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 in those cases. 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 leg 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 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.

When a person states they have broken their leg, they may be referring to the femur bone of the upper leg or the tibia or fibula bones of the lower leg. The hip and knee may also be involved. While significant fractures of a large bone like the femur are often obvious, smaller fractures near the joint line of the knee or even in the lower leg may mimic a less serious injury. Signs and symptoms of a broken bone include:

• Pain, tenderness and swelling over the bone
• Redness and bruising
• Difficulty walking on or moving the leg
• Signs of deformity in the bone

PHYSICAL THERAPY FOR A BROKEN LEG

Your PT will avoid manipulating or stressing the broken leg 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 body to prevent stiffness and atrophy while the leg is healing
• Modalities to manage pain and promote healing
• Training on the use of crutches, cane, wheelchair or walker to offload the leg when it is painful or healing
• Education on the healing process of bones

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