Fractures are common injuries that require specialized care from a physiotherapist. Proper management of fractures includes early mobilization, appropriate exercises, and the use of various modalities to promote healing and prevent complications.
Sarah Peters - BKIN(CH), R.KIN, CAT(C)
As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.
What is a Fracture?
A bone fracture occurs when a bone is broken. Most fractures are caused by trauma through high force impact or stress. See separate section on Stress Fractures. Fractures can also be caused by diseases which weaken the bones including osteoporosis, some types of cancer and osteogenesis imperfecta or brittle bone disease.
What Does a Fracture Feel Like?
Quite often, you will feel the bone snap when a fracture takes place. After a fracture, you will feel pain and stiffness due to the swelling that takes place due to bleeding from the inside of the bone. If the fracture is in a lower limb, you will likely be unable to walk on it or put any pressure on it. In some cases, such as in fingers and toes, you will see an angulation to the bone that is broken.
How is a Fracture Diagnosed?
The only true way to see a fracture is through an x-ray done at the hospital or prescribed by your doctor. You doctor or emergency room physician will be able to review the x-ray or the report done by the radiologist to diagnose your fracture. A review of the angles and spaces between bones at joints will be performed to determine if your fracture also requires surgery to stabilize it.
How Can Physiotherapy Help with a Fracture?
Your Physiotherapist or Athletic Therapist can help provide education on how to best minimize your symptoms in the early stages of fracture healing. If your injured limb is inside a cast, this will likely consist of mostly elevation of it. If the immobilization device can be removed or it is not immobilized, the use of ice, heat, anti-inflammatory creams or gentle exercises or treatment may be indicated.
Your Physiotherapist or Athletic Therapist can help you throughout different stages of your injury and recovery from a fracture. Depending on the type of fracture and method of immobilization, your therapist can teach you how to safely use a walking aid if one is needed. While your fracture is healing, your therapist can adjust your splint or brace as needed.
Once healing is complete and the immobilization has been removed, your therapist can provide you with customized exercises and guidance on timelines and expectations as you work towards regaining normal life capabilities and activities through the rehabilitation process. If you have been immobilized in a cast, splint or brace or movement has been restricted, you will likely experience stiffness in the joints near the fracture, tension in the muscles and loss of muscle strength. Through manual treatment and a personalized exercise program, we can help you regain full range of motion, balance and strength. All of these things will help you return to normal activities and sports.
Return to Sport and Life
Once you can move normally, you can generally return to most things in life. In order to return to more intense activities or sport, you may need some exercises to help return your range of motion, stability and strength to pre-injury levels. Your Physiotherapist or Athletic Therapist can help you with this along with manually mobilizing and moving your joint passively into the ranges of motion it needs to go through in order to help you regain movement.
Stages of Physiotherapy in Fracture Recovery
There are three main stages in the physiotherapy process for fracture recovery:
Stage 1: Acute phase (0-6 weeks)
During the acute phase, the primary focus is on pain management, swelling reduction, and preventing complications. Physiotherapists use gentle techniques like passive range of motion exercises and muscle stimulation to maintain muscle strength and joint mobility without causing further injury.
Stage 2: Sub-acute phase (6-12 weeks)
In the sub-acute phase, physiotherapists introduce weight-bearing exercises, depending on the fracture site and severity. They also focus on improving joint mobility and muscle flexibility with the help of stretching exercises. The aim during this stage is to increase function and independence gradually.
Stage 3: Late stage (12 weeks onwards)
During the late stage, the physiotherapist focuses on restoring full function and strength. They introduce more advanced exercises, including balance and proprioception training, to help patients return to their pre-injury activities. This stage may involve sport-specific or activity-specific exercises to ensure a safe return to daily life.
What are the best exercises/ stretches to help with a Fracture?
After the immobilization cast or brace are removed or the doctor gives the go ahead, it is important to try to regain range of motion and strength that was lost during immobilization and healing time. For these exercises, we will use the ankle as an example and give range of motion and strength exercises to rehabilitate after an ankle fracture.
Range of Motion
You can lay down or sit for this one as you work on the range of motion in your ankle. With big sweeping motions, draw letters or circles with your foot.
Theraband Strengthening - Dorsiflexion
Place your elastic band or tubing around the foot and attach it to something sturdy in front of you. Make sure that your knee is slightly flexed. Pull the foot toward you.
Theraband Strengthening - Plantar Flexion
While sitting, place an elastic around the ball of your outstretched foot and hold the ends of the elastic in your hand. Push down against the elastic with your forefoot and return to the initial position. The movement should occur at the ankle only. Do not push down with your knee.
Theraband Strengthening - Inversion
Sit with your leg straight and tie an elastic to a solid object and around your foot. Without moving your knee, turn the sole of your foot towards the inside by pulling on the elastic. Return and repeat.
Theraband Strengthening - Eversion
Sit in a chair or on the floor with an elastic tied around your foot and against a stable object. Keep your knee still and your heel in contact with the floor while you move the sole of your foot towards the outside. Return in control and repeat.
Proprioception - 1 foot balance
Stand in front of something you can hold on to if needed. Lift one leg off the ground so as to stand on one foot. Try to keep standing without holding on.
Stand and place one foot in front of the other in parallel lines. There are two versions of this stretch.
How Can you Prevent Fractures?
To prevent a fracture, you would have to remove all potential risk from your life. Fractures can happen in sport, at work or at home and be the result of any sudden fall, impact or trauma. With the exception of the inherent risks in sport and life, your therapist can help give you guidance on how to prevent falls and strengthen your bones, so that the chances of future trauma are minimized. Weight bearing exercises can improve bone strength, muscle strength and balance, which can all help reduce falls and ultimately reduce the risk of fractures.
What is the fastest way to heal a Fracture?
Fractures have a physiological healing time of about 6 weeks. In children, sometimes this number can be 4 weeks and for bigger bones in adults or after surgical fixation of the bone, sometimes this number can be 8 weeks. This length of time cannot be changed. What can be affected is the length of time that it takes to get back to normal after a fracture is healed. Generally, there is a period of rehabilitation that can last an additional 4-6 weeks or longer after immobilization is removed. This length of time can be sped up by following a Physiotherapist or Athletic Therapist's advice and performing a daily home exercise program. Range of motion exercises, strength exercises and stability exercises will be necessary and can dramatically speed up your return to your regular daily activities or sport. Hands on physical therapy can also help mobilize your affected joints and loosen up the muscles to help you get back to normal as quickly as possible.
Contact Us For Help
Inertia Physio+ offers Kanata and Stittsville exceptional Physiotherapy, Athletic Therapy and Registered Massage Therapy with private treatment rooms, one on one care, a maximum of two patients per hour and treatment focused on the evidence-based practices of manual and exercise therapy. Don’t suffer any longer. If you have pain or injury, our Kanata and Stittsville Physiotherapy, Athletic Therapy, and Registered Massage Therapy team is here to help you get back to living pain-free life and activities. Please reach out to us at(613) 672-2200 or email@example.com for an appointment today! You are also welcome to book online. We also offer direct billing on Physiotherapy and Massage Therapy services whenever your plan allows.