foam wedge piece with leg propped up on it now. I have to work. PT people want me to use brace instead of boot. The dr doesn’t seem to mind either way. I went from only taking medicine once a day to now needing it more often. Suggestions please. I don’t know if I need larger or wider shoes to allow for brace, less constrictive socks, or a bigger and more loosened brace. Or all the above. Desperate. I was really excited about possibly getting to drive but I haven’t even tried since I’m hurting so much. Any suggestions are appreciated.
With all of this swelling, I would talk to the doc and the PT about perhaps getting a compression stocking for the leg???? This leg is going to swell for quite a while, and if you have to sit at a desk it might be helpful to have compression. Almost the exact same thing happened to me a few years back, so I do remember how this feels.
If you think that the brace and shoe are bothering you, take them off as you work. If you are just sitting there I don’t see why you would need to wear them. You might also want to find a softer ankle brace, maybe one without hard plastic or metal uprights in them. I would also take small and careful steps.
I have a nondisplaced spiral fracture of my proximal fibula. I was given a boot like the one in the top picture minus the circle thing by the ankle.
The lady who fitted it said it makes the foot & ankle secure. Is this what I need? That steel rod does go right over the bronen bone it feels like. I can’t make the top really tight enough I guess as it “flops” at the top. But the bars leave indentations in my leg.
I guess I don’t understand why the foot & ankle needs to be so secure when the break in the bone is several inches higher.
A friend sent me this link because after one day in the boot my back hurts so bad I’m in tears.
My boot is so elevated that I think a lift that would make the feet even would have my foot above the top of the shoe. Or in a tennis shoe it would make it not sit right in the shoe.
Just not a happy camper I guess. But my back hurts more than the leg!
Thanks for any insight.
Trudy I can’t see the picture with this WordPress platform. What you are describing sounds weird though. I would think that keeping weight off the foot with crutches would be enough.
I would ask the doc about getting an “even up” shoe balancer. You should definitely be as level as possible for your back’s sake.
On my last long run training for N.Y. marathon, I broke my 5th metatarsil on my right foot. Needless to say, no marathon and I was in a boot cast with crutches for 5 weeks. When the cast came off, much to my surprise I started experiencing burning pain in my upper leg around IT band; gradually my lower back and hip pain increased. Stretching, p.t., massage, working out in the gym seemed to gradually help but then a regression occurred. I went to a physiatrist and a new p.t. The p.t. did decompression therapy which seem to make me worse. Is that possible? Today, I am going to start swimming, continue my stretches and gym routine. I miss running but hope I will gradually get better. Just was not counting on these problems. Your input would be appreciated
I am not sure what compression therapy is Anne. I would have my jogging evaluated by a PT to see if there is something mechanical going on with your stride. I am guessing that the boot also threw you off a bit in terms of alignment. I would work on lower back and pelvis alignment in addition to hip strengthening. Maybe find a new PT with lots of manual experience?
I broke my ankle in 3 places, foot came off the socket. I have incision and plates on the outside of the leg with 9 small screws and a 3 inch screw on the inside of my foot. On the inside incision I have the screw head that is right where the cut is. This has given me problems since they put me in casts and now the boot. My cuts have sealed, but the metal uprights are right on the incisions and they don’t let the incisions heal completely. And I can feel the screw. Feels like a marble inside my foot. So painful. The top of my foot is also still numb as is one of my small toes. I am 6 weeks in and the surgeon says I can start putting pressure on my foot. In the beginning she said my breaks and dislocation were so bad I would have to wait 3 months before putting pressure, now a rotating doctor says I can start at 6 weeks. I just don’t feel right about this. Everything is so painful and my back and hips are hurting as well. I’m going to order the leveler. But tell me what you think about the numbness in my foot and toes and about the screw head. She says that can be removed after 6 months. Why put such a long screw in a bad position if they know it’s going to be in the way. Is there any way not to wear that heavy boot and still heal by just doing the exercises and maybe wearing another kind of shoe? Thank you
Ugh, I can certainly empathize with you given that I broke my ankle in three places as well. It took me the better part of a year to totally recover from it. Your ordeal sounds worse because of all of the metal and screws. My first thought is that the metal needs to eventually come out. At least one of those screws are going to cause some soft tissue irritation.
