Recovering from an ankle fracture requires immobilization, often in a cast or splint, which challenges routine hygiene. While maintaining cleanliness is important, the priority is protecting the cast or dressing from moisture. Getting a cast wet, whether plaster or fiberglass, compromises its integrity and can encourage skin irritation or infection beneath the padding. Carefully preparing the bathing area and utilizing specific techniques allows for safe showering without risking the healing process.
Essential Safety Preparations
Showering begins with consulting the treating physician or physical therapist. They provide specific instructions regarding weight-bearing status, which is a significant factor in determining the safest showering method. Modifying the bathroom environment is necessary to mitigate the risk of falling while balancing on one leg. Installing temporary or permanent grab bars provides a stable handhold for navigating the space and for transfers into and out of the shower area.
A sturdy, non-slip shower chair or bench eliminates the need to stand and balance on the unaffected leg during the shower. The chair should be placed inside the shower or tub, ensuring it is stable and positioned for easy access to the water spray. Additionally, using a textured non-slip mat both inside and immediately outside the shower perimeter helps secure footing and reduces the chance of slips upon exiting. These modifications transform a high-risk area into a more manageable one for a person with a non-weight-bearing injury.
Techniques for Keeping the Cast Dry
Protecting the cast from water exposure prevents complications like skin infection or softening of the underlying padding. The most reliable solution is a specialized, commercially available waterproof cast cover. These durable sleeves are designed with a tight, self-sealing ring, often made of silicone or neoprene, that forms a watertight barrier above the upper edge of the cast. When applying the cover, ensure the seal rests on the skin several inches above the cast line to prevent seepage.
Alternatively, individuals can employ do-it-yourself (DIY) methods using common household materials for a temporary barrier. A large plastic bag, such as a trash bag or sealable storage bag, can be pulled over the cast and secured tightly at the top. The seal must be created using waterproof medical tape, duct tape, or a thick rubber band wrapped firmly around the plastic and the skin, just above the cast.
Showering Maneuvers and Execution
Entering and Positioning
The physical process of entering the shower requires slow, deliberate movements to maintain balance and prevent placing weight on the injured foot. Using crutches or a walker to approach the shower chair, carefully back up until the unaffected leg touches the chair. Execute a controlled transfer by placing both hands on a stable surface, such as the grab bars or the sides of the transfer bench, and lowering the body onto the seat. The injured leg, with the waterproofed cast, must be lifted and positioned outside the direct spray of the showerhead. It often rests on a small stool or the edge of the tub if a transfer bench is used.
Washing and Exiting
Once seated, adjust the shower to a lukewarm temperature. A handheld shower head is highly beneficial as it allows for precise control of the water flow. Direct the water only to the parts of the body being washed, ensuring the casted leg remains elevated and completely dry. After washing the torso and the unaffected limb, use the handheld spray to rinse thoroughly, taking care not to let the water pool around or stream toward the cast.
Exiting the shower requires reversing the entry process. Use the grab bars for support to push up from the chair while keeping the injured foot elevated and non-weight-bearing until completely out of the wet area. Following the shower, carefully remove the waterproof cover and immediately inspect the cast for any signs of dampness or water penetration.