Emergency and Urgent Care - Walking Boot

Why have I been given a Walking Boot?

You have been given a walking boot because you have sustained a stable fracture, severe sprain or tendon injury to your foot or ankle. The treatment for this is a walking boot. They can help to stabilise your injury, aid healing and help to manage swelling to the injured area. There are 3main types of walking boot that can be dispensed by the Urgent Treatment Centre:

A standard walking boot – usually for ankle fractures and sprains
A short leg walking boot – usually for metatarsal fractures
An Aircast Boot – usually for Achilles Tendon injuries

Walking boots consist of a plastic rigid casing, soft inner liner sock/liner and Velcro straps. If you have an Achilles Tendon Injury, you will also have heel wedges to raise your heel and relax the tendon and air bladders which provide extra support to the ankle and tendon whilst walking.

When should I wear my Walking Boot?

You should wear your boot all the time including in bed, unless you have been advised otherwise by the Clinician that treated you. You can remove the boot for washing, skin checks, and exercises. If you have an Achilles Tendon injury, you should keep your toes/foot pointing downwards when you remove the boot for washing.
 
You should remove your boot at least twice a day to ensure there is no skin damage or changes. If you notice any skin damage, irritation or changes then please return to the Urgent Treatment Centre as soon as possible.

Caring for your leg

Things that you should do:

• Keep your leg raised (elevated) with our foot higher than your hip as much as possible (at least 2-3 hours per day). This will help prevent/reduce the swelling and bruising. You should elevate your leg on 1-2 pillows and make sure that your heel is not resting on anything and is pressure free
• Use ice packs (frozen peas wrapped in a tea towel) for 15-20 minutes every 2-3 hours
• If you are allowed to take your boot off, you can gently move your ankle up and down and wiggle your toes. This will help to prevent stiffness and improve blood flow in your leg
• Take regular pain relief such as ibuprofen and paracetamol. These can be bought over the counter in a pharmacy or in the supermarket. Follow the direction on the packet. Alternatively, if you have been given medication from the Hospital, take this as directed
• You should wear loose fitting clothing that will go over your boot. This will allow you to change your clothes easily without having to remove your boot. DO NOT tuck your clothing into the boot
• You should take your boot off each day to was and cream your leg with unperfumed moisturising cream. If you have an Achilles Tendon injury, you must keep your toes always pointing downwards during washing and creaming until you have reapplied your boot
• When you remove your boot check your skin for any abrasions or red area to your skin on your leg or foot. Check your heel is not red or painful, as this is an area where pressure can build and create a sore. It is very important to check your skin if you have Diabetes or any condition that affects sensation in your legs
• Make sure that you have plenty to drink during the day. Keeping well hydrated will help to prevent DVT developing in your leg. You will be assessed for the risk of developing a blood clot whilst wearing the boot. You may be given a tablet or injection to thin the blood to prevent a blood clot if you are assessed as being at High Risk
• Reduce the amount of alcohol and cigarettes you consume as this can affect the healing of your injury
• Use a sock whilst wearing the boot to help absorb any sweat and reduce smells. Make sure the sock does not wrinkle inside the boot as this can cause sores to develop. Always replace your sock before reapplying your boot

Things you should NOT due:

• Use ice packs over areas of skin that are in poor condition, have poor sensation or poor circulation
• Place ice packs directly on skin as they can cause a Cold Burn
• Leave ice packs on whilst you are asleep
• Do not soak your injured leg in a hot bath as this can make the swelling worse

Caring for your Boot:

It is advised that you always wear a sock whilst wearing the boot, this will help absorb sweat and reduce odours from the boot.

Ensure that your sock does not wrinkle whilst inside the boot as this could cause sores or blisters to your foot or ankle.

If your boot is visibly dirty or starts to smell, you can wash it at home. The inner sock lining can be removed from the boot and hand washed with cool water and mild detergent. Make sure you rinse thoroughly to avoid skin irritation.

Allow the inner sock lining to air dry.

The outer casing of the boot can be cleaned with a damp cloth.

DO NOT put any part of the boot in the washing machine or tumble dryer.

Walking boots are for single patient use only. Please discard when no longer required.

Applying and removing your walking boot:

Walking boot/short walking boot

• Ensure your heel is positioned at the back of the boot
• Start by tightening the strap across the ankle and the top of the boot
• The extra foam pads can be used to protect any pressure areas
• We suggest using one underneath the ankle strap as there is no padding there
• Fasten the remaining straps until the boot feels snug, but not tight
• If you fasten the boot too tight, you may cause pressure to your skin

Aircast boot

• If you have been provided with a heel raising wedge, insert this the boot prior to fitment
• Ensure your heel is placed at the back of the boot
• Fit the front plate section
• Fasten the ankle strap first, followed by the top strap
• Fasten the other straps until the boot feels snug but not too tight
• Use the pumps on the sides to introduce air into foam insert to give support to the ankle

There is a video that you can watch demonstrating how to fit your boot, follow this link:
https://vimeo.com/488591560/01313ea6de

Work

If you do not feel capable of working either due to pain or reduced movement/mobility, you are able to self-certify sickness for the first 7 days.

You must complete a self-certification form found on the government website and give this to your employer. This entitles you to statutory sick pay from your employer for up to 7 days.

To access the self-certification form, follow this link:
https://www.gov.uk/government/publications/statutory-sickpay- employees-statement-of-sickness-sc2

If you feel you need longer than 7 days off work, you must contact your GP for a sick note. The Urgent Treatment Centre does not issue sick notes.

Physiotherapy

Once you have been advised to remove you boot, you may feel some stiffness in your ankle. You should perform some simple ankle exercises, as previously mentioned in this leaflet.

If you are unsure about what to do and feel you need support with your rehabilitation, then you can always go to see a Physiotherapist.

If you live in the Heywood, Middleton and Rochdale area, you can refer yourself by using the following link:
www.physiodirect.northerncarealliance.nhs.uk

Possible complications:

Walking boots have minimal complications. You will have been assessed by your clinician for the risk of developing a DVT and may have been given medication to prevent this.

You must seek medical advice if you have any of the following symptoms:

• Severe pain
• Swelling or throbbing pain to the calf of thigh
• Pins and needles to feet/toes that does not go away with movement
• Struggling to walk after suggested healing time
• Pain remains despite suggested healing time and pain relief
• Chest pain

You can return to the Urgent Treatment Centre or contact us on 01706 517023.