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 such as from a fall or motor vehicle accident, 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 or splint or unstable or displaced and treated with either closed or surgical reduction and fixation followed by a cast or splint. 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 neck, known anatomically as the cervical spine, consists of 7 cervical vertebrae that connect the base of your skull with the thoracic spine. The spinal cord is housed in the long spinal canal created by the vertebrae. The spinal cord provides sensory and motor function to the body below the neck and the spinal nerves that exit the spinal canal in this area provide sensory and motor function to the arms.

Signs and symptoms of a broken neck include:

• Severe pain, tenderness and swelling around the neck
• Pain and difficulty moving the neck
• Sudden onset numbness, tingling or muscle weakness or paralysis in the arms or legs
• Loss of bowel and bladder control
• Difficulty breathing along with these other symptoms

If you decide to work with a physical therapist to help with a fractured neck, your entire treatment plan could consist of around 8-20+ different physical therapy for 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 NECK

Your PT will avoid manipulating or stressing the broken neck until the fracture is healed in order to prevent disruption of the healing bone. A neck brace will be worn during therapy until your physician or surgeon says it is safe to begin normal movement of the neck. During this time, your physical therapist may recommend the following interventions:

• If needed, strength training, stretching and range of motion of adjacent areas of the body may be prescribed to prevent stiffness and atrophy while the neck is healing
• Strength training and range of motion to the arms and scapular muscles that do not break spinal precautions may be recommended to help restore strength and mobility in that area
• Education on the healing process of bones
• Recommendations on how to adapt daily tasks while wearing the spinal collar and maintaining spinal precautions
• Balance, gait, core and lower body training to promote recovery of lost nerve function

• Stretching, joint mobilization and range of motion to improve the flexibility and mobility of the shoulder, neck and thoracic spine
• Soft tissue mobilization to address any adhesions, scar tissue or tissue restrictions in the area
• Modalities and interventions to address pain
• Strengthening, motor control and coordination training of the muscles that support and move the neck as well as any muscles in the arms, trunk or lower body that may have been affected by injuries to the nerves or the period of immobilization and reduced activity
• Sport and work specific training to help the injured neck return to higher impact and repetitive activities
• Education on how to adapt daily activities if any movement or motion restrictions persist