Orthopaedic Surgery: Your Footwear Journey

From elevation to orthotics. What you wear (and don’t wear) on your feet after surgery matters more than you think. Here’s what you need to know from our podiatrists who work extensively with patients undergoing and recovering from orthopaedic surgery.

When it comes to recovering from orthopaedic surgery, footwear and foot supports are key elements. From the moment your procedure is complete, every step forward must be taken carefully. Whether the goal is to reduce swelling, protect the surgical site, prevent compensations (or complications), or support you as you start to walk again, make no mistake: the devices you wear and use can significantly influence how quickly and how well you recover.

As podiatrists working alongside orthopaedic surgeons, we help patients navigate the many stages of post-op care with a focus on foot health, pressure offloading, gait retraining, and biomechanical support. That often includes helping select and fit the right footwear or support device at the right time. But this process isn’t one-size-fits-all. Your foot support needs will likely change over the course of your recovery, from the very first day to the day you return to full mobility.

So to help, we’ve put together this guide on the different shoe and support options and how each contributes to a better recovery.

1. The Early Days: No Shoes, Legs Elevated

In the first 24-48 hours following orthopaedic surgery, rest is crucial - and that means staying off your feet. While we’re quick to talk about what shoes to wear after surgery, the truth is that not wearing shoes initially can be just as important. Your body is in its acute healing phase, and the priority is to reduce inflammation, manage pain, and encourage circulation to the area, all of which are supported by elevation and rest.

Keeping your legs at or above heart level helps reduce post-surgical swelling, which is one of the most common and uncomfortable symptoms patients experience. This also lowers your risk of complications like wound tension, delayed healing, and skin breakdown. For surgeries involving the foot or ankle, avoiding shoes entirely during this very early initial phase (while you’re still in the hospital) avoids unnecessary pressure on the surgical site and allows dressings to sit evenly without compression from footwear.

During this time, your footwear isn’t your focus - your positioning is. Use pillows or leg elevation devices to keep the limb raised, and follow your surgeon or podiatrist’s guidance on how often to move, wiggle your toes, or perform simple circulatory exercises from bed.

2. Crutches: Reducing Load, Preserving Independence

Once you begin transitioning out of complete rest, your first ‘mobility aid’ likely won’t be footwear - it may be crutches. Crutches help you maintain independence while reducing the load on your healing limb, allowing you to move safely without placing weight on the surgical area too early.

The keyword here is partial offloading. Crutches aren’t designed to keep you completely off your foot forever, but they are invaluable for bridging the early recovery period when the tissues are vulnerable to stress and strain. Depending on the type and location of your surgery, crutches may be recommended for a few days to several weeks. In a foot or ankle procedure where weight-bearing needs to be delayed, you may be non-weight bearing for 2–6 weeks, gradually increasing the load (as directed).

Podiatrists play an important role here in helping you progress safely. We assess how you use your crutches, check for compensations (like limping or uneven loading), and help transition to partial and then full weight-bearing when the time is right.

3. Moon Boots & Pneumatic Walkers: Immobilise, Support & Protect

Once you're cleared to begin putting some weight through your foot, you may be advised to use a moon boot or a pneumatic walker. These specially designed medical-grade devices serve a very specific purpose: to immobilise and protect the surgical site while still allowing you to walk safely and progressively increase your activity.

Moon boots (also known as CAM walkers) are rigid boots that protect and stabilise the foot and ankle. They’re typically prescribed following foot, ankle, or lower leg surgeries such as fracture repairs, tendon surgeries, or ligament reconstructions. The goal is to allow healing to continue nicely without the stresses and micro-movements from a typical walking pattern. We see moon boots worn for 4–6 weeks after surgery, depending entirely on the type of surgery and your healing progress.

Pneumatic walkers are a type of moon boot that includes an air bladder system. By inflating or deflating specific areas of the boot, we can adjust the level of compression and support to suit your needs, often improving comfort and helping to manage swelling more effectively. This feature is beneficial in the first few weeks when swelling levels can change daily.

4. Ankle-Foot Orthoses (AFOs): Stabilising & Rebuilding Confidence

For some people, especially those with ongoing weakness, instability, or neurological involvement after surgery, an ankle-foot orthosis (AFO) may be introduced as part of the recovery process. AFOs are external braces designed to support the foot and ankle, often used to control movement, improve walking ability, and prevent the foot from dropping.

Unlike moon boots, which are temporary and bulky, AFOs tend to be more lightweight and discreet, and they’re often used over a longer period to help retrain movement or compensate for lasting deficits in muscle function. Some are rigid and designed to keep the foot in a set position, while others are dynamic and allow controlled movement depending on your needs.

