Guide to Best Walking Boots for Foot and Ankle Injuries

One of the best ways to get a foot or ankle problem to heal is to rest it. But of course, it&#;s hard to rest your foot and still carry on your normal activities.

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Walking boots allow you to rest your foot while still walking around and doing your day to day activities. And walkers are not just for fractures. In our Seattle foot and ankle clinic we also prescribe them for heel pain, ball of foot pain, tendonitis and other problems.

Call 206.344. or use our Patient Portal to schedule an appointment to ensure you get the right walking boot and it fits properly. 

Walking Boots for Foot and Ankle Injuries

Walking boots are also called walkers, cast boots, Aircast boot, medical boot, walking cast and fracture boots. Keep in mind that walkers are usually just a part of an overall treatment plan. We recommend you see your podiatrist for complete treatment. Also, the product links in this post are affiliate links. If you click and purchase one of these items, we may make a small commission.

This page is a guide finding the best walking boot for all kind of foot problems. For each condition we will answer the following questions:

• How long should you wear a boot for your particular problem?
• Should you wear a tall boot (figure 1) or short boot (figure 2)
• Should you use a regular boot (figure 1) or a pneumatic boot (one that has air bladders that can be pumped up to provide more immobilization) (figure 3). The pneumatic boots offer more protection for problems like fractures, but are more expensive. We&#;ll let you know when it is worthwhile to spend the extra money and when it is not.
• Do you have large calves or lower leg swelling? If so you&#;ll need a walking boot designed to fit wider calves. We have recommendations on medical walking boots for wide calves below

Please note that some of the links below are affiliate links, and at no additional cost to you, we will earn a small commission if you decide to make a purchase.  Please understand that we have used all of these items for our own patients and we recommend them because they are effective and a good value, not because of the small commissions we make if you decide to buy something.  

Here are some of the conditions that can be treated with a walking boot

Walking Boot for Plantar Fasciitis

The purpose of a walking boot in treating plantar fasciitis / heel pain is to reduce tension on the plantar fascia so that the fascia can rest and heal. For many patients it is the only thing that provides enough protection for the area to heal and still allows the person to walk around. In addition, it can act to reduce pressure on the heel.

How long to wear it? For plantar fasciitis most patients wear the boot for 7 &#; 14 days depending on severity of heel pain

Tall or Short Boot? Either one. Most people are more comfortable in the tall boot as it does not irritate the shin. But if you are short, you might want to use the short walking boot.

Hints: Use an arch support inside the boot to take more tension off of the plantar fascia.   We recommend the FootChair Orthotic with Adjustable Arch Height (figure 4). This arch support comes with pads that can be inserted to increase the arch height for a customized fit. For plantar fasciitis use the highest arch that you find comfortable.

Walking Boot for Ball of Foot Pain (metatarsalgia, neuroma, sesamoiditis)

The feature of cast boots that work so well for pain under the ball of the foot is the rocker aspect of the sole. Pressure studies show that this rocker works to dramatically reduce pressure under the ball of the foot. Reducing pressure here allows the tissue to rest and heal.

How long to wear it? For ball of foot pain, most patients wear the boot for about 7 days.

Tall or Short Boot? Either one. Most people are more comfortable in the tall boot as it does not irritate the shin. But if you are short, you might want to use the short walker boot.

Hint: Use an arch support like the FootChair Orthotic with Adjustable Arch Height inside the boot to transfer even more pressure off of the ball of the foot.  The FootChair comes with pads that can be added to increase arch height in order to transfer more pressure off of the ball of the foot and onto the arch.

Regular or Pneumatic Boot? Use the less expensive regular walker. You don&#;t need the more expensive pneumatic walking boot for metatarsalgia.

Walking Boot for Sprained Ankle

Recent studies on ankle sprain treatment have shown that immobilization in a cast boot for the first two weeks will allow proper healing of the injured ligaments to begin. We put every ankle sprain patient in a boot initially. Don&#;t try to diagnose an ankle sprain on your own &#; see a podiatrist.

How long to wear it: Wear the medical walking boot for two weeks following an ankle sprain.

Short or Tall Boot? Always use the tall boot for ankle sprains. The short one does not provide adequate ankle protection.

Regular or Pneumatic Boot? The less expensive regular tall boot should work fine for ankle sprains.

Walking Boot for Metatarsal Stress Fracture

Metatarsal stress fractures should always be immobilized in a boot. Like all fractures, metatarsal stress fractures will heal faster and better when they are immobilized. The easiest way to do this is to use a medical boot. If a stress fracture is suspected you should see a doctor as soon as possible.

