Broken bones require immediate and specialized medical treatment. Depending on where the break occurs, your doctor will immobilize the bone so that it can heal. Sometimes the bones can be set in place easily from the outside. If the case of a severe or complex broken bone, surgery may be required and screws or plates inserted to get them properly aligned.
By the time a cast or brace is removed, the muscles and supporting tissues are likely to be stiff and atrophied. Physical therapy is an important part of treatment for a bone broken bone. It is the best way to regain strength and function in the injured area. Your physical therapist can help you regain normal range of motion, strength and functional mobility after a broken bone.
So what do physical therapy and rehab entail after a broken bone?
Physical Therapy After Various Broken Bones
The location of a break also impacts your treatment plan and will dictate the general type of physical therapy that your doctor recommends.
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Physical Therapy After a Broken Leg
As your broken leg heals, you will want to avoid putting the usual amount of weight on it. A physical therapist may show you the proper way to use a cane or crutches. Light exercises and movement can help prevent or reduce muscle stiffness and atrophy that occurs from reduced activity.
Once the cast or splint is removed, physical therapy restores range of motion and strength to your muscles. If your ability to maintain balance is affected, exercises to shift your weight back and forth between your legs can help reduce your risk of falling.
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Physical Therapy After a Broken Foot
The physical therapist has goals to help you regain normal function, including weight-bearing, range of motion and strength. Weight-bearing is a term used for putting your body weight on your foot. Your weight-bearing ability is at 100% when you can stand on your foot without any pain or discomfort and it is at 0% when you cannot put any pressure on it at all.
The range of motion refers to the full movement of a joint, measured in degrees counting up from 0 in resting position. For your foot, this includes the ankle movements rolling inward (inversion) and ankle movements rolling outward (eversion). When fully rolled to either side, most people have about 35 degrees of range of motion.
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Physical Therapy After a Broken Arm or Wrist
As your injury starts to heal, physical therapy helps reduce and manage potential stiffness in your arm, hand and shoulder that can result from wearing a cast or sling. Physical therapy often continues once you are no longer immobilizing the arm to further improve muscle strength and joint flexibility.
While recovering from a broken arm, expect to do hand or shoulder exercises based on the injury’s location. Once the cast, sling or brace is taken off, therapy will progress to full arm motion exercises. Especially if you underwent surgery, this phase of therapy may last a few months.
Along with motion, physical therapy can address sub-acute pain and potential weakness that affect how you lift and hold items. After a broken arm, many patients experience decreased muscle and bone mass that affect how the joint or muscles in the injured area function. Physical therapy ultimately helps you restore movement and achieve a sense of normalcy.
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Physical Therapy After a Broken Elbow
A major problem with an elbow fracture is stiffness that limits the range of motion. Sometimes, this stiffness persists long after the broken bones have healed. Therefore, your healthcare provider may have you start physical therapy soon after the injury to help introduce an early motion to your healing elbow.
Your physical therapist may work with you to help you regain normal use of your elbow and arm. They may use many different physical therapy treatments and modalities to help you quickly return to normal activity. Some impairments that you may work on in physical therapy may include the following.
One of the main goals of physical therapy after an elbow fracture is to restore normal range of motion to the elbow. The elbow is a complex joint that allows you to bend your arm or turn your hand over. Restoring the full range of motion of the elbow and forearm is paramount to regaining normal use of your arm.
As a rule, the early introduction of range of motion therapy achieves not only better but faster results.
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Physical Therapy After a Broken Spine
People with significantly less bone density, such as those with osteoporosis, are at risk for spinal broken bones. Physical therapy can help you regain strength and be active without fear of reinjuring yourself. It is common to shift posture by stooping to relieve pressure on the broken vertebrae, but this can cause the bones to heal improperly.
Strengthening the core muscles in physical therapy helps to keep your spine straight, as does wearing a brace for support. While healing, a physical therapist can show you how to perform activities to reduce pain and prevent further damage to your spine.
Starting Physical Therapy After a Broken Bone
The goal of physical therapy is to restore full range of motion and functionality. For hairline broken bones, physical therapy is a good way to restore strength and flexibility; for more complex injuries physical therapy can be the key to learning how to become mobile again.
Immobilization resulting from casts and splints can contribute to joint stiffness and muscle weakness; to overcome this, physical therapy can prove effective. Physical therapists can begin to guide you in moving exercises that benefit the surrounding tissues, joints, and muscles, even before your broken bone has healed.
