Amid the many long-term effects of ankle sprains and other types of trauma to the ankle or foot, the issues related to wearing an immobilization boot following treatment may seem insignificant. Certainly, a patient whose physician prescribes an immobilization boot should heed his doctor’s advice. The boots help to protect lower leg bones and joints, allowing for healing to take place. However, as helpful as these oversized ankle boots may be, they can cause problems related to balance and asymmetrical alignment.
Imagine you were asked to wear a “pair” of shoes, one flat and the other a 2-inch wedge heel. And not just around the room. Would you wear that far-from-matching pair for weeks on end? If you did, what do you think would be the result?
Well, when a person wears a surgical boot on one foot and a regular shoe on the other, the same issues present themselves. Whatever the cause, unequal weight bearing and asymmetrical alignment causes trouble for a person’s joints. A surgical boot causes one side of the body to be inches higher than the other.
An often-cited problem that accompanies boot-wearing is lower back pain caused by the one-sided elevated pelvis. The good news is that there’s a simple solution to this dilemma: wearing a thick-soled shoe or adding a lift to your shoe. By raising the unaffected leg to the level of the booted leg, you can help your stance to become level.
You can use a temporary heel lift on the short side. To provide additional cushion and height for the “short side,” you can purchase a cushioned insert.
Temporary heel lifts* like Clearly Adjustable® Heel Lifts or AliMed® Adjustable Heel Lifts are a great solution, and they can be purchased from a healthcare professional or ordered easily online. They can be transferred from shoe to shoe quite easily.
The Clearly Adjustable Heel Lift has a design for elevating your heel and is unlike a pad or cushion. The heel lift is placed under the footbed or insole and molds to the shoe, so both fit and feel the same. It has a long, constant slope that supports the arch and reduces arch stress, and its firm multi-layered material prevents heel rubbing in the shoe. It is made of clear vinyl material that conforms but does not compress, and retains its height even with extended use.
The Evenup Shoe Balancer and Leveler is another terrific option. This provides variable elevation to your “bootless foot” through having your regular shoe strapped to it (see picture below). The Evenup Shoe Balancer can provide more height for your foot than the two heel lifts mentioned previously, since those are inserts into your shoe, whereas the Evenup option attaches to the sole of your shoe.
After adding a lift and/or insert to your shoe, you’ll want to ascertain whether your alignment is even. You may be able to do this yourself, by looking in a full-length mirror and viewing your pelvic alignment. Alternatively, you can ask someone to look at you from behind and check to see how even your pelvis appears when you’re standing.
While the benefits of wearing a surgical boot certainly outweigh the potential problems associated with asymmetrical alignment, anyone with chronic back pain will tell you that it’s best to avoid that side-effect of the boot. Not only is the pain far from enjoyable, but it can lead to putting stress on other joints as well, and it can become a problem that long outlasts your ankle or foot recovery period. Thankfully, you don’t have to merely “grin and bear it” when it comes to the potentially painful side-effects of wearing the boot.
PhysioDC of Washington, D.C.
Daniel Baumstark and his professional team of physical therapists operate a boutique physical therapy office in downtown Washington, D.C. From athletes to government officials, and from ballerinas to corporate executives, PhysioDC helps people recover, strengthen and return to healthy living. Visit their website at www.PhysioDC.com or call them at 202-223-8500.
*PhysioDC is not making an official endorsement of any of the products discussed in this article, nor is PhysioDC providing medical advice, treatment or diagnosis through this article.
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