I’m still in the boot at 10 weeks. My next ortho appointment isn’t for 4 weeks. Looking at the stats on http://achillesblog.com/atrpt.php, that puts the doctor at the heavily conservative end for switching to two shoes. I called my doctors office for their thoughts on getting more aggressive. The holiday week is not the easiest time to get ahold of a surgeon. I may get an earlier appointment, may not. We’ll see next week.
Should I just liberate myself? That is the question of the week. The only reason I haven’t ditched the boot on my own is that this time period (6-14 weeks) seems to be exactly when re-ruptures occur.
Is anyone else holding onto the boot past 10 weeks?
Progress:
- I can walk around fine with boot. I can actually manage a 2-3 mile per hour stride in the boot for almost a half mile. That hurts, though. I’ve done as much as a mile with the help of one crutch.
- I do get pretty awful heel pain if I walk around too much (20-30 minutes brisk walking) It goes away rapidly.
- Doing my PT exercises rigorously.
- I’m at 10 degrees past neutral.
- I rarely wear the boot unless I need to walk somewhere. Actually I sometimes don’t wear the boot inside at all.
- I can balance 40 seconds on my bad right foot, a couple hours on my good left foot
Off topic
Played Frisbee with my 4 year old tonight - something I haven’t been able to do in months. We’ve been playing Frisbee since he was 2 and a half - the disk is actually easier than a ball. In the shameless bragging department, he rode his bike to the park without training wheels. I can’t quite run or lunge to catch his wild throws, but it worked out just fine. Occasionally the frisbee came close enough for me to catch. 15 minutes icing the heel and calf afterwords, but entirely worth it!
10 comments ↓
Cliff–I would say do what feels good, as your body is your best indicator. Having been on the aggressive side and going to 2 shoes (with 2 heel lifts on my ATR side), I have enjoyed some more freedom but have had to be more careful as I have no boot protection.
Cliff, you sound at a similar stage to me, I’m seven weeks on, with a boot that I only wear to go walking outside. In the house I normally don’t bother, but I do need to be careful and a few times I’ve had some pain. My next appointment with my consultant is Jan 14th. He told me to bring shoes for both feet as I should be able to give up the boot for good. This will be eight weeks after the injury. I see my consultant every fourteen days for a fifteen/twenty minute chat. He has always said I should do what feels OK to me, as it is my foot; any pain is a sign to ease up. However each case is different. I’ve had conservative treatment and I’m 52 years old. I did my injury playing squash. I’m always worried about a re-rupture but I don’t think being over careful will necessarily help. Four weeks seems a long time to go between appointments. I think I would want to discuss things with my consultant as early as possible, can you talk over the phone with your doctor, is there a specific reason you need to be in the boot for that amount of time or do you think your doctor is just being cautious?
Hi, I would appreciate any advice from anyone…I am in week 8 post-rupture, have not had surgery, am in my third cast with my foot almost at a normal angle and FWB. I get the cast off next week and the Dr says I do not need a boot. My concern is that the consultant originally said I would need a boot and I suspect it is just the NHS can’t afford one. I am happy to buy one, but wonder if it is necessary. And if so do I need a moving or fixed one? Does anyone know? Thanks, Sara
jsdecody, I don’t think anybody “knows”, but I’ve got some experience and some opinions. If you can afford one, I’d get a hinged boot, even though you’ll probably only use it for a few weeks, and intermittently during that period.
I used a Donjoy MC Walker, which is fine. There’s also (online) a few much less $$$ imitations that look identical and probably work identically. And the new-fangled VacoCast (or VacoPed in the UK?) is getting raves from almost everybody who’s used it.
If you can buy one that you can return unused, that might be good, just in CASE you’re lucky enough that you feel great in shoes or bare feet after you’re released from the cast. But since the casts haven’t given you a chance to exercise or get PT, or even stand in the shower barefoot, etc., that’s very unlikely.
Your injured foot has probably “forgotten” how to “be a foot”, in ways that aren’t directly related to AT or calf strength. While it’s remembering, you’ll be nervous, slow, and at risk of tripping or twisting an ankle, etc., which could be a threat to your healing AT (among other body parts). A hinged boot, “stopped” at “neutral” but free to flap toe-down, will let your calf-and-AT work at walking and striding and such, while they’re still protected. You’ll want to do some exercises barefoot, and maybe walk around the house barefoot or in soft squishy shoes. (Many of us loved Crocs.)
But if you’re going out to take a bus or a subway, or walk through Piccadilly or in the snow, the boot will give you confidence, and it’s not just psychological.
Many ATR patients who were casted made the transition to 2 shoes and survived fine. Another trick is to get 1 or 2 crutches (or a cane) out of the cellar. Those “sticks” can be used for support, and they also present a “flag” that keeps rushed passers-by from bumping into you or tripping you. Me, I like hinged boots, and I’ve enjoyed using one through TWO ATR recoveries — both sides, and both approaches (op and non-op)!
BTW, the old “conservative” non-surgical approach — which always used casts without boots, exercise, or PT — usually demonstrated a re-rupture rate in the 12%-18% range. That’s much higher than post-op, and also much higher than non-op studies that used good modern in-boot protocols, like bit.ly/UWOStudyPub .
Those aren’t miserable odds, without a boot, and you’ll probably escape regardless. But you can almost eliminate that 12%-18% risk with a good boot.
BTW, jsdecody, cliff and andy and steve posted their comments almost 2 years ago, so they’re probably out running and jumping now! If you’ve got time and energy, start a blog of your own and several people will respond. Alternatively, many people post notes on the no-name topic-based threads that are linked from high on the Main Page.
Good luck, and good healing!
Hi jsdecody, I saw your post. I’m about 2 weeks behind you on exactly the same treatment – non-surgical, 3rd cast, foot almost at normal. However, I’m still completely NWB – are you walking in your cast?
I’m assuming that you’re in the UK?
My doctor is also telling me that I don’t need a boot and can go straight into shoes with heel lifts. I am also thinking about buying my own boot. I’m struggling to find suppliers of Vacocast or Vacoped in the UK, but there are suppliers for Norm’s Donjoy MC Walker which is an adjustable boot. It seems to be around £150.
I’m going to ask my consultant about it and will let you know how I get on. Do you fancy doing the same thing and we can compare notes?
Hi Norm, thanks loads for that advice, I think I will definitely try to get an MC walker. Very helpful - much appreciated! (Have been too technophobic to get my own blog but have enjoyed reading yours!) Thanks again, Sara
Hi Aileen, great to hear from someone in similar situation to me. Yes I have been FWB for about ten days now since they put me in the third cast, getting easier all the time and has improved my life no end. Love to hear what your consultant says etc. Think I will follow Norm’s advice and get a walker regardless of my Dr’s opinion (he always seems too busy to chat anyway)! Let me know how you get on, Sara
Can anyone tell me the difference between a ROM walker and an MC walker? Does it matter which one I buy? Also am a UK size 7 - will I fit into a ’small’?! Very grateful for any info….Thanks! Sara
Not sure about the difference, check out hteir website. I would get a medium, I’m a uk 7 too and in the medium, it fits perfectly.
Thanks! Will go for the medium then x