Tuesday, December 7, 2010

Life in the Aircast caste - some helpful hints

So, just about 5 weeks done in the aircast, with less than 10 days to go.   I've learned a lot about living life with this thing, and it's probably worth posting some of it for posterity.  Hence, a list of helpful tips:

  • Stairs.   Since the aircast immobilizes your ankle and foot, there is a trick to going down or up stairs with your aircast.  
    • To descend stairs:
      1. rotate your body slightly, so that you are facing about 45 degrees towards your side that does NOT have the aircast on.
      2. take one step down at a time, leading with the leg that has the Aircast on.
    • To ascend stairs:
      1.  rotate your body slightly, so that you are facing about 45 degrees towards your side that DOES have the Aircast on.
      2. take one step up at a time, leading with the leg that does not have the Aircast on.
  •  General walking.   An aircast adds a non-negligible amount of length to your leg, leading to a leg length discrepancy that can rapidly result in substantial back, hip, groin, and knee pain.  I've discovered that a shoe with a 2 inch heel is the closest match.
    (as an aside -- I'm going to be a bit sad when I take this off for good and return to my original height of 5'4", instead of the lofty 5'6" to which I have become accustomed).

    Even after you even out the discrepancy, your gait will still be off -- the lower leg with the aircast is immobilized, meaning no flexion in the ankle joint, meaning that your knees, hips, and other ankle function in a modified way.  You're going to have some pain somewhere, and there's no real solution to this, other than doing what you can to minimize your walking.

  • Working out.  You now have one of your two legs encased in a device that adds a) 2 pounds in weight to that leg; b) adds 4 inches in circumference to that calf; 3) makes that leg much less stable to balance on (both because the ankle is frozen and because the bottom of the aircast is designed like one of those silly MBT shoes).

    These facts add a bit of difficulty to your gym workout.  Obviously, anything that involves standing or balancing on one leg is out (i.e. squats, lunges).   My philosophy has always been that free weights are best, but I've learned that there is a place for machines, and that's when you're injured.  Some observations on individual exercises:
    • For stuff like the abductor/adductor machine, or back raises, you can use a towel behind your good leg to balance things out -- effectively making your calves both the same width.
    • For pull-ups, even if you normally do them without assistance, it's better to do them with some sort of machine assistance and just add more reps -- when you hang freely from your hands, the imbalance between your two legs makes you twist in an annoying way.
    • IF your injury is in the foot, then you can still do planks and push-ups by removing your aircast and placing the tops of your ankles on a small exercise ball.  I imagine you could do the same thing, but on your knees, if your injury is to your lower leg.  Of course, make sure that you're stable and strong enough to do this without risk of falling, since you don't have the aircast protecting you.

  • TMI.  If you're a runner, then your aircast probably means you're in the pool.   Do yourself a favor and invest in some spray Tinactin or something similar.  Think about it: a) you're doing an activity in a very moist area; b) if your injury is to the foot, it's probably prohibitively painful to dry your toes thoroughly with a towel; and c) after you fail to dry your feet well, you place them into the same thing (the aircast) that you've been wearing for days now.   I assure you, you'll thank me for this tip.

  • Warm feet. Toes stick out of your aircast -- it's totally fine to wear a sock on the foot in the aircast to keep it warmer. 

  • Clean feet. If you're spending time in dusty/sandy places, it makes sense to get a plastic grocery bag to wear over the aircast (looping the top velcro strap through the bag handles).  Yes you look stupid, but it's better than getting sand in the damn thing that you've got to wear constantly for the next few weeks.

  • Arch support. Talk to your doctor to confirm, but in many cases, you can buy an arch support and place it in the aircast --your plantar fascia will thank you for this.

  • Accessories.  Your aircast comes with a pump to inflate it (after you've put it on) and deflate it (before you remove it).  You need this pump (called a "bulb"), and you will likely lose it.  Here's where you buy a replacement bulb.   For that matter, you can also buy a replacement liner for your aircast there.  Heck, you can even buy a replacement aircast, if things go really south.

  • Perspective.  Your life will be a lot happier if you learn to see your aircast NOT as something that keeps you from your normal life, but rather as something that enables you to live as much of your normal life while still protecting your healing limb.


    1. Great post! I think this will be helpful to a lot of people when having to face the fact that they need one of these. It's good to see you taking it "in stride". ;-)

    2. This soooo speaks to me! but i'm not working out. i'm eating bon bons at my round-the-clock pity party :-). (and i am NOT losing this bulb! i have it with me at all times!!). let me know how your "weaning" goes once you get the green light to ditch the cast. good luck!

    3. Thanks guys!

      Adina -- if you do misplace it, you know who to reach out to -- I now have two of them.

    4. This post actually helped me out alot, I am 15 years old ( skateboarder ) and I take working out very seriously and have been very upset over this aircast, but this helped me out alot, thank you.

