Walking with crutches - advice appreciated

I’m now using elbow crutches, having moved onto a PWB cast about 10 days ago (this was 2 weeks after reconstructive surgery).  It is a hard, lightweight cast, consisting of a synthetic coloured bandage material over inner bandages and other padding.  I use a  light orthopaedic sandal to protect the cast.  The cast  starts shortly just beyond my toes and ends a few inches below my knee.  It seems some ATR people move straight from the post op cast to the boot, but I will be in this PWB cast for about 3 weeks.  It gives me a feeling of security re the operated tendon.

I get around VERY slowly using crutches, but have improved upper body strength with use.  However, I’m wondering if I’m using the best technique and whether the discomfort I have in my heel is normal or avoidable.  The longest walk I’ve attempted was about 400 yards and took 20-25 minutes, with several pauses along the way.  Naturally uneven surfaces, crossing roads, etc along the way provided further challenges.

I am finding that my operated foot gets quite sore on the heel even with quite short walks.  Also I am aware of rolling my foot forward towards my toes makes the end of the plaster come up against my foot and I worry about blisters.  I’m also slightly higher on my operated foot which makes me out of alignment and concerned about possible back problems (with which I had trouble in the past).

The brief instructions  from the hospital plaster room read as follows:

  1. Do NOT swing your hip
  2. Do NOT walk with foot turned out
  3. Walk “Heel” and “TOE” and STRAIGHT FORWARD
  4. MOVE YOUR TOES and TIGHTEN YOUR MUSCLES inside the plaster
  5. Use crutches as instructed
  6. DO NOT WALK WITHOUT THE PLASTER SHOE, EVEN INDOORS

My technique based on my recollection of the instructions on using crutches is to move forward with the operated leg in line with and supported by the two crutches, then bring up the good leg, keeping upright and looking ahead (but also for obstacles/ uneven surfaces!!).

Any input/ advice/ best practice?  Is the discomfort in my heel due to my tendon or to placing excessive weight on my operated foot?  Have others had back trouble from misalignment, or found ways to compensate?  I’d like to be able to move more easily, as I enjoy walking, although perhaps I need to accept the limited mobility for the present.

BTW, I bought a cover for the cast which I’ve found excellent and absolutely necessary in the wet winter we are having in the UK!  Their waterproof protector is also good for showers/baths.

http://www.limboproducts.co.uk/shop/category/2/outcast

6 Responses to “Walking with crutches - advice appreciated”

  1. 1) Sorry, but you’d be much happier in a boot. All your friction and fit problems are simple to solve with a boot, and impossible with a cast (except by replacing it, which is another dice roll).

    1a) With a boot it’s also easy and pleasant to progress from NWB to PWB then FWB. For you I fear it will be a challenge. If your cast is abusing your scar/wound or letting your foot slip around, it needs (labor-intensive) attention, because those things are BAD. Me, I’d fight for a boot.

    2) Heel pain UNDER the heel is very normal and usually harmless. Heel pain BEHIND the heel — whether internal or from bad-fit rubbing on your wound — is very different, and to be avoided.

    3) Fix your alignment! Put a similar sandal on a hiking boot, or use several foot beds, or an Even-Up, or… Your bod doesn’t care HOW, just IF!

  2. Norm, Thanks again. I appreciate your helpful input!
    1) Re. boot v cast, I guess my surgeon’s method is the second cast then the boot, and I would have been sooner into the boot but for joint availability of the surgeon and physio.
    1A) The fit of the cast is OK at present, I’m more concerned about what might happen with friction. I’m still not sure about my technique with crutches, but as long as I’m not hurting myself I’m sure the activity is good for me: managed my c. 400 yards today more easily than last week!
    2) It’s good to know I needn’t be concerned about a slightly sore heel - rest of foot is fine at present.
    3) Finally, I’ve taken some steps to get better alignment as you suggest.

  3. Boot!!

    I had a torn ligament in my youth and a similar cast to what you seemed to describe. Seriously, I am not employed by “the boot company” but that thing rocks compared to a cast.

    My leg seems to swell substantially enough at evening/nighttime compared to morning/day that it’s really nice being able to adjust the fit frequently.

    Being able to take it off in the bath tub when the foot is safe from slips and blunders and wash it, dry it, put oil on - ahhh….. Wash the boot liner and put a clean one on…

    I even took it off a few nights ago before going to bed, laid on my leg and held the leg straight up in the air wiggling toes and foot itself (VERY carefully of course) - what a relief.

    And lastly: Being able to put socks and real pants on!
    After running around half of my life looking for opportunities to take my pants off (all right, all right…) - I can’t say how the opposite can be rewarding just as well.

  4. Thank you niewneon, so at least I can look forward to good time when I move on to a boot in a fortnight! :-) Although that may feel a long time away.

    Funnily enough, my walking with crutches has become significantly easier since posting this, probably helped by confirmation that some discomfort in the heel is normal. I can now bring my good (right) leg further ahead of my leading bad (left) one, making my walking more natural, faster, and with less stress on my body. This repeats my earlier experience post op: there seems no progress or even going back some days, then there can be a sudden improvement.

    Comments on experience with using crutches while PWB still appreciated.

  5. Glad it’s improving! But I’d rather you took full strides on crutches while PWB and varied the weight, rather than shortening your stride with more weight. Try to make your stride as normal as possible except for the weight taken by the crutches. That will give you less to unlearn later.

  6. OTOH, if your cast isn’t strong, stiff, and protective enough to make that safe, then your way is better!

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