In terms of the weight bearing, the fractures should be healed entirely by six weeks. If it were me, I would practice with just quiet standing at first to get your body used to bearing weight through the leg. The transition to planting weight through the leg with walking should be gradual, and I have found that it is much easier to start walking with crutches so that some of the weight can be taken by the crutches. (It is called a “step through” pattern, I am sure that you can find a demonstration on the internet). I would ask the doc if you can practice all of this barefoot. The boot is more for goign out in public etc., but clear this with the doc please.
The numbness may be a by-product of the swelling in the ankle placing pressure on some of the superficial nerves. That is probably going to be present for a while. If the numbness gets worse, or if you start losing muscle strength in the ankle muscles, I would bring it to the attention of the doc immediately.
In terms of the lower back and the hips, this is probably the effect of unequal weight bearing for so long. I would get the “even up” shoe balancer for the boot. If you are not seeing a PT who does manual treatments, I would find one. Your pelvis is probably a bit out of whack.
You are going to get better, it is just going to take many months. I do remember how annoyed I was during this process. Hang in there.
Great article. I’m a boot for 8 weeks so far for a 5th met stress reaction and a torn abductor digiti minimi. The boot is KILLING my medial malleolus. I have tried all sorts of padding but I can barely get it on anymore. Also the abductor digiti minimi is still so swollen and painful on my sole by the head of the fifth met. Any tips?
There are different brands of boots out there, you might try getting another similar type boot and see if you have some more space. For instance, I do know of a boot that has a “pump up pressure” feature that adds snugness with a simple finger pump. You might have luck with something like that as it would give you some control to let pressure off the foot.
I wold also get out of the boot whenever you are not putting weight through your leg (with the docs permission).
Partial tears of peroneal tendons, brevis being the worse. Placed in a boot for 1 month, no improvement. Amino fix injection, no improvement after 1 month, remain in boot for another month. Again no improvement after 3 months in boot. MRI ordered, surgery suggested, done. Both tendons needed to be repaired and an anchor needed to be placed. Non weight bearing for 6-7 weeks, then mild weight bearing, start PT
Total boot time was approx 6 1/2 months. As PT progresses, I am unable to push off on surgical foot with out immense pain across what I think is the top of my foot towards my ankle. My PT is baffled, as I am. I have some knee issues I believe from using the knee scooter, so that also makes walking difficult. Just getting back to work, but as I’m a nurse this has proven to be very difficult. My Dr is out of town for next 10 days and I feel this is getting worse. Any thoughts would be appreciated!
I am guessing that your ankle is super stiff and will not “dorsiflex” adequately when you are walking. That tends to happen when the foot sprains severely, or when the foot is immobilized for long periods of time. I would have the subtalar joint distracted and the entire midfoot and rearfoot mobilized. I would walk very slowly in the mean time and try to walk as normally as possible.
I broke my fibula bone and have been in a cast for a few weeks and just nearly a week ago i got my cast off .They gave me a boot to put a little bit of pressure on my foot with crutches still and told me to wait until 4-5 days to walk without crutches . Today i tried walking for the first time in a long time and it was sort of easy , but as i put pressure on my foot with the boot on it felt a little bit tingly and that was on and off . I took a break and took off the boot and later on i tried again and as i took step on it , my whole foot felt tingly . Then the steps after didn’t feel as tingly as it first did. Should i contact my doctor ? And when i wear the boot my knee hurts or feels weird as I walk . Do you know if any of this is normal ?
The boot might be placing a bit of pressure on one of the superficial nerves. I would try adjusting the boot and see if that makes any difference. I would also go with a gradual transition into weight bearing. Use the crutches to de-weight you a bit as you walk. If the numbness persists I would look in to getting a new boot.
