Mar 30 2014

Vacocast Tips

Published by smick at 7:05 pm under Uncategorized

I’m at 5.5 weeks and am using one crutch only for longer excursions where I might want to rest my foot if it starts aching. Still have an achy heel when I walk for more than a couple minutes and a burning/stretching feeling in my tendon with steps that stretch it more, but otherwise all good so far!

Here are some tips from using my Vacocast for the last three weeks that I’d thought I’d share:

- If you swim in it and didn’t buy an extra liner, I just remove the liner and swim in the air bladder. Makes drying afterwards a breeze!

- When I got to PWB, I still locked the boot at night to force my ankle at whatever angle I’m supposed to be at. This stretched my achilles overnight (I could feel it burn!). The next morning I set it to hinge to aid with walking.

- I took off the soles at night because they were dirty, but also it makes the boot a lot lighter when I have it elevated on pillow.

- I didn’t pay a lot of attention to setting up the liner the first week and had some strange lumps of the beads inside, a huge lump at the ball of my foot for instance. This actually made walking/weight bearing more difficult. Make sure you follow their instructions and smooth out the beads to make it even, particularly the sole of the liner. Then suck the air out and strap it up. The downward pointing angle also tended to make the beads gather by my toes.

- Being able to wash the liner is a big advantage over my old boot which got smelly within days. I just did a quick hand wash in the sink and then a tumble dry on low temp for thirty minutes while I iced my foot nearby and it smelled great!

8 Responses to “Vacocast Tips”

  1. normofthenorthon 31 Mar 2014 at 1:09 pm

    Good stuff! Did you ever try a squishy gel footbed to help with the heel bottom ache?
    I washed my AirCast liner, no problem. Not my ROM Walker though.

  2. sportion 03 Apr 2014 at 11:44 am

    Hi smick - I’ve read through your posts with interest. You’re a few weeks ahead of me in time, but only a millisecond of difference in terms of overall recovery. We both injured ourselves while on the slopes, me skiing though. I just finished my last post in which I got into some detail on my experience with the vacocast subsequent to going FWB. Without going into detail here, I found it to be incredibly difficult to walk in compared to the boot I was originally prescribed. Worlds apart. This is me just now at 3wks, 2days:

  3. smickon 09 Apr 2014 at 8:08 pm

    Hey sporti,

    I’m actually a skier as well and mostly ski these days as I’ve been teaching my kids. This accident wouldn’t have happened in ski boots I think, and is take an acl tear over this any day! Ironically I used to think snowboarding was safer as I felt like my knees never were at risk… I do like it on powder days so I may stick to skiing in firm stuff from now on.

    Congrats on walking FWB! I found the vacocast rocker heel to be very high and had to compensate with a pair of hiking boots and some extra liners to make it work, but I also used crutches for most of the time until I got down to 5 degrees of angle and started using the flatter base. I didn’t start trying to walk FWB except for short distances until around 6 weeks when I was down to 0 degrees of angle. I am pretty used to it now and find it very comfortable. I’ve even done a couple 1 mile+ walks in it with no problems!

    Its awesome to see you walking at 3 weeks! Don’t push yourself too much as it is a marathon like the tracker on the site portrays. My doctor really stressed letting it heal unstressed for the first four weeks and not stretching it much to avoid rerupturing or healing long in the first critical period. He also said the risk of rerupture really doesn’t drop until 12 weeks and that weeks 6-12 are the highest risk times as people are learning to walk again and have accidents. As a result, I’ve been consciously forcing myself to hold back on pushing my recovery until I get to week 12 when I can start to really work on strength and active flexing.

    Until then I’m just going to be walking a lot, riding the bike and swimming!

  4. goldmanon 10 Apr 2014 at 5:33 am

    Hi Smick,

    with reference to, “doctor really stressed letting it heal unstressed for the first four weeks and not stretching it much to avoid rerupturing or healing long in the first critical period” — I have the impression that stretching is ok, as long as one does not force motion through pain. In other words if it feels neutral or good, then it’s ok to stretch. Or do I have that wrong and will too many, even good feeling stretches over a day cause ‘long’ problems?

    23 days post-op, 46 days post-injury

  5. JB3on 10 Apr 2014 at 7:37 am

    Nice going on your progress.

    I had a milestone yesterday to give you hope. I am just shy of 16 weeks post surgery for ruptured achilles.

    2 weeks ago, I ran a mile one day and then 2 miles on treadmill at 8min pace. Yesterday, I went to the track and ran 2 miles at a 7:45 and 7:15 minute pace. Have a little swelling from it but got up this morning to do bike/elliptical and feel really good.

    For Norm, is this too aggressive? My PT seems to think if there is no pain and normal swelling that I can keep pushing. Your thoughts?

  6. smickon 10 Apr 2014 at 10:56 am


    Dorsiflexion stretching was his concern. Still no active dorsiflection stretching until 12 weeks. Passive and rom type work is fine.

    Dorsiflexion stretching obviously puts the max load on the tendon as everything is stretched, particularly with your leg straight.

    I’ve avoided it as I don’t want to heal long either (although it seems like no one knows why you heal long).

    My dorsiflexion range is around 5 degrees compared to 20 in my other foot, which I guess is on track and fine.

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

  7. smickon 10 Apr 2014 at 10:59 am


    Nice and congrats! Very jealous. Running at any pace seems a long ways off still but it’s great to hear its possible in 6-8 weeks! I’m just trying to walk without looking like an old man walking on sharp rocks…

    I am thinking about buying a road bike and taking up cycling as I used to mountain bike a lot. It sounds like the ideal exercise to rehab over the summer.

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  8. wobble manon 11 Jan 2021 at 2:09 am

    Not my ROM Walker though..

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