Post-Fracture Rehabilitation
Fractures range from minor cracks in a bone to severe breaks that can displace the bone and pierce the skin. Physiotherapy can promote healing and recovery, and the earlier it’s introduced after immobilisation, the better.
Physiotherapy starts in the hospital when you start using assistive devices like crutches and slings. The next stage is seeing a physiotherapist to get you moving in ways that strengthen your bones and your muscles.
Your first physio visit for post-fracture rehabilitation will be an evaluation assessment – to determine your range of motion, pain, gait, and flexibility.
From this, your physiotherapist will determine the best active and passive treatments to overcome the adverse effects of immobilisation, such as loss of motion, and improve functional mobility, helping you return to normal more quickly.
Once you have that range of motion, treatments like remedial massage and ESWT come into play to return you to your former self.
What is a fracture?
A fracture is a broken bone that varies in presentation depending on the direction and force causing the break.
A linear fracture is a straight break along the long axis of the bone. An oblique fracture is at an angle across the bone, creating a sloped break line. Pathological fractures occur when an underlying disease has already weakened the bone. Spiral fractures are caused by a twisting force, breaking the bone in a spiral pattern.
Fractures of a broken but aligned bone are ‘stable’; most are treated at the bedside with minor setting or casting only. Fractures with a displaced bone or involving the joint are ‘unstable’ and usually require surgery to correct. An ‘open’ fracture is when the bone breaks through the skin, requiring emergency treatment.
How are fractures treated?
The first step in treating a fracture is immobilisation to stabilise the bone by casting or splinting the affected area.
More severe fractures may require surgery to realign the bones or use metalwork like plates, screws, or rods to provide support and hold the bones in the proper position.
The type of fracture determines the immobilisation approach. Stable fractures that haven’t shifted alignment usually only need a cast. Unstable, displaced fractures require surgery before casting or splinting. Open fractures with broken skin need emergency surgery and antibiotics to prevent infection.
Follow-up X-rays monitor healing progress and assist in decisions about when removing casts or other devices is safe. The less a fractured bone moves early on, the more likely it is to heal properly, making physical rehabilitation crucial.
Implications for rehabilitation
Moving as much as possible is vital after fracture immobilisation to rebuild strength and mobility following a loss of flexibility, muscle mass and stamina. It also decreases the risk of complications like blood clots from poor circulation.
Gentle range-of-motion and stretching exercises improve flexibility, while light strength training helps regain muscle mass lost during immobilisation, and targeted exercises facilitate using the healing limb in daily tasks.
The physio adjusts activities as the fracture site heals to increase challenge and gradually restore normal function. They may use adjunct therapies like ultrasound, heat/ice, and electrical stimulation to control pain and swelling during rehabilitation sessions. Home exercise programmes reinforce gains made with supervised rehabilitation.
The goal of rehabilitation is to help you maximise your function after a fracture and speed up recovery times.
Physiotherapy as post-fracture rehabilitation
Physiotherapy involves hands-on techniques to promote healing after a fracture. Joint mobilisation and manipulation, remedial massage, and extracorporeal shock wave therapy (ESWT) are three specific methods that can facilitate recovery.
Joint mobilisation and manipulation get the joint and bone moving, achieving movements that are impossible to do alone due to pain.
Remedial massage involves a physiotherapist manipulating the soft tissues around a fracture site – helping improve range of motion problems from prolonged bone immobilisation.
We find that remedial massage reduces pain in patients and promotes confidence in using the bone, helping stimulate healing further.
ESWT delivers high-energy sound waves to the injured area through a handheld applicator. These acoustic pulses trigger anti-inflammatory reactions, stimulate cell regeneration, and encourage new blood vessels, speeding up the natural healing cascade. The treatment is never done directly over the fracture site, but adjacent to stimulate circulation. ESWT also overrides pain signals and is non-invasive with very few side effects, enabling patients to benefit early on in rehabilitation.
Importance of physiotherapy in fracture rehabilitation
Manual therapies like joint mobilisation and remedial massage are essential for managing pain, swelling, and muscle tightness following a fracture.
Benefits include:
- Restores mobility and range of motion. Physiotherapy helps stretch, strengthen, and mobilise the area around the fracture to improve flexibility and movement, preventing stiffness or contractures from developing.
- Relieves pain and swelling. Physiotherapists use modalities like heat/ice therapy, TENS, ultrasound, etc., to help manage pain and inflammation after a fracture.
- Prevents muscle atrophy. Being immobile for a long time after a fracture can cause significant muscle loss. Physiotherapy provides exercises to rebuild muscle strength.
- Improves stability and weight-bearing. Weight-bearing exercises and balance training help improve the ability to bear weight through the affected limb.
- Faster recovery. Starting physiotherapy soon after the fracture and surgery can significantly speed up the healing and recovery.
- Prevents complications. Regular physiotherapy helps prevent complications like thrombus formation, improper bone healing, and joint stiffness and helps regain pre-injury status faster.
- Psychosocial benefits. Physiotherapy provides encouragement and motivation during the recovery process after an injury. Setting goals aids positive mental health and can make a huge difference in your recovery journey.
How ProPhysiotherapy can help
We know the frustration of recovery after a fracture. Regaining mobility and strength can feel like an uphill battle. That’s why our experienced physiotherapists use proven techniques to get you back on your feet. We alleviate pain and restore function through joint manipulation, soft tissue massage, and customised exercise plans.
Our hands-on approach targets the root of dysfunction, not just the symptoms. We dig deep to relax contracted muscles, mobilise stiff joints, and retrain proper movement patterns. And we don’t stop there – we empower you with the knowledge and tools for self-care, preventing re-injury down the road.
Whether it’s a broken wrist or a hip fracture, our physiotherapists have successfully rehabilitated countless patients. With research-backed treatment and unwavering encouragement, we help you regain strength, confidence, and quality of life.
Contact us or book online today to start your fracture rehabilitation.