First day of weight bearing pain

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4 weeks ago I had surgery to repair a split posterior tibialis tendon. I was in a splint 10 days, and in a boot after that.

Went to the doc today and he said "You'll be able to ditch the crutches and start walking in the boot. You may need to use one crutch for a bit."

So I walk with 2 crutches out of the doctor office, putting as much weight as I could on my foot. Which wasn't much. I told him, "this is pretty painful in my Achilles area, is that normal?" And he said yes because of my foot being unused and at a 90 degree angle.

So, on the one hand it seems like he expected I could walk out of the office unassisted in my boot. But it really hurt (I'm a wimp though).

So, how much pain is "normal" when you first start weight bearing? Is there anything I can do to make this transition smoother and less

painful? Or did I just Powe through it, knowing it'll get better?

Thanks for any insights!

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6 Replies

  • Posted

    Hey there Kim, 

    I had two ligaments repaired and some extensive damage done due to a fall last year and had the surgery this year Nov 13th.  Today was two weeks to the day and I had my splint cast taken off and a hard cast to my knee on for one week. Today I was told I can put almost 50% of weight down and try to walk on the foot. Next Monday the cast comes off again and take the stitches out then a cast until Christmas. Then to a brace for 3 weeks to a boot!  It seems to me that you just went from a crutches to walking??? Without physical therapy???   That seems so extreme to me after only 10 weeks!  My foot is super painful today in the cast but I am only 2 weeks out. I was told that I would have a lot of pain for a while due to the ligament damage. 

    I would give it some time and hopefully with some time it will lessen for you. Make sure you stay ahead of the pain with your meds they gave you. 

    We are similar in injuries so I will try to keep you posted as I move along! 

    Good luck!


  • Posted


    I had a similar feeling when I was told to weight bearing.  The doctor and PA wanted me walking with my boot and no crutches. The doctor gave me a choice a couple weeks into weight bearing.  He said try walking with your boot and no crutches OR crutches and no boot!  I chose no boot and used crutches.  For me that was a positive shift to more weight bearing.  I started using one crutches sometimes and now after 3 weeks of transitioning I am not using crutches at all!  I walk slow and have to put my foot up a lot but I’m on my way!  

    Good Luck!


  • Posted

    It is painful to start bearing weight bearing after being NWB for a long time. I had a trimalleolar fracture of my ankle in September and was NWB for 8 weeks. Then 50% for two weeks before being 100% WB. I worked with a physical therapist and have just started to walk with no "aids" in the past two weeks. I have been going to physical therapy and my therapist has worked with me to regain my mobility.  She emphasizes a gradual approach rather than just working through the pain.  Personally, her approach has worked well for me. I think doctors view the process in a very technical, clinical way, not necessarily as a drawn out process. Have you consulted a PT? I recommend it. A PT would help you develop your muscles at a pace suited to your needs. And be thankful that you know you will get better.

  • Posted

    Thanks everyone for the info! I am going to start PT this Friday.

    Today, the worst pain I have is in my outer heel, but the only surgery I had was on my inner ankle (PTTD), not my heel at all!

    I'm guessing it's because my foot was frozen in place and unused for 4 weeks. It hurts worse the more weight (in the boot of course) I put on it. So I've been standing and rocking on it like 25% weight. I'm asking my PT about it when I go.

    If it weren't for that pain, I think I could walk in the boot unaided. My surgical site is a little sore, but the heel pain is horrible.

    Thanks again to everyone for their thoughts, stories and information. I wish and pray speedy and complete recoveries for you all ??

  • Posted

    Hello Kim,

    I experienced an injured post tibial tendon subsequent to an ankle fracture/sprain.

    I was in a CAM boot NWB for about 6 weeks, then about 2 weeks PWB (50%).

    The injured post tibial tendon (it was stretched but not completely torn) developed into post tibial tendon dysfunction (PTTD), and it was the single biggest hindrance in my recovery since initial fracture/sprain. Everything else (ligament, bone) bounced back on schedule.

    When I started walking with and without boot the only pain I had was from PTTD. That tendon, when injured, can be vexing in recovery. It has a reputation among doctors that treat it (usually sports injuries in athletes and enthusiasts from too much running, sprains, etc.) as being problematic, and not always healing completely. If it doesn't heal properly it could spell chronic ankle problems down the road.

    For the first few months, simple walking produced minor but nagging pain in that tendon (it runs in its connective tissue sheath from calf down around ankle bone and connects on foot bottom near arch). Walking down stairs was too painful (tendon has to stretch like a pulley to do that). Also single heel lifts (toe raises) on that foot was impossible at first (tendon too dysfunctional to aid in that mechanical action-- that's typical).

    Now, I walk and use the stairs with confidence and little or no pain (since about 8 months or so). But it hasn't been easy.

    I've done fairly aggressive rehab to forestall life-long chronic PTTD, with physiotherapy, PEMF therapy, and supplements to regenerate connective tissue. I've relied heavily on elastic bands for inversion/eversion exercises to tone that tendon, and a lot of work on wobble board as well.

    A good orthotic shoe insert has been a great help in supporting tendon, as it has been for many PTTD patients.

    Best of luck to you.

    • Posted

      Hi Kpower, yes, PTTD was the bane of my existence for about 6 months as I tried PT, acupuncture, RICE to relieve the pain in my ankle. No injury but I was born with flat feet, and after 50 years of walking alot for exercise and only sporadically wearing orthotics, my tendon finally wore out. Doc gave me the choice of surgery just to fix the tendon ( debride including sheath, stitch tendon splits back together and wrap tendon in suture to help it heal back together), or more invasive surgery to correct my flat foot. I opted for the former, with the understanding I will never walk barefoot and will always wear orthotics.

      So far, the boot pain has been my incision (I can feel the skin pulling when I move my foot but no really deeper pain), and walking in the boot feeling like there's a rock under my heel. I'm trying gel heel cups in the boot next.

      What kind of supplements did you take? Did the PEMF really work, do you think? I don't even know if anyone in my area practices that.

      I start PT tomorrow and intend to work my butt off to get back my mobility.

      Thanks for the info!


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