WHAT TO EXPECT AFTER A FRACTURE



With an increasing aging and active population, fractures have become a more common type of injury we treat at Integral Performance Physio. I


n Canada, fractures have been reported to be the second most common activity-limiting injury (17%), just behind sprains and strains (51%). The post-fracture experience can be very overwhelming at times due to the sudden changes to the body and the significant loss in functional activities.


Today our blog post provides you more information in regards to what will happen at each phase of recovery. This will help you set realistic expectations to better plan out your return to work/activity/sports and understand the goals of every recovery step.



0-8 weeks (Cast):



At the onset of the fracture, an X-ray will be taken by your orthopedic specialist to determine if you require surgery depending on the location, shape and type of fracture.


Bone healing in adults usually takes around 6-8 weeks, but this can vary based on age, injured body part, medical background, nutrition (click here for more), etc.


The goal during this phase is for the bone to be immobilized in order for proper bone cell regeneration to occur. During this period, it is recommended to already start consulting your physical therapist to get a head-start on treatment, to make sure the other body parts surrounding the injury are moving properly, and to start working on exercises. This process is important to prevent the body from atrophying (losing muscle) and prevent the development of injuries related to overuse because of the altered movement patterns necessary during the immobilization period.



3-6 months (Early stabilization after cast comes off):



At approximately 8 weeks, you will usually be able to remove the cast. This is both an exciting and anxious period. You will notice that the skin might be very dry and flaky, the joint will be stiff, and the area is swelled up and discolored. You can also see muscle atrophy due to the lack of movement over the past few weeks.


Don’t worry, this is completely normal! Keep in mind that during the immobilization period, your skin/muscles/tissues have not been stretched, your muscles have not contracted, the blood circulation has been reduced, so all these changes simply highlight the dis-use. However, this also signals the proper time to start using the injured body part again.


Although the bone fracture site has already healed in the immobilized position, the bone will require progressive stretches and exercises to be able to take on the loads from external forces required in your daily functioning. Don’t be surprised if the injured location will not be able to move much at the beginning. Due to the stiffness and muscle weakness, it is very common to also experience pain and swelling between 3-6 months post-fracture.


At this phase, your physiotherapist will help guide you on what you should be doing, what to avoid, and relearning how to move. The focus will first be on regaining full mobility at the joint which involves mobilizations, massage techniques, and stretches. Furthermore, we will start to gradually load the bone which helps to 1) activate the muscles 2) encourage bloody supply 3) get rid of swelling 4) improve bone healing.


It may take several weeks before regaining full mobility and returning to weight-bearing activities such as squatting/climbing stairs/walking (for lower-body injury) or pushing/plank/lying on the body part (for upper-body injury).


Week by week, you will notice an improvement in pain, mobility, and strength.



6-12 months (Return to sport/regular activity):



At around the 6 months mark, you can probably resume most of your daily activities/work as full bone healing is achieved after 3-6 months. If you are a higher level athlete, it is essential to work on sports specific training. It is important not to assume that sport-specific skills will come back naturally. Following a fracture, many of the muscles become inhibited and new movement patterns are developed.


So that fancy slapshot technique, or fast change of direction, or high jump that you practiced so many times before the injury will need to be relearned. This time the learning process will be much faster since the mental motor patterning has already been developed. Your physical therapist will help you build a customized program to target your flexibility, power, strength, and agility catered to your specific sport movements. This will be specific to your goals and will allow you to go back to your sport without hesitation and fear. This period could vary from 6 months to 1 year depending on your previous fitness level and the intensity of your sports.



Keep in mind that you will be able to regain each component little by little every day. This process can be long, but it doesn’t have to be scary if we can mentally and physically prepare ahead. If our experience has taught us anything, it is that having a professional guide you and tell you what is normal and not normal truly helps alleviate many uncertainties and stress allowing you to get back to your normal self faster and safer.


Give time and patience to your body to heal and solidify properly. Do not jump steps to avoid residual damage. Don’t worry, this process is only temporary, you will be strong again!


P.S. The best treatment is prevention, to avoid getting a fracture in the first place, stay tuned for our fall prevention content!