Weaning off the boot
Had my weekly physio today and have now begun the process of weaning my achilles off the boot. I have new exercises - standing with support on my AT leg - god the floor feels hard - building to no support. Using a theraband to develop the stretch in my achilles and build flexibility in the ankle joint. Also cleared to sleep out of boot and leave it off for sections of the day. Also took my first barefoot steps with the aid of my crutches, all felt very weird and a little scary - but its the slow road to walking without my boot or crutches - hurrah 
November 23rd, 2010 at 11:13 am
Sounds like a good turn of events! Congrats.
How far out are you, 8 weeks?
Fantastic!
November 23rd, 2010 at 12:54 pm
9 weeks tomorrow since the actual ATR but feeling the light at the end of the tunnel is glowing a little brighter today
November 23rd, 2010 at 3:55 pm
Congrats! Another milestone passed! I bet you’ll sleep better without the boot, since coming out of the cast, I’ve made up for lost sleep and have been sleeping like a log. It does feel scary being on your own two feet after so long , but I’m willing to bet that you’ll make really fast progress from now on. I’ve found the theraband really easy to use, and I’m sure it makes a difference.
November 23rd, 2010 at 5:55 pm
Your “god the floor feels hard” takes me right back! The bottom of my bare foot was unusually sensitive for the LONGEST time! Crocs were great, barefoot on carpet was OK, floors were way hard, and God Forbid that I accidentally stepped on a little flat phone cord or a dropped piece of spaghetti — even COOKED spaghetti!!
November 24th, 2010 at 1:12 am
I am about to attempt the barefoot walk with the aid of crutches too. I must admit that i am a little wary of taking that step. Putting that boot away for good will be a milestone, and then retiring the sticks. Hope all goes well for you and i both. Paul
November 24th, 2010 at 6:20 am
Thanks everyone did my single leg stands today and managed 2 lots of 10 seconds with less sensation than yesterday. Also did some barefoot steps across the room but putting about 30% body weight through AT all felt relly good. AT is still tight - I do have some dorsiflexion but not enough for a comfortable step but the theraband seems to be working on that; little by little I seem to be getting there. It’s such a thrill to be standing on your own 2 bare feet and taking steps even with crutches at the moment. Also slept without the boot last night can’t say it was my most restful night but I suppose I just have to get used to it again. Keep healing everyone and thanks agian for your words of encouragement.
November 25th, 2010 at 6:18 pm
LL and Paul, you’re doing something that I never did! I became FWB, walking solidly on 2 feet, while I was in a boot. The crutches (and a cane) all got put away, except for a few exceptional activities, mostly showering (barefoot). The only time I ever crutch-walked barefoot was getting out of the shower and onto a stool. After I was FWB in the boot, my PT got me barefoot-hobbling from his main table to the station where the laser was set up, and I almost had a panic attack!
But eventually, approaching 8 weeks (and almost 4 weeks after FWB in the boot), I started padding around barefoot and in Crocs, as part of the “wean off boot” step.
There are a few separate “re-education” steps that your injured leg needs before you’re back to normal. One is to get used to carrying your full weight, and then some. That can all be done in the boot, while you’re walking around, walking on stairs, carrying stuff, maybe bicycling, etc., etc. By the time you can stand on one foot in a boot, you can do it in a Croc — except for the strength, flexibility, and balance, of course! But you can do it in a doorway, for example.
Building up strength and balance (including “proprioception”) gradually happens with time, and happens better with exercises, but I’m not convinced that crutch-walking on bare feet is either especially effective or especially safe as an exercise. If you need the crutches because you still can’t handle FWB on a bare foot, even on carpets or foam (or in Crocs), then I’d spend more days padding around in the boot until you’re fully FWB.
My fave protocol does suggest getting the crutches out again for a few days when you wean off the boot, but frankly that never sounded good to me. I got rid of the crutches between 4 and 5 weeks in (on schedule), and I didn’t want to use them again at 8 weeks. My solution included a hinged boot, set to hinge from neutral to full PF, so I could walk fairly normally (and VERY fast!) while still being protected if I fell forward or tripped. I even bicycled that way.
I’m not discounting the value of exercising and even stretching in bare feet (though DF stretching does make me nervous). But of all the exercises I got, did, and recommend, none of them included getting around barefoot on crutches, and the benefits are mostly lost on me.
Just my $0.02, as always.
LL, the beginning of your last post confuses me: “Also did some barefoot steps across the room but putting about 30% body weight through AT all felt really good.” If you made it across the room barefoot without crutches(?) that’s 100% on your injured foot, as is a “single leg stand”. Can you do 1-leg stands in the boot? For 10 seconds, or until the cows come home?
When you’re walking barefoot, one of the key variables is how far in front of your healing foot you step with your uninjured foot. Keeping your healing foot in front protects it from DF while it’s weighted, and stepping up to it and past it dorsi-flexes the ankle and stretches the calf-and-AT under load, so it’s a big deal. You don’t mention that measure. But when I started in 2 shoes and barefoot, that was the main measure that mattered.
November 26th, 2010 at 1:42 am
Norm
Just to clarify, i have been FWB in the boot(no crutches) for over two weeks and getting around well. I am able to FWB(in boot) on the injured leg. As you may see from my most recent page post i have been instructed to wean of the boot over the next week and get into 2 shoes. At no time
November 26th, 2010 at 1:59 am
did the surgeon ask me to use the crutches while practicing barefoot walking for the first time, it was a personal choice due to my hesitancy. Last night i first walked barefoot with crutches and later in the evening without. Today i have only walked barefoot without crutches. It is a good feeling. I am interested in your comment that people may find it more difficult to walk barefoot than in shoes(ie crocs). I guess i may have done this backwards and should have tried on some comfy shoes first?
