Four weeks to the day after surgery and I’m now in a boot - DeRoyal Pacesetter Air Walker. Getting the cast off yesterday was a thrill. Seeing my ‘peanut’ for a calf, however, was a reality check. Thanks to reading other posts on I knew not to expect much (thanks alfia). I will use the crutches for at least the next couple of weeks while I get more comfortable with the boot, put more weight on the Achilles, and start PT.

For those about to get the cast off, be warned…you may feel ‘pin pricks’ on your heel as you start walking around, even when you’re not putting much weight on your foot. I was told this is normal as the foot starts to figure out how to be useful again. Anyone else have comments on these ‘pin pricks’?

Something to noodle on as well… I decided to sleep last night without the boot on. Probably not the best idea I’ve had, I woke up at least 5 times worried about the Achilles. Tonight, the boot stays on, and hopefully I’ll sleep.

Next goal, get in the pool!


28 Comments so far

  1. sfcat on January 21, 2009 12:27 pm

    Pin pricks and pulling…yup. I got them too…and still do. I recommend getting something like Icy/Hot patches (as long as you’re not allergic to menthol or the other stuff they have in it), and wrapping one around your heel and where ever else your calf/leg is sore. It helps relieve some of the pain at night. I didn’t use them my first time around and am grateful for them this time around…I’m taking much less pain meds now than I was in ‘07.

    As for sleeping with the boot…do it. You’ll be glad you did because it keeps your tendon stretched while you sleep, you won’t wake up to a sharp pain because your foot flexed and tugged on your tendon (although this happens to me even when I have the boot on…it’s much much much less severe on the pain meter), and you don’t have to worry about bedding getting twisted up around foot…and then a tug on bedding unknowingly…eek! That has happenned to me, although I was awake and it was a slight tug and therefore didn’t cause reinjury, but yeah, wouldn’t want you to experience that if you/I can help it.

    Oh…btw- don’t know if you care, but I’m researching night splints as an alternative to my boot while sleeping. Because the boot is rather bulky and heavy…I purchased a Futuro brand splint online and am waiting for it to arrive. I’ll post my review on my site at

  2. georgie on May 8, 2009 6:26 pm

    While you are on the subject of pain I would love to know if my experience is common. I had terrible pain when having my boot (with 30cm heel wedge) fitted after six weeks in plaster. Now two days later I have some pain, still have a swollen foot and have a small dark bruise just above my heel. I am worried the achilles might have re-ruptured. The Orthotist who fitted the boot said it was not possible. As far as sleeping goes I am without boot on doctor’s advice and it is great.

  3. patty on January 28, 2010 2:57 pm

    i am in a air boot cast and it is horrible my foot burns and swells all the time the boot is on , i tryed sleeping with the boot 4 nights and got very little sleep . I have gone to the air splint . i wonder if i am allergic to the boot ??

  4. normofthenorth on January 31, 2010 12:40 pm

    I’ve gone the non-surgical route this time (2nd ATR, 8 yrs ago I had the surgery). I’ve been in an Aircast boot for most of the last 7 weeks, though I just switched to a hinged boot that I still had from 8 years ago(!). I’ve got it locked in neutral position with no heel lifts (which just got removed about a week ago — see my blog if you care!).

    My skin didn’t suffer badly, but it didn’t love being plastered against the foam of the Aircast boot. Being able to shower barefoot helps, partly because it lets the boot air out a bit, and you can also clean it up some. (I started that at around 4 wks — but remember that I had no incision to worry about.)

    The other thing that’s cheered up the skin on my leg is when I started wearing a long sock on my bad foot/leg. Obviously, putting a tight sock onto a foot with a recently torn AT is a delicate operation, but if you dare, and you’re careful — not to EITHER dorsiflex the foot OR to use your AT to hold your toe down while you pull it up hard with the sock — it is much more comfortable and “normal” to have a sock between you and the boot, than not.

    Yes, I think most of us experienced “pins and needles” when we first put weight on our bad foot after weeks of NWB. I compared it to little electrical shocks. I think it’s a good “speed limit”, i.e., make your WBAT (Weight Bearing As Tolerated) stop short of that point.

    I also experienced some discomfort right under my heel, as I progressed to FWB and also afterwards. After I walk around a lot in the boot, my heel is sometimes uncomfortable or mildly pained even now, and I’m scheduled to come out of the boot soon, at 8 weeks in.

    My current sock is a thick ski sock, which also adds a bit of (helpful) padding under my foot.