How long to wear it? Depending on the type of fracture, most of our patients are in a boot 2 &#; 4 weeks. Wear the boot until you can get an x-ray and a doctor can tell you if are ready to come out of the boot.

Tall Boot or Short Boot? Always use a tall boot for metatarsal fractures. This is necessary because many of the muscles that attach into the metatarsal region start in the leg. If you have a stress fracture you want to limit motion of the foot by immobilizing those muscles.

Regular or Pneumatic Boot? The less expensive regular tall boot should work fine for metatarsal stress fractures.

Walking Boot for Toe Fractures

Too often people are told that nothing can be done for a toe fracture. This is not true. Like all fractures, toe fractures will heal faster and better when they are immobilized. The easiest way to do this is to use a fracture boot.

How long to wear it? Depending on the type of fracture, you could be in a boot from 2 &#; 6 weeks. Wear the boot until you can get an x-ray and a doctor can tell you if are ready to come out of the boot.

Tall Boot or Short Boot? Always use a tall boot for toe fractures. This is necessary because many of the muscles that attach into the toes start in the upper leg. In the presence of a toe fracture you want to limit motion of the toe by immobilizing those muscles.

Regular or Pneumatic Boot? The less expensive regular tall boot should work fine for ankle sprains.

Walking Boot for Foot Fracture / Broken Foot

There are many types of foot fractures and specific fractures may require specific treatment. So we always recommend seeing a doctor to have a foot fracture treated.

How long to wear it: Again, see a doctor first as it really depends on the type of injury. It could be anywhere from 3 weeks to 8 weeks or even more. Wear it for as long as your doctor tells you.

Short or Tall Boot? Tall boots are best for foot fractures as they immobilize both the foot and the leg muscles that attach into the foot.

Regular or Pneumatic Boot? For fractures we ONLY recommend the Aircast tall pneumatic boot. You need the extra protection to limit motion as much as possible. This walker is the closest boot you can get to an actual cast

Call 206.344. or use our Patient Portal to schedule an appointment to ensure you get the right walking boot and it fits properly. 

Walking Boot for Ankle Fractures

You really should not try to treat an ankle fracture on your own. This should be seen by a podiatrist or an orthopedic surgeon.

How long to wear it: Again, see a doctor first as it really depends on the type of injury. It could be anywhere from 3 weeks to 8 weeks or even more. Wear it for as long as your doctor tells you.

Short or Tall Boot? Always use the tall pneumatic boot for ankle fractures.  This is the type that has air bladders that can be pumped up for extra support.

Regular or Pneumatic Boot? For fractures always use the pneumatic boot. You need the extra protection to limit motion as much as possible.

Walking Boot for Posterior Tibial Tendonitis and Peroneal Tendonitis

The goal of a walking boot for tendonitis of the foot and ankle is to decrease tension on those tendons in order to allow healing to start.

How long to wear it? Most of our patients wear the boot for 10 &#; 14 days.

Short or Tall Boot? Always use the tall walking boot for tendonitis. The muscles start high up in the leg and to best rest these muscles the boot must go up high on the leg.

Regular or Pneumatic Boot? Either one. Most people will be fine with the less expensive regular tall walking boot. If the pain is severe, use the tall pneumatic boot.

Hint: For posterior tibial tendonitis use an arch support such as the FootChair Orthotic with Adjustable Arch Height inside the boot to help reduce tension on the posterior tibial tendon. This unique arch support has an arch that is adjusted by slide-in pads. This allows a customized fit that will maximize the benefit to the tendon while still being comfortable. even more pressure off of the ball of the foot. We recommend using both of the extra pads if you have posterior tendonitis and just leave the orthotic as is (no extra pads) for peroneal tendonitis.

Walking Boot for Wide Calves

If you have large calves or a lot of swelling of your lower leg you will require a walking boot with adjustable uprights to fit your lower leg. The boot must be made so that the uprights can be bent outward to accommodate larger calves.

There are few medical boots on the market that fit those with wide calves. Our favorite is the DonJoy MaxTrax Walker Brace.

The Donjoy MaxTrax has malleable upright which can be bent out to accommodate for larger lower legs. It also is wider than average around the foot and ankle.

If you have a wide lower leg or swollen calf you will often have a wide foot also and so will require a wider orthotic to wear in the boot. For those with wider feet or lower extremity swelling we recommend the PowerStep Wide Orthotic Arch Support.

Walking Boot for Children&#;s Heel Pain

Kids with heel pain due to Sever&#;s disease (inflamed growth plate) often need to wear a boot for a week or so to allow the foot to rest and heal.