Hi i i broke my ankle in 3 places its been nearly 4 months now i was wearing a cast fir 7 weeks then a boot for 5 weeks the last week of useing the boot i started getting bad back .now my foot slowly recovering i feel back to square one because my back is so sore and limits me when trying to do things .i see a pt for my foot is it worth mentioning to him or go my docter.i am desparate to go back swimming and gym to get healthy again as i also put on bout stone and half when i was house bound but my back stopping me doing things i blame the boot never had it before .but also very annoyed that nobody told me this could happen or how to avoid it now ive my sore back to cope with.
Hell yes, talk to your PT about treating your back in addition to the ankle. Walking around with a boot causes asymmetry in the pelvis and lower back. If the lower back is treated it should help a lot.
Wearing boot for a stress fracture in my left foot the metal bars and air pump are digging into my leg any suggestions on how to alleviate this problem
Adjust air pressure, some people will place little pieces of foam into the boot. Some people will switch boots entirely.
I am wearing a surgical boot for 5 weeks after a bad sprain and possible break. Doctor not certain as On X-ray he doesn’t think it is but examination for pain he said might be. Are surgical boots designed to fit left or right because people keep saying it looks like A right foot but it is my left that is damaged.
Some are designed for lefty or righty, some aren’t. I would Google the boot name and go to the manufacturer’s site. That should shed some light on the situation. We don’t need you walking around with the wrong boot on.
hi ,
i am 18 an i going to be 19 in October. i am also disable on my left leg ..i did 2 times treatment of it …..but still the same thing i am also disable on my left leg …….
Hello, I rolled my ankle about 10 days ago. Four days later I went to an urgent care center where they did xrays and informed me that I broke the distal end of my right fibula, minimally displaced, and gave me a pneumatic walking boot which I was told I could remove for showers and sleeping. I was also instructed to see an orthopedic surgeon to make sure i didn’t have any torn ligaments or require surgery. 6 days after the break, I went to see the surgeon who said I didn’t need surgery and I didn’t tear anything but put me in a cast and told me I needed to be in it for 6 weeks. I was told I could walk in it with the aid of crutches and could walk in it as long as I did not exert myself to the point of feeling pain. I have had this on for 6 days. I have not needed to use crutches for 5 days and am able to walk and move my toes back and forth without any pain or discomfort. The swelling has gone down considerably and I can easily wiggle my leg and ankle up and down and side to side in the cast. The only discomfort I feel is my ankle resting against the hard cast and cramping when I stretch from not being able to stretch my right calf and foot. I go to school which requires me to commute weekly between Houston and Dallas not to mention that I must drive myself to and from classes on the days I attend class. My questions are, is it really necessary to wear a cast for the entire 6 weeks and wouldn’t wearing a pneumatic walking boot would be just as effective considering the fact that I am already walking around? The surgeon said i could opt for surgery but that is out of the question since I truly feel it is unnecessary. I am concerned about my skin developing a sore from friction/pressure and muscle atrophy from not being able to properly use it for 6 weeks. I would slowly and carefully stretch my calf several times a day before the cast and that is impossible now so I am also concerned about having a stiffened ankle due to it being immobilized. I’m sorry for such a long story but I wanted to ask the opinion of someone other than my husband. Thank you.
The cast is indeed a pain in your ass, but it is really the best way to assure that the bone heals correctly. When I broke the same bone a few years back, I was in a cast (with orders for no weight bearing whatsoever) for 5 weeks, and then a boot like the one you described for another two weeks. I think that the problem with wearing the boot from the start is that there is a slight danger of the fibular piece “pistoning”, or cramming up into the rest of the bone before it is set in place. That bone needs at least 5 weeks to fuse into place solidly.
You are by the way going to have a very stiff ankle and calf once you are out of the boot, that comes with immobilization. Don’t worry too much about that, I am guessing that you are young and will be much more mobile within a week or two. I remember that I was extremely annoyed by the whole matter as you are. You will get through it, better to be safe than sorry.
