Posted by: onhiatus | July 19, 2012

6 weeks & Cast off!! But no boot?? Yikes!

I’ve actually grown kind of attached to my NWB cast over the past few weeks.  It’s been my security blanket through the 5k, my taekwondo class, tons of airport trips & flights, up and down stadium stairs, and through the many other adventures that ultimately destroyed two sets of crutch tips & the one set of cane tips. Having that extra protection from a few key bumps & slips has provided its fair share of a loud audible Phew! time and time again.

Here’s what my last pair of tips looked like as I retired them. Poor things lasted a whole 12 days!  Seriously, maybe I need to look into an industrial version or something….


So today (6 weeks & a day since surgery) when I was told the cast was coming off, I started asking questions about the boot- only to find out that my doc’s not a fan. He prefers to get you started on range of motion sooner than later so once the cast is off, it’s off. Your leg is naked and you just have to be careful.

So.. goodbye cast! In a weird way, I’m going to kind of miss it.


Cast came off with no problems this time but I was told to be careful and not scrub my leg, just kind of let the skin heal by itself.  Really cool seeing your foot move on its own that first time. Huge sigh of a relief that as far as I could tell, all was well.

Passed the tests and it’s strange how free the leg feels– I can flex the foot up and down & side to side pretty well but I’m still kind of freaked out not knowing its limits yet. Was told I can bike & swim but unfortunately, the PT office doesn’t have an opening until the end of the month- right before my 2 week check-up with the doc.  I’ll try and get it moved up but suggestions on exercises or what I can be doing before then welcome!

Apologies in advance for how dry and scaly my leg is post cast removal but goodbye cast, hello free leg!



How wierd…
why doesn’t he like the boot? I guess you’ll just have to be careful but when my cast came off at six weeks I would not have felt I could manage without more protection but maybe that’s just in my head?

Wow, yes, take care! Your doctor seems to have had good experience of this route to fitness so good luck. A longish time in a cast, and no weight bearing until week 8 or 9, and no pt yet.

You’ve been very active so far - has the cast removal caused you to cut back at all? Certainly if you’d been on a good, booted, protocol, you’d be better protected, probably fwb and no crutches by now, and able to do pt.

@sheena- he said he prefers to go straight to working on range of motion so no boot. That initial walk from the examining room to the front office was probably the longest, slowest walk of my life. Even stepping into the car and resting my naked leg on the floor was scary…Going to sleep was a whole other issue- i was panicked I was going to move the wrong way. Fingers still crossed constantly! Wondering if this means I won’t get any boot for slowly increasing miles & on uneven terrain when I start walking? yikes..

@hillie- day one so far so we’ll tell soon but I know I was definitely moving slower & more cautiously last night. This is the dangerous part- you feel Ok and things are moving seemingly OK.. and there’s that part of you that just wants to try it out. Being patient waiting for an earlier PT appt to open up so I can start working on it…

Your doctor seems unaware that some boots are hinged and can be adjusted to give a range of movement. At beginning of week 3 (first 2 weeks I was in a cast) my Vaco was fixed at 30 degrees pf (down) for 2 weeks, after which I always had a ROM. 6 weeks later it was -30pf +15df. The week after that I was in 2 shoes - with silicon wedges for a week.

Worked for me and many others. And you have protection and support at a vital, vulnerable stage. Depends on the practitioner, the injury, and the hospital budget (and patient budget too if no NHS or similar).

Wow….I would be terrified but thankful my Dr is a fan of boots. Just ordered the VacoCast. Your leg really looks great and I can’t believe your in a shoe already. You may not be walking but your looking the part being in a shoe and I’m so impressed.

I also was told no boot. I was vey nervous at first but now I’m happy I went that way. A friend of mine ruptured his left AT in Feb. and he still walks with his leg out to the side and has a pronounced limp. My foot stays straight out in front and my PT says mt gait is fine. So it seems to have worked out fine for me so far.

Hi Corey

We seem to have rehab’s varying from super high tech boots to £40 short-term models to no boot at all.

Personally I’m very happy to have gone the booted route.

Was your’s a complete rupture and how long were you in a cast?

What was your friend’s timescale/treatment? I’m assuming that he was in a boot but don’t know how this could have had a negative effect on his recovery. Any injury complications, apart from the obvious?

I was serial casted for 8 weeks. Non -op full rupture. My friend was the same except his was his left leg. He was in a boot now he tends to lead with his left foot pointed out. I don’t belive that he had put a lift on his right foot for the height difference created by said boot. He says long walks make his hips sore now. I would assume that is from the left foot going out to the side as it does. I had asked about a boot when I was having my third cast put on my dr. asked if I thought I could walk on it then. I said “no”. When my fourth cast came off he said no boot and ween off the crutches in 3 to 4 days. Took longer to ween off the crutches I think it was closer to 12 days, then on to a cane.So in my case I think no boot worked very well.I’m at 15 degrees of dorsi flexion now and the strenght is progressing slowly but is progressing.

Any pain in the ankle at 6 weeks? I was in cast 6 weeks. Then put into boot and told to walk. But putting weight on the foot is impossible it’s to painful. Is this typical. I’m at 7 weeks and it hurts even more probably because I’ve been pushing it.


Ariel - This pain is to be expected after being locked away for 6 weeks. You can try some Active ROM without the boot. Write the ABC’s with your foot but make sure your leg is supported. This will help loosen things up. It is not only the AT that has been locked up. All the bones and other soft tissue have to start working again and this can cause pain. Sometimes the scar tissue around the tendon will hurt and do not be surprised if it breaks away. It can feel like you have done damage but it is a good thing. Not too many bad things can happen to your AT when you have the boot on if it is properly fitted. Weight bearing is usually as tolerated so if it hurts too much then back off. Start with crutches and add weight to the point your are comfortable.

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