Healing beyond the break: the vital role of physiotherapy in post-fracture rehabilitation

Fractures are not just about broken bones—they’re about disrupted lives.

While the initial treatment focuses on stabilising the bone, true recovery begins with rehabilitation.

Physiotherapy is essential in restoring mobility, strength, and function, and preventing long-term complications.

Why post-fracture rehabilitation is crucial

After immobilisation, patients often experience joint stiffness, muscle atrophy, and impaired coordination.

Without structured rehabilitation, these issues can persist, leading to chronic pain and functional limitations.

A systematic review of clinical practice guidelines found that rehabilitation is a key component of fracture management, though often underemphasized in practice.

The phases of bone healing

Understanding the biology of bone healing helps tailor physiotherapy interventions to each stage of recovery.

Bone healing occurs in three overlapping phases:

1. Inflammatory phase (0–7 days)

• Hematoma formation and inflammation occur immediately after the fracture.
• Inflammatory cells clear debris and initiate healing.

Rehab focus: Immobilisation and pain control. Gentle movement of adjacent joints may be introduced to prevent stiffness.

2. Reparative phase (1–6 weeks)

• A soft callus forms, gradually replaced by a hard callus.
• Osteoblasts begin forming new bone tissue.

Rehab focus: Controlled mobilisation. Physiotherapists may introduce passive and active range-of-motion exercises, depending on fracture stability.

3. Remodelling phase (6 weeks to several months)

• The hard callus is remodelled into mature lamellar bone.
• Bone regains its original shape and strength.

Rehab focus: Progressive strengthening, balance training, and return-to-function exercises.

The role of physiotherapy in recovery

Physiotherapists design individualised programs based on the fracture type, healing stage, and patient goals.

Their interventions aim to:

• Reduce pain and swelling
• Restore joint mobility and muscle strength
• Improve balance and coordination
• Prevent re-injury and promote independence

Evidence-based protocols emphasize early mobilisation and functional training to optimise outcomes.

A collaborative approach

Successful recovery involves a multidisciplinary team: orthopaedic surgeons, physiotherapists, and the patient.

Skipping physiotherapy can lead to long-term disability, even if the bone heals correctly.

In summary, bone healing is a biological process, but full recovery is a functional journey.

Physiotherapy bridges the gap between healing and living well.

If you’ve experienced a fracture, don’t just wait for the bone to heal—rehabilitate to reclaim your life.