A controlled ankle motion (CAM) walker, commonly referred to as a walking boot, stabilizes the lower leg, ankle, and foot following an injury, surgery, or fracture. This temporary immobilization protects the healing site and prevents movements that could disrupt recovery. Proper application ensures stabilization and maximizes comfort, directly influencing the success of healing. Understanding the correct procedure for putting on and securing the boot is crucial.
Preparing the Limb and Boot Components
Before placing the foot into the boot’s shell, prepare both the limb and the components for optimal fit. Ensure the injured limb is clean and completely dry to prevent skin irritation beneath the liner. Wear a long, thin, moisture-wicking sock, such as a cotton cast sock, that extends above the liner height to minimize friction and manage perspiration.
The boot’s soft liner must be completely open and free of wrinkles or folds before insertion. The liner provides cushioning and compression between the hard outer shell and the limb. If the boot includes air bladders, ensure they are fully deflated using the designated release valve, allowing maximum space inside the shell.
Step-by-Step Application and Securing the Boot
Begin the application by sitting down and placing the foot flat into the boot shell and liner. Ensure the heel is seated firmly at the back of the heel cup. Correct heel placement prevents the foot from sliding forward, which compromises immobilization and causes pressure on the toes.
Once positioned, smoothly wrap the soft liner around the foot and lower leg, securing the Velcro closures snugly. If the boot has a separate plastic front panel, secure it over the liner, tucking the bottom lip inside the boot shell near the toes.
Fasten the external straps starting from the bottom strap (over the forefoot) and working upward toward the calf. Tighten each strap until the boot feels secure and the foot is stabilized. Do not tighten the straps so much that they cut off circulation or cause numbness.
If the boot has an integrated air bladder system, inflate it after securing the straps. Press the pump button repeatedly until the air cells feel comfortably snug, providing customized compression. This pneumatic support enhances stabilization, but avoid over-inflating, as this restricts blood flow.
Verifying Proper Fit and Alignment
After securing the straps and inflating any air bladders, check the fit for safety and comfort. Ensure the toes are not jammed against the front of the boot, nor should they hang excessively over the edge. Allow approximately 10 to 20 millimeters of room for the toes to wiggle slightly, which helps maintain circulation and accounts for potential swelling.
Assess circulation by checking for numbness, tingling, or discoloration in the toes, which suggests the straps or air bladders are too tight. The boot’s rigid uprights should align parallel with the midline of the leg, holding the ankle in a neutral, straight position. When standing, the boot should not wobble or allow the foot to slide forward, confirming the heel is seated and the straps are tensioned correctly.
Usage and Walking Guidance
Walking in a CAM boot requires specific adjustments to maintain a safe gait. The boot’s sole typically features a curved “rocker bottom,” allowing the wearer to roll smoothly from heel to toe without flexing the injured ankle or foot. To utilize this feature, aim for a controlled heel-to-toe motion while maintaining a slightly shortened stride compared to a normal gait.
The boot’s height creates a leg length discrepancy that can cause hip or back pain. Use a shoe leveler or wear a shoe with a comparable sole height on the unaffected foot to balance the hips and pelvis. For hygiene, remove the boot liner daily to wash the foot and check the skin for redness or irritation. Sleeping with the boot should follow a healthcare provider’s specific instructions; straps may be loosened at night for comfort, and pillows can support the boot and elevate the leg.