I cracked my fifth metatarsal a few weeks ago and today I was given a walking boot on my right foot. I also have a boot level for my left shoe, and it works wonders! The boot itself is causing no pain, which is a relief. My concern is my knee. My right knee (the same leg as the boot) hurts quite a bit when I straighten it while standing/walking on it. It started just on the inside of the knee but has spread over the top and bottom of my kneecap as well. There’s no swelling or bruising, just the pain. Any ideas regarding what could be causing this and how to fix it? Thank you!
It probably has to do with the weight of the boot and the slightly different walking pattern that you are doing. Once you get rid of the boot it should rectify, but I would also let the orthopedist know about it. If you see a physical therapist I would of course bring this up as well.
I was in a cast six weeks ago (I fractured my foot) for three weeks, then I switched to a boot for ten days. I had severe knee pain while in the boot, but I figured it was just from the new adjustment. I switched to a tennis shoe about a week and a half ago and the pain is still persisting. It’s pretty much all around my kneecap and it has a grinding feeling when I bend my knees. The pain is slightly sharper when I walk and straighten my knees. It seems to go away with exercise, but comes back shortly after. Ice makes it worse, but heat helps. I’m currently in physical therapy and I recently asked my therapist about it; she said she thinks the walking boot messed up my alignment. I wouldn’t doubt that, but I’m just worried it could be something worse. What are your thoughts?
I would have the ankle and lower leg mobilized by the therapist. I would bet that the lower leg is super stiff and effecting how the knee and hp are moving.
I had a plate with four screws and two long screws on the other side of my left ankle removed. I can walk ok until
It gets super sore then I start to limp. But I been wearing my boot. Will it be ok to transfer to regular shoes now ?
Keep in mind my hardware was removed almost a month now.
I think that the operative word here is to “wean” off the boot. Short distances in shoes to start is a good idea. I also have patients practicing just standing in bare feet and building endurance that way. You do need to build up strength in order to be able to handle the demands of walking, so hopefully you have a good strengthening routine as well?????
i wore a boot for about three weeks for a stress fracture on top of my foot. Had to stop wearing boot because of painful knee (mainly outside of knee but pain spreads to back of knee). I didn’t level my other shoe up, as i didn’t think about it!! I’ve now had the pain for over 3 weeks. It’s improving but slowly. I only really get pain when walking. At first i had the feeling that my knee might give way but it never did and it definitely feels stronger. i’m icing it at least twice a day, taking ibuprofen and stretching. I have a cross-trainer at home – do you think that would help? Any other advice would be much appreciated
That’s tricky to give advice Helen because I can’t see how you are walking. I have a sneaking suspicion that you may have been “locking out”, or hyper-extending your knee when you were walking. I would make sure that the knee is not hyper-extending when you are walking. Otherwise I would not tax it too much and let it take its course to heal. Some cross trainers (like elliptical machines) actually may encourage your knee to hyper-extend, which would not be a good thing.
Hello. I have a 5th metatarsal fracture and was given the boot to wear. After 3 days my “good” foot now has severe pain in the arch and my back hurts so bad. I came out of the boot in agreement with the orthopedic because I have anklyosing spondylitis and they don’t want to make that worse. Can you advise if the “good” foot being so irritated is normal or I should worry now?
Thank you
If your legs became uneven from wearing the boot (stilted up on the boot side), that could have easily irritated your back. This could also have the effect of changing how you were bearing weight through the uninjured foot. It is a good thing that you are out of the boot. I would try walking as normally as possible, even if this means slowing yourself down quite a bit. It might not be a bad idea to get some PT for the lower back and foot to help calm it down.
My immobilization boot for my torn Achilles tendon has two extra heel inserts added by my doctor, making it EXTRA high, such that an “Evenup” (using both inserts) added to a hiking boot on my good foot is an insufficient height boost. I therefore inserted a cannibalized thick sole from an old Reebok sporty walking shoe between the hiking boot and the Evenup and then duct-taped it all together. That height it almost ideal (about a quarter inch short), but it’s somewhat unstable and I could wobble and fall. If I add a quarter inch heel lift inside the boot, the height is about perfect, but that makes it even less stable (even with the high lace-up of the hiking boot). What other options do I have???
