Can a walking boot make an injury worse?

Have you ever tried to treat a symptom, only to find that the treatment lead to other seemingly unrelated problems? For example, maybe you may have been prescribed a medicine that created harmful side effects. That is similar to what a group of patients are reporting, when they were prescribed a walking boot for a severe ankle sprain or broken ankle. A group of patients have filed a class-action lawsuit against a major manufacturer of walking boots, claiming they developed secondary injuries from the limb imbalance created by the walking boot’s thick sole. They also claim they were never warned of the danger.

Índice Show

Should it hurt to walk in a walking boot?
Do you need physical therapy after a walking boot?
Does a walking boot help heal a fracture?
Should I wear my walking boot all day?

Walking boots are a staple in any medical professional’s treatment portfolio. They have been used for several decades and are perceived as the “go-to” solution for ankle immobilization. They have treated countless people recovering from ankle and foot injuries. However, they also have shown to have many side effects. Recovering patients have experienced secondary pain in the back, hip, and knee, caused by the limb imbalance from the thick sole. Walking with a limb imbalance throws the entire body out of alignment, leading to abnormal gait and poor posture.

The walking boot is also heavy and cumbersome, leading to immobility, muscle de-conditioning, and lower quality of life. Thankfully, there is now an alternative to the traditional walking boot.

The TayCo External Ankle Brace is the only ankle brace that allows you to use your own footwear and orthotic, while providing the necessary ankle support. This lightweight alternative eliminates the limb imbalance with functional recovery.

The brace’s hinge can be fixed for joint immobilization for the first few days or weeks after the injury, and then can be converted to range of motion (ROM) to allow for ankle movement and functional recovery, while providing unparalleled inversion and eversion support.

If you have been prescribed a CAM walker by your health professional, chances are, you’re recovering from a significant injury or you are in a post-operative phase of recovery.

Most CAM boot wearers will most likely need this protective boot for at least 6 weeks so it’s important to know how to use it and what to look out for especially for medical conditions such as DVT (Deep Vein Thrombosis). Because the natural walking action is purposely restricted by the CAM boot to assist with resting and recovering from an injury, the calf muscle’s usual pumping action (contract-relax action) is inhibited allowing blood to pool and coagulate in the calf potentially giving rise to DVTs. Some people have an unnatural ability to coagulate super efficiently, great if you’re bleeding, not so great if you’re stuck in a CAM boot forming DVTs at a rapid rate.

Below we have listed things you need to know when wearing a CAM Walker:

DRIVING WITH A CAM WALKER

Never drive with a CAM walker on your break or clutch foot. Due to the ankle having restricted movement, the time it takes to break or change gears increases. This could potentially put you at an increased risk of a having a motor vehicle accident, so it is advised you remove your CAM walker (if medically advised) before starting the car and fitted back on, once you have parked. Some insurances may not pay for damages if you did not take reasonable steps to avoid a potential incident.

NAVIGATING STAIRS

Extra care is needed whilst walking up/down stairs using a CAM walker. Due to restricted ankle motion, your balance and dexterity will be affected. When walking upstairs lead with your good foot, and lead with your CAM foot, downstairs. “Up with the good & down with the bad” is an easy way to remember which leg to use first.

Try to keep your hands free (backpacks are handy) and always use handrails whenever available. If you are with someone, ask them to walk behind you just in case you lose your balance especially when you are new to using a CAM walker.

KEEP YOUR BOOT DRY

It is important to keep your boot dry. If the boot gets wet this can lead to moisture getting trapped under the CAM walker, potentially leading to skin irritation and bacteria growth. This is particularly important for people with diabetes or recovering from a wound or surgery as it can increase the risk of infection.

DEEP VEIN THROMBOSIS (DVT)

DVT are blood clots that form in the veins most commonly occurring in the lower leg. One of the main causes of DVT is blood pooling due to immobility, which is why you have to be aware of the symptoms whilst wearing a CAM walker.

