Week 4 - Into the Boot!

After 5 weeks in a cast (4 weeks post op) I’m finally in a boot.  It’s a big leap forward as I can now wash my damaged leg.  On an evening I can take it off and watch tv with a naked, elevated leg.  It’s difficult to describe how liberating this all is.  As for the leg, it’s still pretty swollen but I can at least start icing the area.  Is there anything else I can do to reduce the darn inflammation?

It’s a bit odd but the swelling is my only discomfort at the moment.  It is broadly in a band around the ankle.  The actual Achilles wound feels fine.  My next move will be a bit of very gentle movement to start getting the foot working again…..

Although the boot is heavier then the cast, I’m leaving it on during the night and it’s not too bad.  When did everybody else feel confident about going without the boot overnight?

15 Responses to “Week 4 - Into the Boot!”

  1. Had my cast removed on Monday. I second everything you said. The very first thing I did was jump in the bath tub and soak. It was awesome! In regards to sleeping without the boot. I did it on the first night, although my wife offered to sleep in the other room due to my nervousness of her hitting my foot etc. Second night I had quite a bit more confidence and she slept in the same bed:).
    The doctor told me that I couldn’t do any harm to my leg unless someone were to jump on it, or I were to walk on it without the boot.
    Good luck to ya. One thing I found, my leg is a lot more comfortable inside the boot with a soccer sock on. It also keeps the swelling down some.

  2. Thanks leftybuck, I reckon a night in the spare room might be a good starting point before I try sharing with the missus…. Thanks for the info on the sock, a bit of compression should definitely help

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  3. Hi, sounds like progress is good. I started to sleep without my boot in week 6, I definately knew when I felt comfortable with it, I tried at 5 weeks and felt uneasy about it! I was told by my PT week 4 was fine for sleeping without the boot, but it used to twitch an wake me up!

  4. Cheers Jimmy, that’s exactly my thoughts. I know I could sleep without it but something is making me nervous. I think I just need to ‘bite the bullet’…..

  5. I took it off at night. If you toss and turn a lot in your sleep, then maybe leave it on. But I think you’d be okay. Not likely to overload the healing ankle/tendon in bed — unless you and a partner are trying kama sutra variations, in which case all bets are off and the boot although a hinderance might even be required.

  6. Janus! That’s a very amusing thought….. I’m sure all the Velcro on the boot can be used to good effect!

  7. Glad to hear the comments about the boot. I get mine next week. I’ve been in a cast for 3 weeks after being in a splint for 2. So I’ll be 6 weeks post op by the time I start weight bearing. Very scary to start walking again, but I’ve almost fallen a few times on the crutches so at least that fear of falling and re-tearing will be gone. My foot in the cast is past 90 degrees, so can’t bear weight even if I want to. How soon have others been able to ditch the crutches?

  8. Thanks for your comments Julius! I’m very much still at the crutches stage (just over 6 weeks post op). I can hardly imagine walking at the moment. My ankle is swollen and I’m just getting a very small amount of movement. My Physio starts on Monday so I hope things start to improve soon. Good luck with your recovery!

  9. Happy healing to you, too. I’ll see what happens with the crutches.

  10. Julias, your “My foot in the cast is past 90 degrees, so can’t bear weight even if I want to” does not compute. The UWO study patients started WB at 2 weeks, while they still had 2cm of heel lifts in their AirCast (fixed, neutral) boots. Then FWB at 4 weeks, and the heel lifts stayed in until 6 weeks.

    Many of us have started WB and walking before we got our ankles to neutral. It’s not a fully natural walking gait, of course, but walking in an orthotic boot usually isn’t. Building the other foot/shoe up to the same height as the boot makes it much more natural — and safer for the rest of your body, too.

  11. I think he means what I meant about walking. If their in the Don Joy boot the foot would be angled down locked so impossible to walk. If it is the other boot thats flat with heal lifts in it but the boots flat = able to walk.
    I will hit week 8 this Friday non-op. been weight bearing PWB since week 3 and pretty much Hobbling around the last 2 weeks fwb sometimes crutcjes alot of times not. My Boot was at 15 now 7.5 the past week. The doc and I don’t see eye to eye and I want to go to neutral this week. Anyone anyone???
    Week 8 neutral??
    He wants me to wait until week 10. Then stay in a boot until weeks 12-14.

  12. Well, speaking from my experience - I am at week 7 as of Tuesday, non-op. After 4 weeks in a cast plantar flexed, my doc put me in a fixed boot at neutral, PWB at 25 pounds of WB. I’ve been gradually increasing the weight on my bad leg in teh past 2 weeks, and in the past few days am only using one crutch (and the boot at neutral). So it seems like you might be able to go to neutral? I will say that my tendon was sore the first day I was put in neutral, but it’s been fine since then.

  13. Thanks.
    How do you regulate 25# of weight bearing?
    I just hobble around with my boot on.
    I have been doing circle with my foot with the boot off since week 3 and also flexing my calf muscles.
    I do heal raises when sitting down a a few times
    A day when the boot is off also. Lost tons of size on my calf. Leg muscle is ok but lost some. I am 40 and spend 3-4 days a week lifting heavy weights. Never stayed away from
    The gym this long is 15 years.

  14. DJ - ha - yes that is the question - how do you know when it’s 25#. He told me to practice with a scale to see what it feels like. I didn’t do that but just tried to only put a small amount of weight on the leg at first while using 2 crutches, and then very gradually increasing it over the past weeks. I haven’t done too much to work the foot yet, other then wiggling it a bit when the boot is off. My next appt. is on Tuesday - I assume I’ll be sent for PT after that. My calf is smaller, but not horribly so. What I’m really looking forward to is being able to drive again (I have a right ATR).

  15. DJ, it’s not hard to walk in a hinged boot that’s locked in a plantar-flexed (toe-down) angle, either. Fiberglass “walking casts” are also similarly toe-down, and made for walking. It’s often better with a “cast shoe” to add a rubber sole, and a similar gizmo on the other foot to equalize the height.
    If you’re “hobbling around” without crutches, then you’re not doing PWB or 25#, you’re doing FWB. And if your “hobbling around” (with or without crutches) is a toes-to-the-side hobble, then you should stop before you hurt yourself — probably not your AT, “just” the rest of your body! Ortho boots and walking casts are all designed so you can walk on them with your toes pointed straight ahead. Land on the heel, then roll straight forward over the gizmo on the rounded sole. As you move forward, the load that your AT-and-calf would normally bear, is borne by the gizmo and transferred to the front of your shin. For PWB, that’s only a fraction of your weight, the rest taken by the crutches; for FWB, it’s all of it, no crutches.

    The various estimates of % FW or pounds are just guidelines. The important thing is to start with ~0 weight, and gradually build it up so it takes a while (maybe 2 weeks) to go from 0 to 100%, while your foot and leg gradually get used to bearing weight again. Many of us experienced pain underfoot during this transition, which is one of several reasons to be gradual.

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