    I’m still sleeping in the boot, ’cause both of my health pro’s say I should — I’m following the protocol from the Univ. W. Ontario study that recently found that non-surgery works just as well as surgery, and that’s what they did, so that’s what I’m doing. The worst part is the contact between the boot and my GOOD foot while I sleep — mostly on my side, either way.

  5. Runner on July 18, 2010 9:46 pm

    I fractured my fibula two weeks ago and and wearing an aircast boot. It was swollen for several days and even now when I don’t wear my boot at night. I saw two doctors and one ortho. The first doctor said I don’t need the boot when I am sleeping. The second doctor said I do need the boot when I am sleeping.

  6. carol on November 27, 2012 3:47 pm

    do you sleep in surgical boot after hammer toe operation? I’m afraid the pins sticking out will get tangled in bed linen

  7. Jacqueline Mackinnon on June 26, 2016 3:18 pm

    Need help please
    Just started full weight bearing in my hinged boot angle still at 10 degrees for extra safety according ortho. Was 7 weeks 30 degrees then moved twice in 14 days to 10 degrees. I have tried full weight bearing but feel or hear a clicking sound which worries me, not really pain just tightness then swelling which goes down quickly after icing and elevation. I can still move foot well in circular and flexing could it be my knee or ankle clicking after not being used or should i be worried btw my husband hears it too.

  8. Angela on July 9, 2016 1:16 pm

    Broke my 5th metatarsal. Have been in the air cast boot for 17 days and am experiencing some significant calf pain. It actually hurts more than my foot does now. Any thoughts? Have read about DVT but don’t know if I’m just over thinking it? Has anyone else had this?

  9. Suzy on July 19, 2016 3:53 pm

    This has been so helpful, thank you all for sharing your experiences.
    I’m having positional pain when my foot is up or perpendicular to the floor.

    I had a tailors bunionectomy at the fifth metatarsal -also constellation of complex buspar cysts which all had to be removed) also w some complications in surgery requiring a last minute pin at the pinkie toe when the bone broke off while putting in a second permanent screw. That was 4 weeks ago. I have one screw and wire that’s permanent and a pin that will need to come out in the next few weeks.

    Today saw the MD and had a lot of bruising so he wants me in the boot 24/7 x 1 week - not allowing to even adjust the straps. I bruise really easily so idk if this will help.
    The pain is most when I lift the boot up to step rather than when I am partial weight bearing. I’m using crutches and a knee walker. The knee walker was fine w the reg cast but now the boot add weight to the heel and that position also is more painful than when I stand on it.
    Anyone ever had this?

    I did buy an even up and it saved my other hip and leg so much pain- it’s so worthwhile. Also I bought the 3″x25″ stocking eye bandage to change out when my foot was hot and sweaty in the boot (ah summer time).
    Thanks if you can help.

  10. Verdean Zimmerman on May 22, 2017 9:37 am

    I had Triple Arthrodesis foot surgery Feb. 16th 2017. I am on my 14th week and going to start putting 75 lbs. weight on it. I already had 50 lbs last week and next week will be 100 lbs. and than full weight. My info is I than start to wean off of the boot. This week I put shoes on both feet for the first time at home and feel so much better walking around the house with my walker. I understand to wear the boot going outside but why in the house. Is it for protection or is there another reason for wearing it. My Therapist asked me if I had tried putting on a shoe and at that time I didn’t. I am going to ask him this question tomorrow when I go back. Did anyone have this surgery and when did you put shoes on?

  11. Jen on June 16, 2017 6:36 am

    Had foot surgery 5/5/17…plate and screw ..break at 2nd and 3rd metatarsal plus bone chip that was fused…I stayed in cast about 2 I’m in boot…foot feels great and looks wonderful after what it was like before surgery. Next Tuesday I go back and have xrays and he said possibly go to 30 to 40% weight bearing and PT.
    My question is ..will I be able to wear regular shoes at that time?…and will I go to crutches (on a knee scooter now) or a cane?


  12. cserpent on June 16, 2017 12:14 pm

    @Jen - If it is PWB then you will probably be using 1 crutch to reduce the load on your injured foot - at least that’s what I did when I was at that point. I did have a period of time where I was told to walk 25% of the time and do NWB the rest of the time, then it changed to walk 50% of the time and NWB the rest. So - not sure if they mean walk part of the time and then do NWB or if they mean walk all the time but use a crutch to reduce the weight on the injured foot. You’ll have to check with them as to what they mean.

