Most fractures heal on their own within 8 weeks. The healing time is different if the bones are stabilized surgically but rehabilitation is still an important component of recovery. While the bone is still healing, physical therapy interventions will focus on adjacent areas. Once healed, your physical therapist may recommend 4-8 weeks of rehabilitation to help restore normal function to the previously broken foot and surrounding areas. Once PT can target the previously fractured area, you should experience improvements in many symptoms such as pain and stiffness within a couple of weeks but returns in strength, flexibility and overall mobility and return to your prior level of activity may take longer. Achieving long lasting results may take some time, but dedication to your program will help you achieve these results more quickly.

BASICS ON BROKEN BONES

Broken bones, also known as fractured bones, occur when stress across the bone exceeds the bone’s tensile strength. A bone may fracture due to trauma, or in the case of a weakened bone, can occur due to relatively normal forces. Fractures can occur in different patterns. They can be stable and nondisplaced and treated with a cast, boot or splint or unstable or displaced and treated with either closed or surgical reduction followed by a splint, cast or boot. A bone that is broken in several places or unlikely to heal well on its own often requires surgery to stabilize the fracture with some type of hardware.

Bone fractures heal in three phases. The first phase is the inflammatory phase which starts within hours of the break and is normally complete within a number of days. During this phase the body lays down a fragile matrix of new tissues to begin repairing the broken bone. During the next several weeks the reparative phase occurs in which a soft callus is initially formed by bone-producing cells and then transformed into a hard callus over time. The soft callus can easily be disrupted if the bone is not protected but the hard callus is much more durable. In the final stage, the remodeling stage, the callus is slowly removed and the bone is reshaped and smoothed out as it responds to the stress and activity placed on it by normal activity. This phase takes months to years to be completed but in most cases a fracture is considered healed in about 8 weeks.

The foot is made up of several areas of bones. The hindfoot consists of the calcaneus (heel bone) and the talus where it attaches to the lower leg bones to form the ankle joint. In front of that are the tarsal bones–the navicular, cuboid and 3 cuneiform bones. Ahead of that are five long metatarsal bones which connect to each of the toes or phalanges. Many muscles, tendons and ligaments create the motion and stability needed in the foot to stand, walk, run, jump and do a whole host of other weight bearing activities.

A fracture can occur in any of these bones. Signs and symptoms of a broken bone include:

• Pain and swelling over one of the foot bones
• Redness and bruising
• Difficulty walking on or moving the foot

If you decide to work with a physical therapist to help with a broken foot, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY FOR A BROKEN FOOT

Your PT will avoid manipulating or stressing the broken foot until the fracture is healed in order to prevent disruption of the healing bone. During this time, your physical therapist may recommend the following interventions:

• Strength training, stretching and range of motion of adjacent areas of the leg to prevent stiffness and atrophy while the foot is healing
• Modalities to manage pain and promote healing
• Training on the use of crutches, cane or walker to offload the foot when it is painful
• Education on the healing process of bones

After the fracture is healed, physical therapy interventions can be directed to the affected foot and begin to include motions or exercises that will place stress on the healing bone. Though your physical therapy plan will be individualized to your needs, these are common interventions used to facilitate healing and return to full function after a broken foot:

• Stretching, joint mobilization and range of motion to improve the flexibility and mobility of the foot and surrounding areas
• Soft tissue mobilization to address any adhesions or scar tissue in the area
• Strengthening of the toes, foot and ankle to help normalize walking and prepare the foot for return to unrestricted activity
• Balance and gait training
• Sport and work specific training to help the injured foot and affected leg return to higher impact activities like running, jumping, stair climbing and walking on uneven terrain.