A fracture occurs when there is a break in the structure of a bone. This takes place when an external force, for example a fall or impact, is stronger than the structure of the bone itself and results in damage to the bone’s integrity. After a fracture, there is a period of immobilization where a cast is applied allowing the bones to heal in the correct position. Typical healing time ranges from 6 to 8 weeks in a healthy adult and 4 to 6 weeks in children. The length of time often depends on the severity and location of the fracture as well as the general health of the individual who is injured. Your doctor will examine the bone’s structure using X-ray imaging to determine when the fracture has healed and when you are cleared to begin rehabilitation. Some aspects of rehabilitation, however, can begin even while the cast is in place. Working on general range of motion and strength above and below the injured region (as instructed by your practitioner) can help assist in your recovery and prevent undue weakness or stiffness in surrounding body parts. After the fracture has healed and the cast has been removed, therapy for the injured area can commence.
A “stress fracture” is an even smaller crack in the bone that typically occurs due to repetitive overuse activities. The weight-bearing bones in the lower limb such as the foot, ankle or shin are often the most susceptible. Stress fractures commonly occur during sports that require a lot of repeated impact such as running, soccer and basketball. Proper assessment and imaging are crucial because if left untreated, some stress fractures can develop into true fractures. Conservative treatment of smaller stress fractures typically requires rest to the site of injury, weight-bearing as tolerated and ambulation modifications as needed. Higher risk stress fractures may also require immobilization through a cast or boot.
After this period of immobilization or rest, fracture rehabilitation generally involves a combination of exercises that focus on restoring your range of motion, weight-bearing status, flexibility, strength, endurance and overall functioning. The use of manual therapy and modalities will help to reduce pain levels and alleviate tight muscles during the initial stages of your recovery. In addition, low impact activities that restore one’s cardiovascular fitness, such as biking and swimming, are also initiated. In later stages of rehabilitation, progression to higher intensity and heavier impact activities (e.g. running) can begin if pain-free. The length of time required for fracture rehabilitation can vary from person to person but it generally ranges between 6 to 8 weeks. Your physiotherapist or chiropractor will be able to guide your treatment plan based on your individual recovery with the goal of restoring your pre-injury level of functioning.
Written by: Vanessa Younes, MScPT.