Motion Is Medicine

by Vince Vacketta, DPM

Casting and bootwalker post-operative protocols are designed to load share our reconstructions until the tissue strength allows for unprotected activity. Being careful by extending immobilization may also doom patients to greater postoperative stiffness and prolonged rehabilitation.

A little motion goes a long way

In the setting of ankle fractures, Llano et al. (2023) found no increase in complication or re-operation in patients who were permitted to perform a prescribed ankle mobility regimen beginning as early as 48 hours post-op. Similarly, in achilles repairs, Mitrogiannis et al. (2024) demonstrated improved patient reported outcome measures and better tendon healing in patients who performed active ankle joint exercises beginning post-op day one following achilles tendon repair. 

Another nail in the coffin of casts

A complimentary study from the NHS has shown a minimal increase in cost, a reduction in productivity loss, and greater patient empowerment when patients were immobilized in boots rather than plaster casts.