    5. I recognize that this is a pretty old post, but I've just been, well not just been (about three weeks) placed in an air cast on my right leg for a high ankle sprain. I broke the same ankle about four years ago. Regardless, I have been experiencing A TON of pain in the patellar region of both legs, particularly my right (non-injured) do you have any advice on what might be causing/how to rectify this problem?

      1. Hi - I'm really not sure, but if I had to guess, I'd think that it might be from your gait being altered by the aircast. I never experienced patella pain, but everyone's walking gait is different.

        Also, did you start cross-training heavily when you got hurt? The knee issues might be due to taking up a new activity?

    6. Thank you so much for this post! I do realize it was a couple years ago, but it has never appeared on my search before (been looking for fitness advice for Aircast wearers for a few weeks now). I tore my right calf very badly while attempting to lose weight (my eliptical slipped it's track and took my leg with it), and I have been trying to find ways to work out for the next 2 months I have to wear the boot.
      Luckily I have a few pieces of equipment to exercise my upper-body quite well, but does anyone have any advice on how to work your lower body? My Aircast is full-length.

    7. Thank you so much for all the hints and advice. It is easy to get wrapped up in self pity (and bon bons). I need to snap out of it and get those core muscles working. I have had two weeks of a pot and now 4 weeks of an aircast before 4 weeks of a splint. I need to get on with it NOW !


    8. Thank you so much for this post! I'm a runner, and have a stress fracture in my foot that happened Nov 8 and I just got the MRI and Air cast on the 25th. It was pretty devastating. I also do kickboxing and pilates, and am very active overall... I decided there is no reason why this has to get me down. I can swim, bike, and do whatever pilates and yoga that I'm able to. There are always modifications! Plus, once I can add running back to my schedule I should be ready for a triathalon! Thanks for all the words of advice.

    9. So this post is wildly old, and thus I'm not sure if anyone will see it, but: a couple years ago I fractured my foot and had to wear an air cast for about 8 weeks. Because I'm an idiot, I did not get and "even up" for my other foot. Since then I've been having problems with that same leg that the doc is saying is a sciatic nerve issue. I'm thinking though that it has a lot to do with the uneven walking I went through for 8 weeks. Does anyone know of how to "right the wrong" of walking unevenly? Is there a term for this I can google? Are there exercises? Any help would be immensely appreciated!

      1. I imagine a good physiotherapist can help :)

    10. I know that this post is several years old. I broke three bones and dislocated my left ankle on Feb 12, 2014. For the first week I was in a splint for swelling to go down followed by surgery (plate and 6 screws) then I was bandaged for 2 weeks. Afterwards I was in a hard cast for 4 weeks. I am now in an aircast (luckily the bulb is attached to my cast) I have had it for a week so far and I still have to use my crutches. My back hurts so much. I still have 5 more weeks of walking with my aircast. What can I do to ease the pain in my back?

      1. Hi - I am a) not a PT or doctor, b) haven't seen you at all. But my hunch is that the back pain is either muscular pain from using the crutches, or pain from your aircast being a higher elevation than your other shoe (even though you use the boot, I'm guessing you put some weight on it).

        Honestly, the only things I can think of are a) minimizing the distance you have to travel, b) making sure to wear a shoe on your right that matches the height of the boot, and c) getting someone to look at your crutches and ensure they're at the right height.

      2. Thank you for the reply. I did have someone check my crutches and they were set correctly. I am trying to put some weight on my injured ankle but scared to try without my crutches. (I know that I will have to get over that fear soon and begin walking again.)

        Thank you again.

    11. Hi! I have been in an aircast for two days now and it's killing my shin! Have you ever had a bruise and touched it? That's what it feels like every time I take a step. Any advice? Thanks!

    12. Totally appreciate this post. Two weeks until my follow up. The random aches and pains are the worst.

    13. Great post, thank you. I wanted to add that you can buy a casing that attaches to your good foot, called an EvenUp. It adds height and has two levels. It's worked perfectly for me while wearing my aircast a month now. Just attaches to my running shoe. I bought two to keep on two separate shoes but it's easy to put on and off. Got it on Amazon. (not affiliated with this product! It just helped so I want to share. My doctor took a picture of it and is recommending it to patients now).

      I've also been working my thighs and butt by doing the "fire hydrant," and in my case strapping two "10 lb" ankle weights to the thigh I'm working. I do traditional fire hydrant, then I do where I lift the leg behind me, and then roll over and work the inner thigh by laying on my side and lifting it up. Then move to the other leg. I leave my boot on as it gives me even more weight on that leg. Can't help those poor calves though...

    14. Great post, just about to go into a boot after five weeks in cast..still nwb...lots of aches and pains from sitting around 10 weeks now and crutches...