first appointment, boot advice

met with doctors assistant yesterday to remove splint and clean up incision. It looked really good, minimal swelling, no redness. The scar was a lot longer than I’d expected, looking forward to next weeks appointment with surgeon when he gets back into town to see what happened during surgery and be updated. I’ve been very diligent the first week with icing every three hours or so, keeping the foot elevated, lowering it often to send blood to the area for repair. Taking supplements and being healthy. So far I’ve made no mistakes bumping the leg and have managed not falling down the stairs on crutches. A couple close calls middle of stair case not sure if I’m going forwards or backwards!

Does anyone have any advice on boots and have any experience using the Vaco boot advertised on this site? During yesterdays first visit they were going to fit me with their in stock air boot. I was not sold by the docs assistant explanation of the boot, their method of inserting removable lifts beneath the heel to give angle to the foot and his general attitude "this is all we have". Once you put it on it’s yours so I showed the Vaco boot to the doc and mentioned I’d be purchasing this one since insurance is paying for it.  They put me back into a splint for the week until it arrives. I really like the features of the vacuum boot, adjustable ankle angle and weight bearing markers, along with sales pitch of recovery time 25% shorter! Any good or bad comments about this boot?

8 Responses to “first appointment, boot advice”

  1. Hi Chippy,
    Great to hear you had a successful check-up!
    Quite a few of us have bought the Vaco Cast. I got the Vaco Cast Pro, $ 299 plus shipping and I found it to be far superior to the boot provided by my surgeon.
    In my case the Vaco did not result in faster healing when compared to other ATR victims here who were injured at around the same date as myself. However, the comfort level made it worth every penny, specially for sleeping. The boot is light, the lining is soft, and the sole removable and washable.
    Other than that, be careful with the stairs and always wear your boot.

  2. thanks for the feedback on the boot. hopefully insurance reimburses me for the cost and it works out well. Apparently they have a zipper bootie that covers the lower portion of the boot and toes that comes in grey. Ordered one of those for our upcoming trip to Paris.

  3. Hi Chippy,
    I found the vacocast really good but had a few issues especially with the liner once I started full weightbearing on it. See my page on boots and casts

  4. I’ve seen more raves and fewer complaints about the Vaco than any other boot. Almost 100% “like” and ~90% “love”, I’d say. I doubt the speed claims, though. But having a hinge in the boot is great around week 6-8, when moving toward two shoes. Except for that, simpler (& <$) fixed boots like the AirCast have produced excellent results, with and w/out surgery — e.g. in the UWO study.

  5. Second week, stitches out. I am so pleased with my progress of the first two weeks. I’ve been so diligent with icing every couple hours, getting leg down regularly, sometimes adding some pressure to the sole of my cast to bring blood with nutrients and oxygen to the repair area. Raising again to drain and keep swelling down. No accidents or bumps to set me back. Taking supplements every day, keeping very healthy and eating well to give my body every opportunity to mend.
    Doctor removed stitches yesterday, the ankle has very minimal swelling although there is some good bruising and numbness on the outside of my ankle. I think the nerve needs some further repair and sends sharp pains sometimes when upset. It’s slowly coming back. I’m in the Vaco boot with partial weight bearing, the ankle setting is on 10 degrees for first week. Adjusting boot cant to 0 degrees second week, then we go to full weight bearing week 4 without crutches.
    This morning started with some very light stretching exercises by hanging my leg low over some stairs, this gives my calf muscle a stretch and feels really good. I push back my straight leg giving my quadriceps a good stretch in the front. Managed to get out of the house getting in some walking exercises with crutches putting some weight on the boot in a rolling motion over the Achilles arched sole. Again it feels really good to get some pressure on the leg and bring some blood to the area. I’m feeling very strong. Resting up now and icing.
    Thanks for the feedback on the boot. I think it was a good decision to purchase that one, hopefully insurance pay’s for it!

  6. Chippy, you are clearly on top of your recovery, excellent! A hinged boot like the Vaco Cast is the right way to go. I used a different brand, probably not as comfortable as the Vaco Cast but with an adjustable hinge and a molded sole to facilitate a heel to toe gait.

    One thing I would caution you on is too much tendon stretching in the first few weeks of recovery. You don’t want the repaired tendon to heal too long, if it does you will not recover full use of your calf muscle. Google “healing long” on this site, you will find a lot of info about it.

    Ask your physio about eccentric contraction, a bit early yet in your recovery but important. I wish I had started on it earlier in my rehab.

    So you suffered your accident skiing, heard that it can happen but not too common, so I’m told anyway. Well, if there was a ski season to sit out this is the one, certainly in the east.

  7. Hey jjniss; recovery is going really well although the incision is a little pissed off right now and tender. I’ve been over doing it a little by dropping the crutches in less than a week in the boot! I have felt so good that I can get around easily without the crutches or pain. That is until my leg has told me to back off leading to a good rest day and back to crutches.
    After reading your warning on tendon stretching and healing too long, I called my doc after reading up further on past blogs. Thanks for that info. I don’t see where I would have tendon stretching when I’m in the fixed position in the boot and do not walk anywhere without it. I never put any pressure on my foot when it’s out of the boot. The other thought is my surgery was completed with fiber wire sutures bringing the tendon together. While there is a small amount of forgiveness I would think these permanent sutures would stop any long healing problems at the healing site. I’ve commented too much now without knowing more. I will know more next Monday after meeting with the surgeon.
    Your right it’s not a good ski season although it’s dumping today. I fell in a deep bump and was wrenched forward and backward over my boot with the binding not releasing. This must have stretched it that much to rupture it. The Achilles did give me some previous warning signs training last summer for a tuff mudder event. Now I know what it all meant.
    best.

  8. Chippy, healing long is a big topic on the blog, probably because we’re all so obsessive about the injury and recovery :) Goal is to get full range of motion back while the tendon is healing without overdoing stretching exercises in the first few weeks of treatment.

    About your sutures, don’t know if fibre wire is typical, sounds pretty cutting edge!

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