How long to wear it? For heel pain in children, most kids wear the boot for about 7 days.

Tall or Short Boot? Either one. Most kids are more comfortable in the tall walker boot as it does not irritate the shin.

Hints: Use an arch support like the PowerStep Arch Support  inside the boot to transfer even more pressure off of the ball of the foot.

Regular or Pneumatic Boot? Use the less expensive regular walker. You don&#;t need the more expensive pneumatic walking boot for heel pain in kids.

How To Wear Walking Boots Comfortably

For more information, please visit support boot for foot injury.

You Must Keep Your Legs Even

The most important thing to do in order to wear a walking boot comfortably is to ensure that you are wearing a shoe of the same height on the opposite foot. A running shoe often works well if it has a higher heel than forefoot.

Many shoes will require a heel lift to be added to the shoe. We like this adjustable heel lift. Try a couple different thicknesses of the lift to see which one is more comfortable.

Use an &#;Even-up&#; for Best Back, Knee and Hip Protection

For people with a history of back, hip or knee pain you will want to make sure your gait is as symmetric as possible. This means you want a rocker on your shoe that matches the rocker on the walker. This can be accomplished with the use of the Even-Up device.

The EvenUp straps to the bottom of your shoe so that your shoe will rock just as the boot does, giving you a symmetric gait and likely decreasing the chance of back or hip pain.

You Must Use Arch Support inside the Boot to Stabilize the Foot

Using an arch support inside the boot will further stabilize the foot in order to promote healing and decrease pain. A full length semi-rigid orthotic with a good amount of arch support works best.

A good choice for most people is the FootChair Orthotic with Adjustable Arch Support as it provides very good support at a relatively low cost and it is the only OTC orthotic we have found with an adjustable arch so that most everyone can get maximum support with comfort. We use this in boots very regularly and most patients find it both comfortable and supportive.

How Do I Protect My Skin When Wearing a Walking Boot?

Use a sock liner. Our favorite is the Aircast Sock Liner. It is essentially a non-constricting and cushy athletic sock that goes up to your knee and protects your skin when you are wearing a boot.

How Do I Keep My Foot Dry in a Waking Boot if it Rains? 

This Walking Boot Weather Cover will keep your feet dry in any weather. It is open at the bottom so you still have traction but otherwise covers your boot and foot to keep you dry and warm. Being that we are in Seattle, many of our patients use this cover.

• The weather cover will protect medical boots from rain, snow and sand.
• Fabric is both waterproof and breathable.
• Easy to clean.
• Fits right or left of almost all medical boots.

If you want a cover that only covers the foot then try this Fracture Cast Boot and Shoe Cover. This one has a non slip sole and goes over the foot portion of the boot.

The Fracture Boot Shoe Cover does a great job at not only keeping your feet dry but also at keeping your house clean. Since it covers the bottom of the boot just take it off when you get home and you have a clean, dry boot.

A Cane Can Help When Used Correctly

If you have an injured foot or ankle and are wearing a boot to protect your injured limb, using a cane in the opposite hand can reduce 30 &#; 40% of the force you are putting on the injured side. This can dramatically decrease pain and make it easier for you to move around comfortably.

Many people use canes incorrectly by holding the cane on the same side as the injury. In fact, canes should be used in the opposite hand and you should move your cane forward at the same time as the injured foot.  So if you are in a boot, the boot and the cane should be hitting the ground at the same time.

Especially during the first week or so of an injury, when it is at it&#;s most painful, a cane can be very helpful. Here is an inexpensive cane that we often recommend for our patients.

Do You Want Your Friends to Sign Your Cast?

Back in the days of plaster casts, one of the few benefits of wearing one was that your friends could sign it. The advent of
the walking boot kind of ruined that. But we have found that a silver Sharpie pen does a great job of permanently writing on walking boots.  So if you want your casts to be signed, carry a silver Sharpie with you.

How To Exercise When You Are Wearing a Walking Boot

Last but not least, what do you do to keep exercising if you have one of the injuries listed above and you want to continue exercising? Many of our patients are in the same situation so we have come up with a Guide to Exercising with a Foot Injury.  Use the link to read the guide and follow the instructions. We&#;ll make sure you can continue your workouts even when you have a foot injury and must wear a walker boot.

Call 206.344. or use our Patient Portal to schedule an appointment to ensure you get the right walking boot and it fits properly.

