Advice on weight-bearing appreciated

I’m confused. Now I’m in a walking boot - 5 weeks since non-operative conservative treatment, but a week earlier than my doctor would seem to have liked - I find I can get about pretty well with one or two crutches - and occasionally without any at all, but I am being very cautious as well. My assumption is that as long as I don’t put the tendon into tension I should be pretty well ok, but putting under a bit of compression shouldn’t do it any harm? Not getting any pain in the tendon at all, but perhaps a little under my heel because of the slight elevation of the ankle in the boot. Also I assumed I could take the boot off at night and do so - but I see on some blogs that the wearer is told to keep the boot on in bed. Why should that be? Any advice on weight bearing would also be appreciated - i.e. how much? Thanks.

8 Responses to “Advice on weight-bearing appreciated”

  1. seems like many are at least PWB at 4 weeks… I was NWB until week 6, then FWB… started this gradually (walking w/assistance of crutches, but was walking w/o the crutches by the 3rd day of FWB… best advice i can say is to take it slowly/gradually to get a feel for how your leg/body reponds to the gradual increases in weight. i took my boot off for sleeping, though got my boot at week 6 so healing was further along. haven’t had any problems w/this, though feels wierd and very vulnerable the first night or 2.

  2. Many thanks - thats pretty much exactly the way I feel. Tendon isn’t seemingly giving any adverse reaction to either partial of full WB. Some nervousness re taking boot off at night - but not while in bed. its only seems scary if I wake up and need to go to the bathroom. Still have hired knee scooter so use that to prevent putting any weight at all on bare foot, but I’ll prob send that back end of next week. I assume one could go barefoot to the bathroom being utra cautious but haven’t tried that yet - way too nervous!

  3. It ishould not hurt you at this point of your healing to walk in the boot without crutches. You can do what is call weight bearing as tolerated. If it hurts then don’t do it. Your tendon is protected while you have the boot on. Regarding sleeping with or without it. It is not advisable if you are a rough sleeper. Your foot could get caught in the sheet as you turn and push it into dorsiflexion or you could get out of bed quickly in the night and stumble. You are tempted to go to the toilet at night without it and could trip. To be honest, I just couldn’t sleep well with it on so around week 3 I took it off and finally had a good nights sleep. It stayed beside the bed and I never left the bed without putting it on. I had a few spasms at night and they gave me some concern but there was no damage done. I am not advising you follow my lead but at 5 weeks there is less chance of something bad happening while you sleep. Some people are in 2 shoes by then and my elderly father took his boot off completely the other week after only 6 weeks non-op. As always, the choice and risk is yours.

  4. I am in a boot 4.5 weeks post-op. I am suppose to PWB but really don’t know what that means,so I don’t do it. My surgeon assures me everything is great but I am too nervous. I sleep with the boot on as directed by my surgeon and I do it because I would be ticked off if I damaged it while sleeping!
    I’m also seeking any advice on what to do. All I think about is what if…and I know that is no way to live but it is how I feel. I was a very active person beforethis injury and Now I just don’t even see myself walking again.
    I guess I’m confused too…

  5. Becky-
    It is important to start the PWB process. So, here’s a few tips to get started:

    1) Start sitting in a char (one that you can put your legs under). Try resting your foot (in the boot), flat on the ground. Put it out in front of you a bit, and rest on the heel. Tuck it under you a bit, and rest on the toes. Get comfortable letting the weight of your leg - or if needed, just part of the weight - resting on the ground.

    2) Next, start out on the crutches as you have been. You’ll be going: crutches, (good) leg, crutches, (good) leg,… Now when your crutches go down- simultaneously touch your boot to the ground. You can try “flat”, or try tapping your toes. You’re not bearing weight on it yet- your just touching it to the ground. No harder than when you were sitting in the chair. All your weight is still supported by the crutches.

    3) Next up, is rolling your foot. So- just like before, you’ll touch your foot to the ground, taking all your weight on the crutches. But, now, touch your foot slightly in front of the crutches, on the heel of the boot. Leave it on the ground as you come over it, letting the sole of the boot roll from the heel to the toe. Again, your just barely touching the ground.

    4) When you’re comfortable with the last step, next up is to put a tiny bit more pressure down. Maybe the progression is from barely touching, to relaxing and letting the weight of your leg rest on the boot as you roll over it. It shouldn’t hurt.

    5) By now you’ve got the hang of it. Over the course of (probably) a few weeks, you’ll be putting more and more pressure down; and one day you’ll realize you don’t need the crutches anymore. Welcome to FWB.

  6. Thank you so much ryanb, that is the best info in regards to PWB. I will start right away. With the information you have provided will give me the confidence to do it, wow I feel so much better. I have been so frustrated with this injury and with that frustration it has led me to be so nervous about re-rupturing.
    I have been taking my foot out of the boot and moving it back and forth, should I not be doing that?
    Should I just stick to PWB in my boot?

  7. Taking it out of the boot and moving it back and forth is probably a good thing. I used to prop my foot up on a pillow, and try to draw out the alphabet with my toes (moving it in all directions) while watching TV. But, until told otherwise, don’t force the motion by pulling or pushing on it - say with a rope or towel. Moving it on it’s own is called “active” mobility. Tugging/pushing on it with something external (to stretch) it is called passive. In the early stages, active is good- if your doc wants you to do PWB, you’re certainly ready for some active range-of-motion work. Passive work will probably start with PT, and you need to be very careful with it; for lots of reasons.

  8. Thanks again, I certainly appreciate the information.

Leave a Reply

To prove you're a person (not a spam script), type the security word shown in the picture.
Anti-Spam Image

Powered by WP Hashcash