3 Comments so far

1. normofthenorth on October 15, 2013 3:10 pm

   Standing up on 2 feet is pretty safe, in the boot. Walking booted is pretty safe too, provided the boot is snug enough and stiff enough that you can keep your ankle-and-AT relaxed while you roll your knee forward so your weight is on your toes (or the ball of your foot). At that point, your weight should be transferred through the boot to the front of your shin, at the top of the boot cuff.

   The main thing holding you back — besides fear — will probably be sensitivity on the bottom of your foot, likely especially under the heel. Squishy gel footbeds help, and time helps, too. Sitting with your bare foot rolling gently over a tennis ball often helps, too, but start very gently (esp. when the ball is under the front of your foot).

   The trick to the walking part is starting on your heel then rolling over the rounded sole of the boot, pushing your knee forward. When you get it right, you should be walking remarkably normally, and even at full speed.

   Most rehab protocols spend some time — like 2 full weeks in the very successful UWO protocol at bit.ly/UWOProtocol — doing Partial or Protected WB. With that, you are still using 2 crutches, but instead of holding your injured foot up in the air, you start resting it on the floor/ground as you stride over it with 99% of your weight on your crutches and arms. Again, the motion is the same as normal walking, but the crutches are doing the heavy lifting and the injured (booted) leg is just going along for the ride. As time goes on and you become stronger and more comfy, you gradually shift more of your weight onto the booted-injured leg.

   It’s always important to Watch Your Step during ATR rehab. Some people like to say that you can’t hurt your AT while you’re in a cast or boot, but that’s not strictly true. Especially when we trip or slip and we think we’re falling, we usually can’t help but fight like a lunatic to “save” ourselves, and that can involve either landing hard on the injured leg OR telling our calf muscle to pull hard on that recovering AT. The trick is not to trip or slip, to get off the scary crutches ASAP, and to Watch Your Step until you’re back close to full strength.

2. Ron on October 16, 2013 2:18 am

   Hi Steve,

   You gotta love Norm’s comments because they are well thought out and extensive. He also always gives great advice.

   With that said, I just went through that last week - PWB to FWB, which is where I am at right now, and it feels great.

   I started by just standing on it, then walking with one crutch and then none (around the house only). I did that for a few days, ending the day on 1 crutch to give my foot a break.

   I am also doing my exercises everyday in and effort to get my foot to 0 (90 degrees) by week 6 (this Friday).

   Good luck.
   Ron

3. steve01 on October 16, 2013 6:58 am

   Ron and Norm,

   Thanks very much for the thoughtful, practical and important advice. I’ll be taking it!

   Steve