Outside of post-surgical scenarios and fractures, it’s rare an orthopedic boot is necessary. I’ve seen them prescribed inappropriately many times. Severely restricting or eliminating movement to that extent with an immobilization boot is the last option for orthopedic disorders. For example, you don’t want to boot a tendinopathy! As I always say, it comes down to competent diagnosing.
Not only are patients often getting incorrect treatment for their ankle/foot complaints, but walking around on an uneven surface can disrupt other parts of the body. A boot can jack you up both literally (by an inch or more) and figuratively. It’s common for people to complain of knee, hip, or back symptoms because of walking around in a boot. For those who do need to wear a walking boot, I usually recommend buying something to attach to the other foot (such as an “Evenup Shoe Leveler”) to level the feet or simply wearing a higher shoe on the unaffected foot. -- Laura
The perfect position is the position that reduces, abolishes, or prevents symptoms. And if a lumbar roll doesn’t reduce, abolish, or prevent symptoms, then it is not indicated. A roll may make symptoms worse initially, but, as therapy progresses, it becomes helpful. Or it may only be tolerated for 20 mins but eventually is useful for long stretches. Its use should always be assessed, not recommended without reasoning.
When it comes to prevention, often that looks like a person who doesn’t have symptoms in sitting but has trouble rising, especially with straightening his low back. Or it may look like a person who has no pain all day sitting at work but then pain in the evenings at the gym. If using a lumbar roll all day prevents pain later at the gym, then it is indicated.
Lumbar rolls can be extremely effective as can any decent lumbar support built into a chair. The point is usually to reduce prolonged spinal flexion or enhance extension. Lumbar rolls can be easily added, adjusted, and removed. They can come in the form of a rolled up sweatshirt, household pillow, or something purchased. I’ve had patients support their low backs with water bottles and purses. I myself used my wallet while driving once. Their low cost and ease of use make them potent tools for helping those with musculoskeletal complaints. -- Laura
If your foot/ankle needs to be immobilized and/or you can't walk on it, you have a few options. There are wheelchairs and crutches, but what fewer people know about are knee walkers (aka knee scooters or knee rollers). If you have the balance to manage them, they're a great way to get around quickly. Also, they don't take up too much space and don't require a lot of arm use like crutches do. Here is an example. -- Laura
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