That does sound a bit dangerous. Can you place a few insoles into your existing shoe that has the Even-Up balancer? Your other option would maybe be to use a naturally tall shoe (like a boot or hiking shoe) and then place the Even Up under that??
Hi Dan, reading your article and comments- very helpful. Thank you. I have a question. I sprained my ankle badly 5 days ago. ER did xrays and said luckily no breaks but seems like a real bad sprain. It was swollen real bad. They put me in a cam boot. And I ordered the heel lift as I feel I definitely need it. It is still very difficult to move 5 days later and for some reason most of my pain on the inner side of the ankle but most of my swelling and bruising are on the outer side. Could I have hairline fractures that are not visible on xrays? I have read that some fractures may not be visible on xrays or not visible until 4-5 weeks later. I did twist it outwards. Thank you!
It is possible that you could have a small fracture, but wearing an immobilization boot would likely have been prescribed for that. Or maybe crutches. Marked sprains can bruise up and feel absolutely nasty like you describe. I am not a huge fan of those boots. If the boot is absolutely killing you, I would plead with the MD for an air-cast. They tend to be a bit more tolerable. You might want to get PT by the way once the doc clears you.
Is that possible that small fractures arent visible on xrays or not visible until later? They did give me crutches but it’s horrible and so slow and they hurt my armpits. Yea the cam boot is killing me, my lower back, and my right leg and hip are feeling it. Thank for the suggestions, I appreciate it.
There is something called an “occult fracture”. I think we did a blog on it?????
It is a day 9 and I was hoping I could start looking into PT, but doesnt seem like it as the ankle is still swollen and very stiff. I was reffered to orthopedic, he checked it and did weight bearing xrays since for some reason i do get occasional pain in my inner side but i twisted it outwards. He did not see anything broken or fractured but he also mentioned its only a day 9 might be still early to tell. He advised to put me in a splint just cause of the concern of inner tenderness. He said the risk is low there is something there. But if there is and if they dont put me in a splint, i may end up in a worse situation. I refused the splint as i just cant afford not being able to move at all. I am just praying there is nothing wrong with that bone. They gave me a better boot , lower profile, a little easier. I will look into the air case though. I am able to bear weight on it just cant bend it when I walk. My pain is minimal unless i try to twist or do something or push tender spots. Bruising is pretty nasty and swelling is about 80% down and mostly on the outer side. But the inner side on top of the bone is tender and all yellowish around. I hope there is nothing wrong with that bone. Whats your opinion on this? why would I have that inner tenderness on top of my bone while i twisted the ankle outwards.
This sounds like a particularly annoying sprain. Sometimes the inner portion of the ankle will actually get slightly damaged if the ankle turns enough inwards during the sprain. My guess is that it will slowly improve. It make take a while though. I do think that getting some PT at some point is not a bad idea once the doc clears you.
Hello Dan,
It has been 8 weeks now since the sprain and due to still having some pain on and off on the inner side, they did an mri and sent me to the podiatrist/surgeon. And thats after I was in PT for 4 weeks. And wanted to continue PT but have to find someone new and the podiatrist/surgeon said no PT now. The podeotrist reviewed my mri and said my 2 ligaments are torn on both sides and inner side bone is bruised about 1/4 and said no to therapy and cast or a no weight bearing boot for 6-8 weeks then a walking boot for 2 weeks. I am shocked with such a conservative approach after 8 weeks including 4 weeks of therapy already and when if I dont dont any walking or stretching, my ankle gets super stiff. I dont have much pain, the sharp pain just on and off randomly comes and goes on the inner side, maybe last a few minutes and usually when i actually sit or lay down. No pain walking. So this approach makes no sense to me and seems extreme and maybe unnecessary? Can i ask for your opinion as a physical therapist?
