In this guide
A fracture heals in a few weeks, but the cast, splint or operation often leave a stiff joint, weakened muscles and sometimes a fear of putting the foot down or using the hand. Rehabilitation helps you regain movement, strength and the use of the limb. At home, it starts without journeys, just when walking or carrying things is hardest.
The most common fractures
Rehabilitation is often prescribed after:
- a hip fracture (femoral neck), especially in older people after a fall;
- a wrist fracture, often after a fall on the hand;
- an ankle fracture;
- a shoulder (humerus) or collarbone fracture;
- a leg or kneecap fracture;
- a vertebral compression, often linked to osteoporosis.
When to start, and within what limits?
Rehabilitation is prescribed by the surgeon or doctor. It often starts when the cast comes off, or earlier after an operation once the bone has been fixed.
The surgeon decides when you may put weight on the foot, partly then fully, and which movements are allowed at first. The physio follows these instructions to the letter: pushing too early can shift the fracture.
What the physio does in the sessions
The physio starts with an assessment: pain, swelling, what the joint can do, walking. They may then:
- bring down swelling and ease pain;
- restore movement to joints that stayed still, gently and without forcing;
- strengthen the muscles that wasted during immobilisation;
- teach you to walk with crutches or a walker, within the weight allowed, then without aids;
- work on balance and the reflexes of the ankle and knee, to avoid another sprain or fall;
- for the wrist and hand, regain the strength and precision of everyday movements;
- loosen the scar after an operation.
After a hip fracture
In older people, a femoral neck fracture is often operated on quickly, and the aim is to get up and walk again as soon as possible: staying in bed loses strength and independence very fast. Rehabilitation at home works on getting up, walking with a walker, the toilet and the stairs.
The physio also helps prevent another fall: strengthening, balance and making the home safe. Ask the doctor about osteoporosis, which makes bones more fragile.
What a home session looks like
A session usually lasts 30 to 45 minutes. All it takes is a bed, a stable chair and a little space to walk; keep the crutches or walker within reach and, if possible, an ice pack.
The pace is often two or three sessions a week, set with the surgeon, with exercises to repeat every day between sessions.
Warning signs
Under a cast: very swollen, cold, blue or numb fingers or toes, or pain that gets much worse, need the emergency department straight away. After a leg or hip fracture: a swollen, red, painful calf, sudden breathlessness or chest pain can be the sign of a blood clot: call emergency services at once (15 or 141).
Also tell the surgeon about a red or weeping scar, fever, or new pain after a fall.
Reimbursement
When prescribed by a doctor, physiotherapy can be covered by AMO (CNSS or CNOPS) or your insurer, depending on your cover. You need the prescription and a care sheet filled in by the physio. On Kinezy, physios who provide one say so on their profile.
This guide gives general information. It doesn’t replace the advice of your doctor or physio, who know your situation.