Fracture & Orthopaedic Injury Physiotherapy

Most people are told a great deal about their fracture and almost nothing about the months that follow. Then the cast comes off, the limb is thin, stiff and swollen, and nobody had warned them.

That is normal, and it is where this work starts. Bone union means the bone can take load. It does not mean the joint moves, the muscle works, or the limb is ready for what you will ask of it.

Immobilisation costs you range and muscle quickly. Of everything that can go wrong afterwards, stiffness is both the most common and the most preventable — and the longer a joint is left, the harder that range is to recover. Past a point, some of the loss becomes permanent.

Muscle returns faster than it was lost, but only if it is trained. A limb will happily let the other side do the work for months, and most people do not notice they are still compensating until someone points it out.

Assessment first: range, strength, function, and any medical or surgical restriction that applies to you.

Early sessions focus on restoring movement gently and settling stiffness and swelling. As healing allows, the work moves to rebuilding strength, then stability and control, then the functional tasks you actually need — stairs, carrying, gripping, returning to work.

You will have a home programme throughout, because range recovered in a session and then not maintained between sessions is range you lose again.

Normal: a thinner, stiffer limb; dry pale skin; swelling at the end of the day for months after a lower limb injury; aching at the site with weather changes or heavy use.

Not normal, and worth telling us or your doctor promptly: pain that increases rather than decreases over weeks, new or progressive numbness or weakness, spreading redness or heat, or a marked burning pain with skin colour and temperature changes and extreme sensitivity to light touch.