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. 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.

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.

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.

Figure 1 - Tall Walking Boot

Figure 2 - Short Walking Boot

Figure 3 - Tall Pneumatic Walking Boot

Here are some of the common conditions treated with walking boots. You can click on the link to learn about walking boots for that particular problem:

• Plantar Fasciitis / Heel Pain
• Ball of Foot Pain
• Ankle Sprain
• Metatarsal Stress Fracture
• Toe Fracture
• Foot Fracture
• Ankle Fracture
• Tendonitis
• Children’s Heel Pain

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 boot.
Hints: Use an arch support like the Powerstep Medical Grade Orthotic (figure 4) inside the boot to take more tension off of the plantar fascia.

Figure 4 - Powerstep over the counter insole

• More home treatment hints for plantar fasciitis / heel pain can be found here.

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 boot.
Hints: Use an arch support like the Powerstep 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 metatarsalgia.

• More home treatment hints for ball of foot pain can be found here

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.

• A complete home treatment plan for ankle sprains pain can be found here

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.

• A complete home treatment plan for metatarsal stress fractures can be found here.

Walking Boot for Toe Fracture
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 recommend the tall pneumatic boot. You need the extra protection to limit motion as much as possible.

Walking Boot for Ankle Fracture
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.
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.
Hints: For posterior tibial tendonitis an arch support such as Powerstep will help decrease tension on the tendon.

• A complete home treatment plan for posterior tibial tendonitis can be found here.
• A complete home treatment plan for peroneal tendonitis can be found here.

Heel Pain in Children (metatarsalgia, neuroma)
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 boot.
Hints: Use an arch support like the Powerstep 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 metatarsalgia.

• More home treatment hints for heel pain can be found here

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Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.