Cast vs. Walking Boot - Brace Direct

Cast vs. Walking Boot

It is crucial to stabilize the foot after an injury. Damage to the ankle soft tissues leads to ankle sprains, while high-impact forces cause the breaking of the bone. To allow proper healing of the ankle or foot, your doctor might recommend medical equipment like a walking boot or a cast.

Your orthopedic surgeon will decide which option will work best for your sprained or broken foot or ankle.  

This article will discuss all you need to know about a cast vs. a walking boot!

What Is a Walking Boot?

man with foot elevated wearing a walking boot for foot fracture

A medical shoe or a walking boot is an orthopedic device to protect and support your injured leg, ankle, or foot following injury. It allows for minimal weight-bearing.

In a study, 8% of participants suffering from lateral ankle sprain were prescribed an orthopedic walking boot. The specially designed medical footwear played an essential role in stabilizing the foot.

Early immobilization of the foot is crucial in quick and complete healing. Research suggests that delaying conservative treatment after acute lateral ankle sprains can worsen the condition. Walking boot immobilization is an effective way of preventing further injury.

The boot is made of lightweight but robust materials that make patient compliance better. The plastic mold of the boot is durable and strong enough to bear your weight. 

Most walking boots keep your foot upright and help the leg maintain a natural posture. Inside the boot, you can find shock-absorbing insoles. 

A walking boot is also used to stabilize the foot after a surgical procedure. Your orthopedic surgeon will prescribe an orthopedic boot and guide you to bear weight on crutches.

A 2022 study concluded that using walking boots and crutches helped heal in Achilles tendon repair surgery. Specially designed cam walker boots are now available to treat ankle fractures. The long cam boots are also helpful in stabilizing lower extremity (lower leg, Achilles tendon) injuries.

The healing of ligaments can take several weeks. The ideal time for complete recovery of ligaments is two to six weeks. Thus, you should wear the boots for the mentioned time. 

What Is a Cast? 

foot in cast with doctor explaining xrays

A cast is a fixed orthopedic device that supports the broken foot and ankle by completely immobilizing it. 

It is a non-weight-bearing device that entirely immobilizes the foot so the fractured bone ends heal optimally. A cast is prescribed in cases where maximum support and protection are needed.

Casts are mostly applied after surgery to prevent infection and abrupt healing of bones. Your doctor will place the device after reducing and fixing your fractured bone in place. According to a randomized controlled trial, early mobilization with a removable cast has short-term benefits in managing fractures.

A cast can also be an alternative to surgery in managing unstable fractures. A close-contact foot cast is a blessing for old patients with ankle fractures who can not undergo surgery. 

Compared to a foot brace, a cast is a safer treatment option. According to a prospective study, the risk of postoperative wound complications with casts is lower than with foot braces. 

There are mainly two different types of foot or ankle casts. A plaster cast is rigid and strong and holds the foot tightly. You can also get a fiberglass cast which serves the same purpose but is more durable and lightweight.

Different conditions validate the use of a foot cast. Stress fractures are the result of repetitive abnormal movements of the foot. Rigid immobilization is necessary to keep your foot from damaging repeatedly. Ankle fractures (caused by falls, sports injuries, or roadside accidents) also need a cast. 

Fractures take weeks to heal. Your orthopedic surgeon will decide how long the cast must stay. However, a plaster cast is usually placed for four to twelve weeks. 

Cast vs. Walking Boot: Benefits of Using Them

foot being examined by a doctor

When it comes to a cast vs. a walking boot, it is crucial to know that both medical devices serve the same function, i.e., keep pressure off the injured area and heal your fracture. 

Your surgeon will advise you which option might be better for your condition.

For severe fractures, a cast is the primary mode of treatment as it is fixed in place, resulting in better healing. A walking boot can be used in the next phase of treatment when the fracture heals considerably.

For minor injuries, a walking boot can be the only device needed to heal the fracture.

Both orthopedic devices have certain benefits, which we will discuss below.

Benefits of Wearing a Walking Boot

A walking boot provides several advantages over a cast, which are as follows:

Light Weight

A walking boot is ergonomically designed to keep it light on the foot. The lightweight design makes it easier for people to use the boot for long periods without fatigue.

Casts are heavy and tend to pressurize soft tissues. The light in weight walking boots softly protect the muscles, ligaments, and tendons of the ankle and foot. There is a reduced risk of straining the muscles.

Ease and Comfort

womans foot with a fracture walking boot on

The best thing about walking boots is comfort. Removing an orthopedic boot does not require any extra effort. All you have to do is unbuckle the straps and carefully remove the boot, like for showering. The ability to remove the boot allows sufficient relaxation of the muscles too.

Wearing a cast too tight can compromise the blood flow of the region, leading to compartment syndrome. With a walking boot, you can remove the device whenever your nerves are compressed.

Unlike a cast, you can adjust the tightness of a boot. The adjustable straps allow you to set the compression at a comfortable level.

Skin Protection

Close contact casts can have a negative impact on skin health. It can lead to the skin becoming painful and prone to breaking due to moisture buildup if allowed to get wet. That can cause sores and itchiness.

Walking boots offer open-air design. The option to remove the boot helps allow the skin to breathe and replenish the moisture.

It was revealed in pediatric studies that skin complications are seen in cases of casts but not with the use of boots.

Faster Healing Time

Getting back to your daily activities can be done sooner with a walking boot. A walking boot partially keeps the muscles and tendons moving.

Recovery and rehabilitation from the injury are quicker because your foot or ankle is not immobilized completely (as in the case of a cast). Accordingly, rebuilding muscle strength happens fast.

Benefits of Using a Cast 

foot in cast elevated

The following are some of the benefits of using a cast instead of a walking boot:

Lesser Complications

Rigid fixation by a close contact cast tightly secures the foot in place and restricts movement, which is at the core of fracture treatment and healing of the bones.

Therefore, a cast is the best option for noncompliant patients. There are fewer postoperative complications as it remains fixed until the fracture heals.

Ideal for Extreme Cases 

A cast is the only option for complex ankle sprain and fracture cases. Casts are placed after the surgical reduction and fixation of fractures.

Rigid casts can also act as alternatives to surgery in senile patients who can not undergo surgery due to old age.

Colorful Options 

Orthopedic doctors offer casts made of a variety of colors, depending upon your preferences. Youngsters and teens can select from an option of different colors, including bright colors.

Fits Your Size

A cast is made according to the particular shape of your foot. Unlike a walking boot, you don't need to search for the ideal size.