Physiotherapy After a Fracture: Getting Moving Again

A broken bone, or fracture, is one of the most common injuries at every age. Children fall from cycles and trees, adults slip in the bathroom or have road accidents, and older adults with weaker bones can fracture a wrist or hip after a simple fall.

Your orthopaedic doctor treats the fracture itself, with a plaster cast, a splint or surgery with plates, screws or rods. But once the bone is healing, there is often a second problem: stiff joints, weak muscles, swelling and a loss of confidence. This is where physiotherapy helps.

How bones heal

Bone healing happens in stages. First a blood clot forms around the break, then soft new bone tissue grows, which slowly hardens over weeks. Many fractures in adults heal enough within about 6 to 12 weeks, but this depends on:

• Which bone is broken and how badly
• Your age (children heal faster)
• Your general health, including diabetes and smoking
• Whether the fracture needed surgery

Bones continue to strengthen and remodel for months after they have “healed”.

Why do you need physiotherapy?

While a bone heals, the limb is often kept still in a cast or protected from weight. Even a few weeks of not moving causes:

• Stiff joints, such as a wrist that will not bend or a knee that will not straighten
• Weak, wasted muscles
• Swelling, especially at the end of the day
• Reduced balance, particularly after leg fractures
• Fear of using the limb or putting weight on it

Physiotherapy addresses all of these, so you can return to normal life safely.

Weight bearing: follow your doctor’s instructions

After a leg fracture, your doctor will tell you how much weight you can put through the leg. Common instructions include:

• Non weight bearing: no weight at all on the leg
• Toe touch or partial weight bearing: a little weight, as instructed
• Weight bearing as tolerated: as much as is comfortable

Always follow these instructions carefully. Your physiotherapist will teach you how to walk safely with crutches or a walker within your limits.

Physiotherapy at each stage

While the bone is protected

Even while in a cast or soon after surgery, you can usually:

• Move the joints that are free, such as fingers after a wrist fracture or toes after an ankle fracture
• Keep other parts of the body strong
• Raise the limb to control swelling
• Learn to use crutches or a walker safely

After the cast is removed or the bone is stable

This is usually when the main rehab begins:

• Range of motion exercises to restore joint movement
• Hands on therapy to ease stiffness
• Swelling control, with elevation, movement and sometimes compression
• Gentle strengthening, building up over weeks

Return to full activity

• Progressive strengthening with bands, weights or body weight
• Balance training, especially after leg and ankle fractures
• Functional practice, such as stairs, squatting, lifting and gripping
• Return to work or sport, step by step

Common fractures and what rehab involves

Wrist fracture

Very common after a fall onto an outstretched hand. After the cast comes off, the wrist and fingers are often stiff and grip is weak. Exercises focus on bending and straightening the wrist, turning the palm up and down, and grip strength.

Ankle fracture

Rehab focuses on ankle movement, calf strength, walking pattern and balance, so you can walk without a limp and reduce the risk of future sprains.

Hip fracture in older adults

Hip fractures usually need surgery. Rehab focuses on getting up and walking again as soon as safely possible, strength, balance and fall prevention. Home visits are often very helpful.

Shoulder and upper arm fractures

Rehab starts with gentle, supported movements and builds to full shoulder movement and strength, following your surgeon’s plan.

Simple tips for recovery at home

• Follow your exercises little and often, several times a day
• Raise the limb when resting to reduce swelling
• Do not force painful movements. Gentle and regular works best.
• Eat well, with enough protein, calcium and vitamin D, to support bone healing
• Avoid smoking, which slows bone healing
• Use your walking aid until your physiotherapist says it is safe to stop

Bone health after a fracture

If you are over 50 and broke a bone after a simple fall, ask your doctor whether you should be checked for osteoporosis. Treating weak bones and improving strength and balance can help prevent future fractures.

How a physiotherapist helps

I start by reviewing your X-rays, discharge summary and your doctor’s instructions, especially any weight bearing limits. I check joint movement, strength, swelling and how you walk or use the limb. Then I create a staged programme, progress it at each visit, and keep you within safe limits. For older adults or anyone who finds travel difficult, I can provide treatment at home.

Tips for a smooth recovery

• Keep moving what you can. Even while one part is in a cast, keep the rest of your body active within your doctor’s advice.
• Be patient with stiffness. It often takes a few weeks of regular exercise for movement to return after a cast is removed.
• Use heat before exercise if your doctor agrees, to make stiff joints feel looser.
• Track your progress with simple tests, such as how far you can bend your wrist or how long you can stand on the injured leg.
• Return to activities gradually. Start with lighter tasks and shorter periods, and build up over weeks.
• Ask before driving or riding a two wheeler. You must be able to control the vehicle safely and react quickly.

When to see a physiotherapist

Book an assessment if:

• Your cast or splint has just been removed and the joint is stiff
• You have had surgery for a fracture
• You are not sure which exercises are safe
• You are still limping or using crutches longer than expected
• You want to return to sport or work safely

Warning signs that need a doctor

Contact your doctor promptly if you notice:

• Increasing pain, or pain that is not improving with time
• New deformity, or the limb looks different
• Redness, heat, discharge or fever, especially around a surgical wound
• Numbness, tingling, or a pale, cold hand or foot
• A painful, swollen calf, or sudden breathlessness (seek urgent care)
• A plaster cast that feels too tight, with severe pain or numbness (seek urgent care)

Children and fractures

Children’s bones usually heal faster than adults’ bones, and many children regain movement quickly once a cast is removed. Some still need guidance to regain full strength and confidence, especially before returning to sport. Follow your child’s orthopaedic doctor’s advice on when activities are safe.

Getting back your confidence

After a fracture, many people feel nervous about using the limb again, especially after a fall. Building up activities step by step, with clear guidance, helps confidence return along with strength.

Key points to remember

• Stiff joints and weak muscles are normal after a fracture and usually improve with exercise.
• Always follow your doctor’s weight bearing instructions.
• Rehab moves in stages, from gentle movement to strength, balance and full activity.
• People over 50 who break a bone after a simple fall should ask about bone health checks.

The bottom line

Healing the bone is only part of recovering from a fracture. Guided physiotherapy helps you regain movement, strength and confidence, so you can return to normal life safely. If you are in Ahmedabad, I can help at my Chandranagar practice or with home visits.