At the Hospital or Out-Patient Surgical Center
After you broken bone a bone, a physical therapist may visit you in the hospital. The physical therapist will teach you how to correctly and safely perform everyday life skills, such as getting out of bed, going up and downstairs, and entering and exiting a vehicle. The physical therapist will act on the recommendations of the doctor, such as weight-bearing restrictions, as well as teach you how to move in light of these restrictions.
If you break your leg or ankle, a physical therapist may instruct you in how to walk with an assistive device, like a cane or crutches. This includes how to use the device to walk up and down stairs or to get into and out of a car. Be sure to ask questions if you have any.
If you have broken bones in your arm, the physical therapist will teach you how to eat with your sling on, as well as how to apply and remove it so you can bathe and go to the bathroom.
When You Get Home
Depending on the severity of your broken bone, your doctor will recommend a course of action with a physical therapist or, in the case of broken bones that have occurred on the job, an occupational therapist.
At your house, your physical therapist can also assess your home environment. He or she can make recommendations to make minor adjustments to allow you to move safely around your home. Home care physical therapy usually is reserved for people who are unable to leave the house as a result of their injury. Your physical therapist can help you master using your assistive device in your home environment.
During physical therapy, expect both a soothing session of therapeutic treatments that will stimulate blood flow and reduce the risk of developing scar tissue, as well as a series of sometimes challenging exercises that will help strengthen the area while working to increase range of motion and flexibility. Performing these exercises over time provides insurance that recently broken boned bones will not become re-injured – especially important for those who are prone to hip broken bones and the elderly.
If surgery was required to set your broken bone, your PT may assess your surgical scar to ensure that things are healing properly.
In the Clinic
When you have recovered enough to travel from your home, your healthcare provider may refer you to a physical therapy clinic to help with restoring normal function after your broken bone. Usually, this occurs after the cast has been removed and you can start mobilizing the area around the broken bone.
Your first visit with your physical therapist will usually involve an evaluation and assessment. Your therapist will likely take measurements of body parts around the broken bone site. This might include measurements of:
- Range of motion
- Strength
- Pain
- Flexibility
- Girth or swelling
- Gait (for lower extremity broken bones)
- Overall function and mobility
After the initial evaluation, your physical therapist can work with you to devise a treatment strategy to help you recover fully. Physical therapy after a broken bone often focuses on overcoming the negative effects of being immobilized by a cast or sling. Immobilization may cause loss of motion and strength and decreased functional mobility.
How Long Should PT Last?
Unfortunately, there is no exact answer to this question. Everyone is different, and your rate of progress and expected time in physical therapy will depend on a number of factors. Generally, physical therapy consists of 1-2 sessions each week lasting 30-60 minutes, in addition to at-home exercises your physical therapist will likely recommend both while you are in physical therapy and after you have stopped going.
However, there are a few guidelines for determining how long physical therapy might last.
The length of time you will be in physical therapy depends on a number of factors, including but not limited to:
- The extent of your injury or injuries
- How quickly your condition improves during the course of physical therapy
- Your progress with pain relief
- Whether you will continue after the injury has recovered in order to rebuild strength in the injured area
- Whether your goals are being met through physical therapy
General Timeline:
- Minor injuries: 2-3 weeks followed by at-home exercises and possible later as-needed check-ins with your physical therapist.
- Soft tissue injuries: 6-8 weeks, which is how long soft tissue takes to heal in most injuries. Your physical therapist will work with you to speed healing, and to make sure that your injury is healing properly.
- Chronic or serious conditions: 2-3 months or more, depending on how quickly you are making progress.
How Can a Physical Therapist Help Before & After Surgery?
Your physical therapist, in consultation with your surgeon, will be able to tell you how much activity you can do depending on the type of knee surgery (such as total knee replacement) you undergo. Your therapist and surgeon also might have you participate in physical therapy prior to surgery to increase your strength and motion. This can sometimes help with recovery after surgery.
Following surgery, your physical therapist will design a personalized rehabilitation program for you and help you gain the strength, movement, and endurance you need to return to performing the daily activities you did before.
To learn more about physical therapy at Ventura Orthopedics or to schedule an appointment with one of our hip replacement specialists, call us at 800-698-1280.