Bone bruises are indeed a pain to deal with, and they take a very long time to heal. I am guessing that the pain on the medial / inner portion of the ankle is the bone bruise. This is also probably why the surgeon wants the ankle immobilized and booted.
I would definitely get one of those “even up” shoe lifts so that you don’t develop lower back or hip issues from the asymmetry that the boot will cause. I would also consider talking to the PT about keeping a maintenance routine going, perhaps exercises that you can do on your bed or on the floor to keep up the strength of the leg?
I honestly dont feel like going into a boot at all. I was in a boot for 4 weeks and it was hurting me. But my issue with this is he wants me not to walk on it and not put any weight at all for 6-8 weeks and no physical therapy. That just seems too excessive to me after 8 weeks of recovery already and me walking. Dont you think? I feel this will set me back a big time but he says the bone bruise wont heal unless you 100% immobilize it and dont walk on it at all. Also, he said the mri showed ligaments on both sides are torn. Then how am I able to walk of they are torn? I can walk almost normally. Now going back into the immobilization and no stretching/no pt for my ankle, I am afraid will make it worse.
Well……….. I don’t want you to go against the doctor’s advice. Is there some middle ground that you guys can reach? Maybe one of those lace-up braces that goes around the ankle joints?
You would be able to walk with torn ligaments, the ankle would just be unstable and more prone to “rolling out” into a sprain position.
Yes, I do acctually have the lace up brace and thats what I have decided I will be wearing. I cant afford to go back into a cast or a no weight bearing boot for 8 weeks. And seems so extreme and being that I think PT actually helped me. It got me to the point of walking almost normally and getting some strength back in the ankle, but guess it did not do anything good for the bone bruise or torn ligaments. From my understanding, one ligament under the bone on the lateral side is torn, and the second one on the medial side under the bone is torn which is so odd as I had a lateral sprain. I did not feel any instability though when I was walking almost normally. I guess PT strengthen the other parts and muscles of the ankle.
The doc is pretty settled: either a cast or a boot but no weight. I think, I will be taking my chance and stick with the brace for now. He did say, if it dont heal or dont heal properly then that’s surgery. The bone bruise is the one that is causing that on and off pain, I believe. Have you had any experiences with those and are there any miracle treatment for that that you may know of? I actually read that PT and insoles can help with bone bruises. The doc is saying – only immobilization.
No miracle treatment. Time mostly.
Hello.. an mri showed bone marrow edema indicating a bone bruise or stress fracture in the talus. One Dr. just wanted me to wear a cam boot, but another said no weight bearing for four weeks and then six weeks wearing the boot so I followed that. Before going non weight bearing I had minimal pain but now after 4 weeks of non weight bearing and one week so far in the boot I have discomfort and pain where I never had it before…so I am not walking much in the boot. Is it normal to have discomfort the first couple of weeks? They do not want to do an X-ray until the six weeks in the boot is up. When they give the go ahead to start walking in the boot is that to start walking as much as possible? Thank you
I would definitely be conservative about a talus fracture. I agree with the doc in that non-weight bearing for a month is a good idea. Let that talus heal! I have had the misfortune of wearing an immobilization boot, and I too had a bunch of stiffness and soreness in other areas, I think that this comes with the territory. In terms of walking in the boot, I would stick to where you need to walk to and skip recreational walking etc.. There needs to be a gradual transition into regular walking once the boot is discontinued. Start with very short distances and build up your strength a bit at a time.
Use an Evenup with caution. It sounds like a great idea, but the effect of wearing one is kind of like walking on a loose-fitting snowshoe. You may find yourself having to compensate for its instability by walking more flat-footed than usual (like you would if trying not to slip on icy pavement), or waddling, or otherwise placing more force than usual on one side or the other of your ankle joint. That can cause strain on that ankle. I’ve been in a boot cast for 5 weeks, have to wear it for another 8, and I ditched my Evenup after the first 2 weeks because it aggravated my “good” ankle so much I had to ice it down nightly. It might work for some people but it is not a perfect solution across the board.