  13. Beth on June 20, 2017 9:07 am

    I am 5 and a half weeks post surgery on a spur removal embedded in my Achilles’ tendon as a result of extensive Plantar Fasciitis. Yesterday I was allowed to do partial weight bearing and progress to full weight bearing as comfortably allowed in my boot. I was so excited to be more mobile after such a long time, but I quickly discovered it’ll definitely be a longer process than I thought. I can barely handle 20% weight using crutches or a walker because of the sharp needle-like pain throughout my foot, and as a result I’m having to do very short trips bearing weight across the house, but use my knee scooter for longer trips or trips in public. Anybody have any advice or any idea how long this will last? Does it steadily improve daily? I’m trying not to get frustrated, but it’s difficult. I’ll be undergoing the exact same surgery in November for my left foot, so I’m a little freaked out.

  14. shell37 on June 20, 2017 9:41 am

    Hi Beth! Check out my blog post from April 26, 2017 titled “Promising 4.5 week follow up with the surgeon”. Lots of really good comments and tips there about this. The needles are normal, they do go away, and partial weight bearing does kind of magically get better by itself! It took me 4 full weeks to transition to full weight bearing. Much slower than most, but that was my reality. And then when I started weaning out of the boot I had to go back to the crutches off and on for 2 weeks or so. Even now, at 12+ weeks post Haglund’s Deformity removal and Achilles repair, there are times I should probably grab the crutch to offload a bit, but pride and stubbornness usually take over! Good luck. It will get easier.

  15. Beth on June 20, 2017 10:33 am

    Thank you Shell37! I’m new to this site and kind of stumbles across this post via google search. Is there a link to your blog post??

  16. shell37 on June 20, 2017 12:21 pm

    Beth, I put in my link which is awaiting moderation because of the link. If you go to the Main page, you’ll see our comments down the right hand side. Click my name to go to my blog, then just click on the calendar on April 26 to get to that post.

  17. shell37 on June 20, 2017 12:38 pm

    Or try copying & pasting this:

  18. Ternisa on August 6, 2017 6:18 pm

    I had ankle surgery go back to doctor Friday 8/11/17 to get cask off and then boot. My question is will my foot still swell and how long will this progress take because I am miserable.

  19. Diane Mozzone on December 22, 2017 7:04 am

    I broke my 5th metatarsal exactly 8 weeks ago. Experienced a lot of electrical shocks at bottom of foot. I had an air cast on which was much better than a cast. My break was bad but it is already getting better and the doctor told me go heel to toe in the boot. I’m 66 years old, and feel this is the best I could do. I started walking like that with a little fear but doing exceptionally well.

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  21. Karen on September 20, 2018 7:29 pm

    Hi I broke 3 bones in my right ankle did surgery 1 week later.
    After one week my stitches was removed had no swelling at all
    I kept my foot elevated and ice plenty but the doctor wanted me
    In boots and therapy the next week I thought this was way too
    Early I’m very worried as the boots is giving me more pain than my cast
    And it’s way too heavy for my skinny foot. I will be calling my doctor tomorrow
    As I am not getting any sleep! Please is this normal?

  22. cserpent on September 20, 2018 11:27 pm

    I could get no sleep with the cast and I got a LOT more pain from the cast. For my surgery (bone spur) my doc gives me the boot for the day and a night boot (plantar fasciatis boot) to wear while sleeping. I don’t know if that would provide the right support for a broken foot. I can’t walk in the night boot, it just keeps my foot at 90 degrees while sleeping.

  23. vin lookup on January 9, 2020 1:24 am

    Oh, great, your article provided me with useful information and a fresh perspective on the subject.

  24. chiara on February 8, 2020 1:15 pm

    Hi I had my surgery Jan 20 2020 I am 3 weeks in I was given the boot to wear . do I wear the boot at all times ,My foot is healing with out the boot I was told that I did not have to wear when sleeping

  25. chiara on February 8, 2020 1:15 pm

    Hi I had my surgery Jan 20 2020 I am 3 weeks in I was given the boot to wear . do I wear the boot at all times ,My foot is healing with out the boot I was told that I did not have to wear when sleeping

  26. chiara on February 8, 2020 1:16 pm

    Hi I had my surgery Jan 20 2020 I am 3 weeks in I was given the boot to wear . do I wear the boot at all times ,My foot is healing with out the boot I was told that I did not have to wear when sleeping

  27. chiara on February 8, 2020 1:16 pm

    Hi I had my surgery Jan 20 2020 I am 3 weeks in I was given the boot to wear . do I wear the boot at all times ,My foot is healing with out the boot I was told that I did not have to wear when sleeping

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