You may be prescribed an AFO if surgery has affected the nerves or muscles controlling your foot, or if a pre-existing condition (like stroke, multiple sclerosis, or peripheral neuropathy) means your foot isn’t functioning as it should during recovery. They’re also occasionally used following major foot deformity correction surgery to maintain improved alignment and help prevent re-injury.

One of our roles is to ensure your AFO is fitted correctly, doesn’t cause pressure points or rubbing, and is reviewed regularly as your strength and movement improve. We’ll also help build your confidence in walking safely and independently with it on.

5. Custom Medical Footwear: When Everyday Shoes Aren’t Enough

In some post-surgical journeys, especially when the foot shape has changed significantly or there's ongoing vulnerability to pressure or re-injury, everyday shoes aren’t enough. This is where custom medical footwear comes in as a tailored solution designed to accommodate specific structural needs, prevent complications, and support your mobility.

These shoes are not your typical ‘extra wide’ or ‘orthopaedic-looking’ shoes that you might find off the shelf. Custom medical footwear is made specifically for your foot, taking into account any swelling, deformities, altered joint positions, surgical scarring, or pressure sensitivity. They're often prescribed for patients recovering from complex foot surgeries, those with diabetes and neuropathy, or where wound prevention or protection is a high priority.

What makes custom footwear so important is its ability to distribute pressure evenly, accommodate unique foot contours, and support safer, more stable walking. For patients who have had reconstructive surgery or major deformity correction, they also help maintain the structural improvements achieved during surgery, helping reduce the risk of regression or compensatory issues over time. Our podiatrists collaborate with trusted orthopaedic footwear providers to ensure our patients are correctly measured, fitted, and reviewed. 

6. Custom Footwear Modifications: Tailoring Support to Your Needs

In many cases, patients may not need fully custom-made shoes, but they need modifications to their existing or prescribed footwear. These modifications are highly targeted adjustments that alter how pressure is distributed across the foot or how the foot functions within the shoe. This may look like:

• Rocker soles to reduce forefoot pressure during walking

• Heel lifts or build-ups to correct leg length discrepancies (often temporary after hip or knee surgery)

• Medial or lateral flares to improve stability

• Stiffened soles to control joint motion or support healing tissues

• Sole reinforcements for long-term durability where heavy wear is expected

These changes can make a significant difference in comfort, confidence, and recovery outcomes, especially during the transition from medical-grade post-op footwear to everyday shoes. They help correct altered biomechanics and reduce the strain on healing joints or surgical sites. Modifications can be added to both custom and off-the-shelf shoes..

7. Supportive Footwear with Orthotics: The Gold Standard for Long-Term Recovery

Once your initial recovery phase is complete and you’ve transitioned out of protective devices like crutches or a moon boot, the next step is often returning to more ‘normal’ footwear. But that usually doesn’t mean going straight back to whatever you were wearing pre-surgery. At this stage, supportive, well-fitted shoes, paired with custom foot orthotics, become important tools for many to keep them moving safely and help prevent setbacks.

Supportive footwear plays a major role in helping your body re-establish a stable, balanced gait. Good shoes provide structure around the heel and midfoot, reduce excessive motion, and help guide your foot through a more efficient walking pattern. When this is combined with a custom orthotic, designed specifically for your foot and tailored to your surgical history, it can help:

• Redistribute pressure away from sensitive or healing areas

• Improve foot and leg alignment

• Reduce strain on nearby joints and soft tissues

• Address any compensations or weaknesses that may have developed

8. Other Helpful Options to Consider

Depending on the nature of your surgery and how your recovery progresses, there are several other tools and supports that may be recommended to make your recovery safer and more comfortable. These include:

• Compression socks and garments

• Heel wedges and temporary inserts

• Shoe lifts (for leg length discrepancies)

• Supportive slippers for at-home use

These (and more) are all things you’ll be able to discuss with your podiatrist to help you get the best outcome from your surgery.

Getting It Right: Working With A Podiatrist

Knowing when to seek guidance around your footwear and foot support can make a significant difference in how smoothly your recovery goes, and how confident you feel throughout it. We’re proud to work closely with surgeons, physiotherapists and other health professionals to help patients undergoing orthopaedic surgery get the very best outcomes - and that includes your footwear. If you have questions about your footwear or want to make sure you’re on the right track post-surgery (or pre-surgery), we’re here to help.

You can call us on 03 355 9481 or book your appointment online here.