We know that walking boots are perhaps one of the most recognizable pieces of medical equipment thanks to their common and frequent use for treating most bone fractures and breaks. Walking casts, also commonly referred to as walking boots, air casts, or orthopedic boots, are specially designed medical devices that immobilize certain regions of the leg, ranging from just the ankle to the foot through the calf. 

By immobilizing the foot, ankle, calf, or all three, a walking cast prevents injured components from moving and keeps them securely in place for more effective healing. This allows injuries to heal even while you remain on the move, making the walking cast a great solution for post-surgical recovery as well. 

Due to their common use and the large number of different conditions or injuries that may be treated using them, walking casts are offered in an expansive range of sizes, shapes, constructions, and specialties. Some of the common sub-categories of walking casts include high-tops, low-tops, ankle casts, stiff or soft casts, and air-cast boots, to name a few. We know it can be overwhelming to look at your options when facing so many variations but don&#;t worry, we&#;ll explain the key differences between these categories later. 

Naturally, with such a diverse field of different walking casts, the process of finding the right product to meet the needs of you or your loved one can seem like a daunting challenge. With that in mind, we will present you with all of the need-to-know information to make sure that you&#;re getting the perfect walking cast for you. We&#;ll also outline some of the important considerations to make when trying to determine what features or specifications you&#;ll need for your walking cast.

Things to Consider

What type of walking boot is the best boot for a broken foot?

If you have a broken foot, we recommend consulting with your doctor first and foremost. Foot fractures and breaks come in many specificities and severities which will determine how long you should wear your walking boot. Tall boots are best for foot fractures and breaks, as they immobilize both the foot and the leg, allowing your foot to heal properly. We strongly recommend pneumatic boots for foot fractures, as the added protection helps to limit motion and assists in healing.

What are the side effects of wearing a walking boot? 

Depending on the location of the sprain, fracture, or break, and the duration in which you wear the medical boot, some people have reported pain or soreness in their knees, lower back, and hips. Most people report pain within the first two weeks of boot wear.

How many hours a day should you be wearing a walking boot?

We recommend contacting your healthcare provider to discuss your specific condition, but in our experience, people typically wear their walking boots for 12 to 16 hours a day. This will fully depend on your injury and your doctor&#;s instructions. It&#;s important to follow your clinician&#;s instructions for your individual needs, as this can severely impact the proper rate of healing.

Is it bad to walk on a cast?

It is usually best to avoid applying too much weight to a hard cast, especially if it has been recently applied. However, using a walking cast to protect both your leg and the cast will allow you to be able to move around and apply weight. We still recommend using crutches while wearing a cast to allow the leg to heal properly, though.

How tight should my cast be?

Casts must be tight enough to significantly limit the movement of the injured region of the body. The tightness of your hard cast will be determined for you by the doctor who applies it. However, for walking casts, the tightness should be enough so that the hard cast and the walking cast move together with no slipping or shaking.

Can I exercise with a medical boot?

Exercise is possible while wearing a walking cast, but it requires some modification from what you might be used to. We recommend that upper body exercises should be done using a bench or a seated machine whenever possible. Exercises that emphasize the upper body without extensive use of the legs are ideal, while cardio exercises such as running should be avoided.

Instead, low-pressure cardio exercises, such as using a hand pedal or low-resistance elliptical exercise are recommended. However, before performing any exercise while wearing a walking cast, we strongly encourage you to discuss your options with your doctor or physical therapist. They will be able to explain the limits of your allowed exercise and can even recommend certain exercises that are ideal for you.

How to Choose the Best Orthopedic Boot

Walking casts act as a treatment device for a variety of injuries or conditions that affect the foot, ankle, and lower leg. Because of the range of conditions that they can treat, walking casts are similarly diverse in their designs. Given this fact, we&#;ll start by outlining some of the major types of walking casts and the specific conditions and types of patients they&#;re designed for.

High-Top Walking Casts

When we mention walking casts in conversation, people usually think of a high-top walking boot. These boots wrap around the patient&#;s leg from the toes to the middle of the calf. These casts are most often used in the treatment of injuries or conditions impacting the ankle or the calf. 

High-top walking cast boots are characterized by a tighter, cushioned leg wrap surrounded by a hard, durable outer boot layer composed of thick plastic or sometimes a combination of plastic and metal portions. This durable outer layer of the boot is usually fastened around the inner wrapping using Velcro or another adhesive banding.

A noteworthy example of this style of walking cast can be seen in Allard USA&#;s Tall Walking Cast Boot.