Another question- at which stage does this site recognise someone in “two shoes”? When someone is exclusively in the shoes or when someone is able to walk in two shoes when they choose(ie boot on in adverse conditions)
Thanks for the notes on the walking.
p.s. i am off to get a pair of comfy shoes as i can now walk barefoot ok.
November 26th, 2010 at 2:54 am
Norm,
My protocol, which may differ from yours and others, but the one i will stick to, reads as follows:
Week 8 - wean off boot and return to crutches/cane if necessary, then wean off.
My interpretation of this is that when i remove the boot and start to walk again(barefoot or shoes) i may use the crutches as needed. As it happened i only needed the crutches briefly as i barefoot walked for the first time yesterday. Eventhough you state that the benefits of getting around barefoot on crutches are mostly lost on you i can state for others that the crutches were of a great benefit to me. They gave me confidence and the feeling of safety as i took my first few steps out of the boot/cast.
I find Achilles Blog very useful to gather information and invaluable for those words of encouragement from others.
Nevertheless, what works for one person may not work for another and as i said in a previous post on Aileens page this is sometimes a very personal approach to recovery with the help of your personal doctor.
I am very pleased with my rehabilitation especially since my surgeon gave me the go ahead to “lose the boot” next week, at least nine days ahead of schedule. N.b. I may return to crutches if necessary, then wean off.
I wish you all a full recovery. Paul
November 26th, 2010 at 4:07 am
Hi all, sorry for the confusion with my post. The 30% I refer to was with crutches. I, like Paul, have taken to crutch walking for support for psychological support rather than physical. I also can stand FWB in my boot and walk around like that with ease. However one leg stands barefoot is very different due to the slight variations of body positions as you stand which you don’t really get in the boot. But it’s coming along. I can now manage to walk around the house slowly without crutches or boot, but I feel so vulnerable. I’m sure that feeling will pass the more I do it. Thank you Paul for your words of encouragement, it’s great to have someone at a similar point. This cold snap of weather in the uk (nothing like our canadian friends I know) doesn’t help and I feel I’m a good few weeks off before I step outside without a boot!!! Good healing everyone
November 26th, 2010 at 9:08 pm
You are welcome LL. We are at the same stage. I too, am walking slowly around the house. I started barefoot a couple of days ago. Today i slipped my feet into a comfy pair of slip-on Clarks i purchased in England on my last family visit. I have no problem walking in them(slowly of course!) and find it easier than barefoot!
Regarding the weather, i have felt colder in Liverpool and Glasgow(when below freezing) than i have ever felt in Canada. The wind and the dampness bites. When it is -10 in the UK it IS cold. Is it just me or has it been snowing more than usual in the UK over the past couple of years? I remember England getting hit with a decent snowfall last winter too. As i grew up in Birmingham i saw little snow but i am making up for it now.
Take care and i look forward to hearing about your progress. Paul
November 27th, 2010 at 12:11 pm
Totally agree about the weather - got up this morning to discover it’s been snowing here overnight (good old Glasgow!) Hope it’s not a bad winter like last year, I’ll be afraid to go out in case I fall.
I’m looking for advice on footwear. I’m going straight from my cast into shoes and I wondered what people ave found best? I’m worried my trainers will catch the achilles so I was thinking about a pair of Ugg boots?
November 27th, 2010 at 2:16 pm
I was just getting off my crutches in mid-November last year and found packpacking boots the most comfortable and safest thing to wear outside. Inside I wore Crocs or was barefoot.
November 27th, 2010 at 2:18 pm
I forgot to mention that unless your incision is quite low trainers or other athletic shoes shouldn’t bother the Achilles tendon. I sometimes wore mine inside last winter and never had trouble, unless my foot swelled up.
November 27th, 2010 at 4:16 pm
LL
my PT said some of my inability to do things was as you said “psychological”(regarding your crutch)
so we reaLLY are all in the same boat .Its great to hear that other people are going through the exact same thing ,for the simple reason that it now becomes “normal” for us ATR’s ;>)
Also the snow and icy has put a different prespective on me getting “out” there and today I didnt venture outside the house AT ALL …..so Im hoping for a change in the weather and not this 2 weeks we have been told to expect it for .
Keep going , its sounds like your doing great
November 27th, 2010 at 5:52 pm
I think it depends whether you are surgical or non surgical, I can wear trainers or shoes(Clarks active air- very pretty) for short periods) but I still find that they irritate my AT after a while. I’m most comfortable in a pair of flat biker type knee high boots when I’m out. They don’t rub my AT and because they are quite thick leather I feel like my ankle is protected, and they have a good tread. It is seriously icy outside though thankfully no snow yet. Sods law that the going is treacherous just as I’m spreading my wings!
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July 5th, 2012 at 1:43 pm
All of this was quite a long time ago for me. But as far as I remember at that point I was literally just gently meaning onto the AT side whilst holding onto a work top. The theraband was the lightest one (yellow I think) which I looped round my instep and then very gently pulled it back. As I became ok with this I began pushing against it. It was all very gentle. Finally I used the crutches to support most of my weight as I took some very tentative and hesitant steps. What I do remember is how sensitive the sole of my foot was. Being nearly 2 years down the line I can tell you it all does get better. Patience is the only way forward. Try to make the most of the time you are out of action. Good luck with your healing. LL
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