April 2011

Pair walking boot with athletic shoe to decrease contralateral pressures

In the moment: O&P

Pairing a walking boot with an athletic shoe effectively offsets the elevated contralateral peak plantar pressures that can result from the limb length discrepancy created by the boot, according to research from Midwestern University in Glendale, AZ.

The investigators analyzed calcaneal peak plantar pressures in 12 healthy subjects while wearing a high-calf walking boot with a rocker bottom sole on one foot. On the contralateral foot, subjects were barefoot, wore a moderately worn athletic shoe, or wore a modified walking boot. The modified walking boot featured metal uprights that had been sawed off at the medial and lateral malleoli to allow for ankle motion, but was identical to the original walking boot with regard to heel height, durometer, and rocker sole.

Both shoe-boot combinations resulted in contralateral peak pressures that were significantly lower than the barefoot-boot combination. However, peak pressures did not differ significantly between the athletic shoe and the modified walking boot.

The findings were published in the March-April issue of the Journal of the American Podiatric Medical Association.

4 Responses to Pair walking boot with athletic shoe to decrease contralateral pressures

  1. Dr. Nalli says:

    this is much to do about nothing. my pt’s do well with any shoe. you must gait train them so they don’t favor the casted leg which is a natural tendancy.

  2. Melody Sokolow says:

    2 failed MTP Joint Fusions last year, just had a much more professional job done on the first one. Majorly higher walking boot on left. Can’t get my right foot with broken toes from last surgery into any shoe similar to athletic shoe, as toes are broken and my knee is now whacked as well as my severely arthritic back DUE TO THE BOOT.

    Aren’t there shoes made with higher soles to sort of pair up with a tall walking boot?

  3. I developed the Evenup device in direct response to the problem Ms Sokolow describes. As a foot and ankle specialist I have heard complaints similar to hers many times. The patient reviews on our website will attest to the fact that complaints of hip and back pain while in a fracture boot frequently fall on deaf ears. I have reviewed the objective literature extensively on this subject. The study listed above measured only peak heel pressure with and without a shoe lift. There are many other parameters that are just as important if not more so when determining the untoward effects of wearing fracture boots. I can attest that, subjectively patients are more comfortable wearing a shoelift while in a fracture boot. I highly recommend a shoe lift to my patients that I put in a fracture boot that have any history of hip, back, or knee problems and to any patients that will spend significant time on their feet walking or standing while in the fracture boot. Patients being treated for achilles injury with a fracture boot and heel lift or those in a diabetic off-loading shoe or boot are also good candidates for shoe lift compensation.

  4. Christine Carrig says:

    Hi. I’m wearing a CAM boot long term as the original admitting doctor misdiagnosed my fractured foot as a sprained ankle. I have found that I now have a bad back/hip due to the fact that nobody told me you could buy a special “evening up” shoe for the opposite foot.

    what do you recommend for me, as I’m going to be in the boot for a very long time, it seems. (boo hoo!!)


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