Naked at night!

I went to the Fracture Clinic on Thursday. It was a little surreal as initially the staff told me that I probably didn’t need to be there as normally all they do at a 2 week boot appointment is to remove a wedge. Because I had bucked the system with my own Vacoped then this wasn’t really necessary as I could make the change myself.

I managed to see a doctor and got him to agree to me moving from 15 degrees to 0 degrees. He also agreed to me not wearing the boot at night. I showed him how I could adjust the hinge on the boot so that I could get a range of movement. He initially agreed with me setting a ROM between 0 and 30 degrees but then had second thoughts and said he was worried that I might be tempted to push off my toes when walking. We set the boot at a fixed position of 0 degrees and I he told me to set it between 0 and 10 degrees when I got home adding 5 degrees a week. I found it hard walking with a fixed position at 0 degrees when I left the hospital. It seemed very different from the 15 degree setting that I waked in to the hospital with.

I feel that 5 degrees a week is a little too conservative so I plan to be a bit more aggressive with the ROM setting over the next few weeks. I am just going to have to be careful with my walking style but I am hoping that advice from ryanb and kellygirl on walking technique in a boot will keep me out of trouble.

When I got home I tried out the flat non rocker sole on the boot but I found that I walk better with the rocker sole. I also think that it will be harder for me to walk in the wrong way with the rocker sole.

The first night without the boot on was a bit strange but I am now used to sleeping without the boot. At first you are very cognisant of any movement at night but after a couple of nights it seems to be back to how I slept in my pre ATR days.

I have to have the boot on for another 4 weeks and then I can move back to 2 shoes and start my PT. I personally think that this treatment plan is too conservative and I may well go to a private PT prior to 4 weeks. We also plan to go of dingy sailing holiday in Greece so I have had to put my appointment back to 5 weeks. Hopefully I can get some pictures of me paddle boarding and sailing a dingy in my boot.

In the meantime I plan to continue my normal exercise regime. I went to the gym last week and enjoyed getting on an exercise bike and also a concept 2 rower (my pt originally told me that I could do rowing after I got out of my cast). It is fun to actually feel that I am doing some kind of lower body workout.

Things are progressing slower than I hoped but as the doctor said to me. The Vacoped boot (in his opinion) isn’t going to speed my recovery but should mean that I make a stronger recovery.

Happy healing everyone!

7 Responses to “Naked at night!”

  1. Sounds like you are making good progress. My boot is non hinged with a rocker sole. I can’t imagine trying to walk in a flat boot–the rocker sole makes getting around so easy. In total agreement about sleeping in the *n#de*–I hardly notice my injured leg anymore. It’s great!

  2. AndrewC, you seem to be progressing a bit faster than my fave studies’ protocols — llike — in a number of ways, and not just in setting your boot free to hinge. When I was (otherwise) following UWO, I added a hinged boot (hinged from 0 to near-infinite PF) at 7 weeks. Hillie and some others have enjoyed doing other and earlier progressive “hinge-ings”, though I don’t think I’ve seen a decent-sized study that documents that earlier hinge-ing produces consistently excellent results.

    You also refer to ~8 weeks in a boot as “too conservative”, though (again) I can’t recall seeing a decent-sized study that documents that earlier weaning off the boot produces consistently excellent results.

    Of course, you can always decide to go faster than any big study has gone before, but you should be aware that you’re not following a well-documented path, but breaking relatively new ground. Several people here have done that and done well, and quite a few people here with problems have also acquired them by going faster than UWO and other modern “aggressive” studies.

    I’m a very avid dinghy sailor and racer (exhausted now from two Albacore races in gusty-shifty-patchy near-shore conditions!), but my two ATRs took place just after the sailing season ended, and I sailed and raced in two shoes (neoprene sailing boots) when the season resumed. Sailing in an orthotic boot sounds “new and interesting” to me, despite my total familiarity with the sailing part and the orthotic boot part!

  3. Hi Norm
    Thanks once again for the sane advice. I seem to be a little too ambitious on my recovery.

    I feel good with my boot hinged between 0 and 10 degrees but will take my time before moving it further.

    At the moment I will be in my boot until at least week 9 and will have to see what happens at that hospital appointment.

    We had planned to go on a back packing tour of Vietnam and Cambodia this summer but my ATR has ruined that. So I have now booked us for a week in a Greek Beach Club that includes dinghy sailing, windsurfers, paddle boards and kayaking. I am a WIndsurfer so I will find it very hard walking by a set of sexy new boards and rigs everyday knowing that I can’t even try one out. To help soften things I plan to take a dinghy out for an hour or two on a couple of mornings (when there is less wind) and have a play. Nothing serious and with the backup of a rescue boat in case I get into trouble. I can strip down my boot and take the cloth cover off it so that I can get it wet.


  4. Could be good, Andrew. Watch out for eccentric loads like walking backwards, because that will almost surely be Too Much Too Soon. Normal concentric loads like walking forwards are much less scary. (Step into a dinghy with your OTHER foot in the lead!)

  5. Hi AndrewC
    Many thanks for posting your rehab, its been very useful seeing how an aggressive rehab can work and glad that it has worked.
    Quick question on the boot settings, as have had the square root of diddly from my doc re the boot.
    1. Would you do the “fixed” posn at just 0 again? (I have just moved to a boot after 9 weeks in plaster!! I know dont tell Norm! Week 10 had settings at 20-30, then planning 10-30 and then 0 -30).
    2. At what stage did you go below the 0 setting? ie into dorsiflexion territory?
    cheers Hoppy
    P.S. You are definitely a celeb - known as that windsurfing bloke on a couple of the blogs!

  6. Hi Hoppy

    I set the boot up as per your regime. I did not go below a 0 degree setting. But moved my settings by 5 degrees per week so over the 6 weeks in the boot I went from 30 - 0 degrees.



  7. AndrewC
    Got it - many thanks for the quick reply.
    Cheers Hoppy

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