May 01 2015
9 weeks- two shoes- difference of opinion?
I saw the PA at OS office today. He said everything looked good and gave me the go ahead for two shoes, as my last wedge was removed from boot on Wednesday and my foot is easily at neutral. However, when I saw PT on Wednesday, he said I would be in boot for another 3 weeks, though he told me my foot was about 2 degrees beyond neutral. I told PA that my PT said I would be in boot for another 3 weeks- which the PA thought was very conservative and not required. So who knows best the PT or PA at the OS office? We kind of settled on two shoes in the house and boot outside. I asked PA if I needed boot on steps in house and he said no. Not sure if I am ready for stairs without boot or not?
Anyway I tried two shoes when I got home and it felt ok. Obviously limping and tentative but no pain. I then tried just walking in my bare feet and everything also felt fine.
One thing for sure- I am sleeping without my boot for first time tonight and showering standing for the first time in 9 weeks. Progress and happy 
6 Responses to “9 weeks- two shoes- difference of opinion?”
You said: “One thing for sure- I am sleeping without my boot for first time tonight and showering standing for the first time in 9 weeks. Progress and happy :)”
OMG I know how good you feel about that, really I’ve been there!!!!!…ha ha
Your PT should be following your particular OS protocols if they work in conjunction (some do & some don’t), if not your PT is just going with standard protocol. The PA should know the OS he works with protocols which would mean maybe your OS and PT don’t work together?
Anyway you said: “We kind of settled on two shoes in the house and boot outside.”
That is perfect, it’s not really a problem. Some just stay in the boot until 12 weeks and then into two shoes and some go from the boot to two shoes as early as 6 weeks, and I’ve even seen going from a cast to two shoes with no boot at all. It’s all over the place. I just wrote up in a few places today (Edhedz & glenskieus’) how you can transition into two shoes using the boot and that sounds perfect for you…we have been on pretty similar protocols all along.
If I remember correctly I didn’t start climbing stairs at home until week 12…first my PT had me do stair exercises for a good two weeks daily before I attempted them without the boot. Ask your PT to get you ready for stairs…I had to climb up and over a step at PT to get the ROM for going down steps and at home I used a pile of textbooks that I could adjust the height of as I progressed. Also when coming down you can use the what I call the “norm” trick of leading with the repaired foot and then hanging your toes (the repaired foot) over the edge and bringing the good foot down to it and repeat. This takes the need for that extreme dorsiflexion away…eventually that will come. I don’t think I climbed down stairs normally until over 16 weeks…maybe not until later…I’m forgetting, I’d have to go back and find some old posts. Going up is pretty easy though.
Also, you are LUCKY to be able to walk barefoot…many lose the fat pad on the heel and it’s like pins and needles for weeks. I had to shower standing on a facecloth because my bare foot was so sensitive without that fatty pad. YAY YOU!
Let me know if you have specific questions.
Donna - thanks for the response. No, the OS and PT do not work together. As you may recall- I had surgery in Florida, and then transitioned to an OS in NJ ( a friend of mine works in an OS office about an hour away). However, unfortunately the NJ OS left the practice- and I have been assigned only to a PA for follow up care. Fortunately, I have had no issues with the recovery, and figured I would depend mostly on my local PT. He has come highly recommended and seems good. So you are probably right, the PT is just following standard protocol. I will discuss with him on Monday. Good idea- about working on steps in PT without boot before trying on my own. I will also have to see about my current shoes/ sneakers to determine how they feel against incision, especially as I spend more time in shoes. Yes, I think my heel pad is ok- as I have not yet noticed that sensitivity while standing/ walking barefoot.
Hi, I’m almost at the same stage as you, had surgery 8 weeks and 5 days ago. I cam out of the boot four days ago, having removed the last wedge a few days before that. The OS was very pleased with the recovery and I could go just beyond neutral. I saw my PT for the first time on Wed, and I am no longer using the boot on the advice of both, so walking slowly and carefully, taking stairs slowly with the good foot leading and the other coming to the same step. So far so good and really pleased to have ditched the boot, even though I’m the slowest walker in the park!
I came out the boot 9 weeks post surgery and didn’t use it again although I was told to use it if required.
Walking was VERY slow at first and I took a crutch with me when venturing out by way of explanation for my slow pace.
Just be patient, don’t be tempted to rush and end up limping and wear the boot if you feel that you need to do so.
Welcome to the first stage of regaining your freedom and independence.
Hey Linda, baring no complications a PA is fine for the few followups you’ll have left…you really are in the hands of the PT now so I’m glad he’s highly recommended and you like him. He is right on with 12 weeks in the boot as the standard. It’s based on re-rupture rates falling off significantly 12 - 16 weeks, they are then small up until 6 months and almost non existent statistically after that…at least for a break in the same location. Wean off the boot at a rate that feels right to you, as you become more stable in two shoes you’ll need the boot less and less, especially since it’s summer. I weaned off mine over the winter and probably wore it longer due to the ice/snow outside. Hopefully you won’t have the shoe issues many of us do, if so I’ve got lots of recommendations on ways to handle it. Even so, shoe issues are usually only temporary. You’ve definitely got this! YAY you.
Walking was VERY slow at first and I took a crutch with me when venturing out by way of explanation for my slow pace. Welcome to the first stage of regaining your freedom and independence.