Contact your GP if any of the following symptoms occur:

Increasing discomfort or pain in the lower leg despite feeling better the previous day
Throbbing or cramping pain in the back of your calf, thigh or groin
Swelling and/or redness in the immobilised leg
Increasing skin temperature around the painful site

GET FITTED PROPERLY

Sizing a CAM boot can be trickier than you think. things to consider are:

Do you purchase a tall or short CAM boot walker for your type of injury?
If you’re in-between sizes, which is the best option?
If the gap between your toes and the edge of the boot is too big will it become a tripping hazard?
If your toes are too close to the edge of the boot are you at risk of stubbing your toe potentially aggravating an injury such as a fracture?
What tricks and strategies can you use when walking in a CAM boot to redistribute the load?
How to best navigate stairs in a CAM boot?
Do you need to wear it all the time?
How do you ween yourself off the CAM boot safely in the coming weeks?
When should you be challenging the recovering tissues without risk of relapse or re-injuring?
Do you need any extras such as a shoe lift, crutches or Achilles wedge?

HOW TO WEAR A CAM BOOT

Remember we always recommend you seek professional advice before you purchase or wear a CAM boot. General rules and recommendations are listed below as to how to wear it but keep in mind these may not apply to your specific injury and may cause aggravation.

Remove the soft liner from the inside of the hard shell of the CAM Boot
Place your foot inside the liner
To avoid skin irritation, make sure there are no creases in your sock or boot liner. Your sock will protect your foot against moisture and keep the liner clean.
Open the side stays of the boot and place your foot inside the boot carefully (don’t knock your injury!)
Ensure you tuck your heel at the very back of the CAM boot
The sides of the stays should run vertically up the middle of your leg
Your big toe should be located approximately a “thumb thickness” away from the edge of the boot. If your toe overhangs, the boot is too small and you may hit your toe as you walk aggravating your injury. If your big toe a too set back, the boot is too large becoming a tripping hazard
If you are purchasing a tall boot (as opposed to a short boot) make sure it sits below the crease of your knee
Remove the white strips on each side if these have not been removed (some CAM boot models may not have these)
The extra padding supplied may be inserted under the straps, either inside or outside the liner depending on comfort. They can also be placed at the heel of the boot outside the liner or under the toes to prevent irritation.
Secure the straps starting with the ankle strap, then the bottom of the foot then working upward the leg
The straps should feel snug, not too tight where it may interfere with your circulation and not too loose where your foot moves inside the hard shell
If your boot has an “air pump” feature, use it until it feels snug
When walking in the boot, place your heel first. The sole of the boot is designed to rock forwards so you can push off without too much effort from the foot. At first, this may feel a little strange but with practice, it will feel better.
Wear a shoe lift balancer on the non-injured foot so your leg height is even avoiding possible hip and lower back pain. This is especially important if you intend to walk a lot.

Our Podiatrists, Physios & Chiros are trained to advise you through the different stages of recovery as well as fitting the CAM boot properly. If you have private health insurance, you may be able to claim on the spot and need only pay the gap.

Whilst our front desk reception staff are friendly and help whenever they can, they are NOT trained health professionals so they cannot offer any advice such as type or size of CAM boot or assist in the fitting. The best help they can offer is to book you in with someone that can!

Should it hurt to walk in a walking boot?

The study found that nearly 70% of patients experienced secondary pain (away from the original injury) after wearing the boot. 1 in 3 patients had continued secondary pain 3 months after the device was removed. The secondary pain from the CAM boot can range from a mere annoyance to a severe pain.

Do you need physical therapy after a walking boot?

Physical therapy will help to strengthen and stabilize your ankle joint after an injury, especially after a period of immobilization. You might notice when you are taken out of a cast or cam boot that your calf is significantly smaller compared to your other leg.

Does a walking boot help heal a fracture?

Walking boots protect broken bones and other injuries of the lower leg, ankle, or foot. They prevent more damage and help the area heal. Your doctor may have you use a boot for 1 to 6 weeks. How long you wear it depends on how serious your injury is.

Should I wear my walking boot all day?

If supplied, wear the boot for comfort and use crutches when walking. It is ok to take the boot off at night, when resting at home and to wash. Regularly perform the exercises below to get your movement back.