Low-Top Walking Casts

A logical counterpart to the high-top walking casts is the low-top walking cast. These products very closely resemble high-top boots, but they're cut lower so they don't extend as far up on the leg. Most low-top walking casts cover from the toes to the lower calf just above the ankle. In our experience, this design makes these casts particularly useful in treating injuries or conditions that impact the foot, heel, or lower ankle.

An example of this form of boot can be seen in Allard USA&#;s Short Walking Cast Boot.

Air Cast Boots

Air Cast Boots represent an innovative advancement from the standard high-top or low-top walking casts. Unlike traditional walking casts, Air Cast Boots surround the covered region of the leg in a supportive air cushion that can be easily adjusted to provide customizable comfort and support. This design has been shown to promote a faster healing time while also allowing for increased mobility. 

While traditional walking casts are almost always designed to be used by patients with hard casts, Air Cast Boots can serve the role of both the walking cast and the cast itself. This is particularly useful, as it allows patients to remove the cast in certain circumstances, such as when showering or to allow fresh air to reach that leg region. 

It is important to note, however, that Air Cast Boots are intended only for minor injuries and should not be used in place of a cast for treating major injuries such as ligament damage or broken/fractured bones. For this reason, we use Air Cast Boots as a transition between a hard cast and no cast at all. By acting as an intermediate, the Air Cast Boot provides the necessary protection but also allows the patient to build up strength in the leg and have slightly more freedom than a hard cast.

Some popular Air Cast Boots we offer include ErgoActives&#; Shoebaum Air Cam Walking Cast Boot.

Hard Cast Shoes and Bottoms

Hard Cast Shoes, as their name implies, are designed as a rough shoe that wraps around the foot of a hard cast. These products do not offer the extensive protection and support that is provided by the previously discussed walking casts. Instead, they serve as a minor protective layer. In our experience, hard cast shoes are typically used to protect the foot region of a hard cast from being scuffed or damaged during a patient&#;s daily activity.

Features to Consider

In addition to the wide variety of different walking cast styles and models, there is a range of design features and variables that are important to take into consideration before landing on your final selection. We'll walk you through the most important of those now.

Cast Size

While likely an obvious consideration to make, it is worth the reminder that walking casts come in different sizes, often corresponding to shoe sizes or specific measurements of the foot with any added bulk of the cast. We encourage you to review the size options available for each walking cast you consider and what the sizing chart is based on before making your final purchase. Part of ensuring adequate healing is making sure that the boot you choose is appropriately sized to provide proper support and immobilization.

Strap Types

While the majority of walking casts use Velcro straps to keep the cast secured on the patient, this is not always the case. In our experience, some products, particularly smaller casts or cast shoes, may use clasps or non-Velcro-based straps for fastening. While perhaps not a crucial concern, it is worth reviewing what kind of straps a product has before making a purchase, especially if you have a preference, or if you live with a condition that makes it difficult to fasten small clasps.

Anti-Shock Technology

One of the more innovative features available in some walking casts is anti-shock technology. While most walking casts are capable of cushioning impact, some take it a step further by implementing anti-shock designs to further decrease the risk of injury. Specific anti-shock and anti-vibration soles or cast constructions are very useful in our opinion, especially if you're suffering from a large amount of pain and discomfort from the impact associated with walking.

Cast Liners

The interior of walking casts often features liners made with a range of different materials. For most products, these liners are designed to be soft, supportive, and comfortable. However, there are a variety of choices available, and some may be preferable for certain people or weather conditions. With that in mind, we think it is worth reviewing what the interior lining of a walking cast is made of, as well as if replacement lining is available, should the lining become worn down.

Supports

Some walking casts implement added supports, usually made of dense plastics or metals such as aluminum. In our experience, these are used to provide an additional degree of support to the leg. These supports are most common in high-top walking casts or Air Cast Boots that require more vertical stability, and they may not be required for every user. But, if you want either more support or greater freedom of mobility, it is worth checking to see if a product has them before making a purchase.

Conclusion

As you can see, there is a notable variety when it comes to the different types of walking casts. Therefore, we highly recommend that you discuss walking casts with your doctor, as they will be able to help you determine which type is best suited for your needs.

However, we hope that this guide has provided some helpful insight into the different types of walking casts and which might be the best for your needs. For more information, check out our full catalog of walking casts, and read more helpful buying guides as well as tips and tricks for better living at Caregiver University.

Author:

Megan Smith, PT

Megan has been a part of Rehabmart since its inception nearly 20 years ago. For the past several years she has been enjoying her role as HR Director while maintaining her Physical Therapy license. When she isn't working on her next in-service or working to find a new team member, she enjoys her five children, helping those who have PT type ailments, baking, practicing yoga, and working out.

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