A walking boot, often called a controlled ankle motion (CAM) boot, is used after lower leg, ankle, or foot injuries or surgeries. Whether you can walk without crutches while wearing this boot depends entirely on the specific instructions from your physician. While the boot provides support and protection, it does not automatically eliminate the need for an assistive device. You must follow the weight-bearing status assigned by your orthopedic surgeon or physician, as premature weight bearing can severely compromise your recovery.
Weight-Bearing Instructions
The ability to discard crutches is not determined by the walking boot itself but by the amount of force your injury is medically cleared to withstand. Your physician will assign a specific weight-bearing status to protect the healing tissues.
Weight-Bearing Statuses
- Non-Weight Bearing (NWB): This is the most restrictive status, meaning absolutely no weight can be placed on the injured leg. Crutches, a walker, or a knee scooter are mandatory. Attempting to walk without crutches when NWB carries a severe risk of destabilizing a fracture site or compromising a surgical repair.
- Touchdown or Toe-Touch Weight Bearing (TTWB): Allows the toes to lightly contact the floor for balance only, but does not permit the application of body weight. Crutches must still bear the majority of your weight.
- Partial Weight Bearing (PWB): Allows you to put a fraction of your body weight, typically between 25% and 75%, onto the limb. Crutches are necessary to accurately offload the remaining percentage of weight.
- Weight Bearing As Tolerated (WBAT): Allows you to apply as much weight as you can manage without significant pain. This is generally the only status where walking without crutches may be allowed.
Understanding the Function of the Walking Boot
A CAM walker boot stabilizes and protects the injured foot and ankle. The rigid outer shell and adjustable strapping immobilize the area, limiting movement that could disrupt the healing process of bones, ligaments, or tendons. The boot can be removed for hygiene and controlled rehabilitation exercises, which is a benefit over traditional casting.
The boot features a rocker bottom sole, which is designed to facilitate a smoother, more natural-looking gait by promoting a rolling motion from heel to toe. This design helps to redistribute weight during walking and reduces the stress placed on the joints and injured site. However, while the boot controls motion and provides protection from external impacts, it does not inherently reduce the overall vertical force of your body weight.
The boot’s design allows for controlled movement and protection but cannot fully substitute for the load-reducing function of crutches. For injuries requiring NWB or PWB, crutches act as an external support system, diverting the body’s weight away from the injured limb and through the arms and healthy leg. The boot is a protective enclosure that manages internal movement, but the crutches are the assistive device that manages external load.
Signs You Are Ready to Transition Away From Crutches
Once your physician clears you for Weight Bearing As Tolerated (WBAT) or Full Weight Bearing (FWB) in the boot, you can begin reducing your reliance on crutches. This transition must be gradual and guided by your body’s response, with pain being the most reliable indicator of readiness. Any significant increase in pain during weight bearing signals that you should revert to using crutches and contact your medical provider.
A common starting point is transitioning from two crutches to a single crutch or a cane. The remaining assistive device should be held on the side of your uninjured leg. This placement allows the device to work with the natural gait cycle, effectively widening your base of support and providing leverage to reduce the force transmitted through the injured leg as you step.
You should continuously assess your walking pattern, or gait, for any noticeable limping or compensatory movements. A persistent limp suggests that the injured leg is not strong enough or that the injury is not healed enough to bear full weight comfortably. A smooth, even stride without leaning to one side is the goal before completely abandoning the last crutch.
As you spend more time walking in the boot without support, limit your initial walking sessions to short distances and controlled environments, such as indoors on a flat, non-slip surface. An important consideration is the height difference caused by the boot’s thick sole, which can be several inches higher than your regular shoe. Wearing a shoe lift on your uninjured foot can help equalize your leg length, preventing unnatural hip and back strain that can lead to new pain or injury.