Fracture Rehabilitation Physiotherapy

A fracture diagnosis tends to stop people in their tracks. There's an assumption that comes with it, and that is that you'll be immobile for months, that the affected area will never quite be the same, that rehabilitation is a case of simply waiting for the bone to heal before doing anything. None of that is quite right, and it's one of the areas of practice where good physiotherapy input from an early stage can genuinely change outcomes.

Bone is a living, adaptive tissue, not unlike a ligament or a muscle, and it responds to appropriate loading in much the same way. Left completely immobile and nonweightbearing for too long, surrounding muscles weaken, joints stiffen, and the eventual return to full function takes considerably longer than it needs to. Managed well, with the right balance of protection in the early stages and progressive loading as healing allows, most fractures can be rehabilitated back to full function without lasting deficit.

I work closely alongside your treating doctor or orthopaedic surgeon throughout this process, respecting the specific healing timeframes and precautions or restrictions they advise are relevant to your fracture and recovery process while making sure that everything else including your strength, mobility, and confidence, isn't left to simply switch back on once a cast or boot comes off.

In the early weeks following a fracture, the priority is respecting the healing timeframes and precautions set by your treating doctor or surgeon, while managing swelling and maintaining the strength and mobility of unaffected areas as much as possible. This phase might include gentle range of motion for adjacent joints, isometric exercises where appropriate, and education around safe movement within your current restrictions.

As healing progresses and precautions are gradually lifted, the emphasis shifts towards restoring range of motion at the affected joint, rebuilding strength that has been lost during immobilisation, and gradually reintroducing functional loading in line with the stage of bone healing and your surgeon's guidance.

In the final stage, the focus turns to higher-level strengthening, restoring full range of motion, and where relevant, a graduated return to sport or physically demanding work, ensuring the area can tolerate the specific demands you're aiming to return to before you get there.

Yes, and this is one of the most common misconceptions I come across. Even while a fracture is immobilised, there is almost always something productive we can be doing, whether that's maintaining movement and strength in joints above and below the injury, managing swelling, or simply making sure you're moving safely and confidently on crutches. Starting rehabilitation early, within whatever restrictions are appropriate, consistently leads to a faster and more complete recovery once the fracture has healed enough to begin more active loading.

Not everyone does, but many people benefit. After weeks in a cast, boot or sling, it is common to have stiff joints, weaker muscles, swelling and reduced confidence. Physio helps restore movement and strength, gets you back to work, sport and daily life safely, and checks that recovery is on track. It is particularly useful after fractures around joints like the wrist, ankle and shoulder, after surgery to fix a fracture, and for anyone returning to sport or physical work.

Expect your limb to feel stiff, weak and a little strange at first, and the skin may be dry and flaky. Start with gentle movement exercises a few times a day, and follow your doctor's advice on how much weight you can put through it. Swelling often increases for a while once you are moving more, so elevation helps. Avoid jumping straight back into heavy lifting or sport. This is the ideal time to start physio, so we can build movement and strength back in a structured way.

Joints that have been kept still for several weeks become stiff as the surrounding capsule, ligaments and muscles tighten. Swelling and pain also limit movement, and fractures close to or into a joint tend to cause more stiffness. The good news is that most stiffness improves with regular movement exercises, hands-on treatment and time. Starting early, once your doctor allows, makes a big difference, and some stiffness can take several months to fully resolve.

Stress fractures usually develop gradually rather than from a single injury. Common signs include pain in a specific spot on a bone that gets worse with activity, especially running or jumping, pain that starts earlier in each session, and pain that lingers after activity or appears at rest or at night. The bone is often tender to touch. They are most common in the shin, foot and hip, and often follow a sudden increase in training. If a stress fracture is suspected, it is important to reduce load and get imaging organised.