Now that we are fast approaching winter months, the number of fractures from unfortunate falls on wet slippery grass and leaves, or dare I say it, ice and snow, significantly increases. In fact, every year almost 4 in every 100 people in England will sustain a fracture.
My Name is Hannah Dacre and I am a chartered physiotherapist working at Lilliput Health based in Poole, and Bournemouth. I have written this blog to discuss the more common fractures that we see on a regular basis within physiotherapy and also to outline some treatments that you may expect to receive.
What is a fracture?
One of the most common questions we hear from our patients is: ‘I don’t know why it’s still hurting, it was only a fracture, not a complete break’. The answer to this is simple, a fracture is the medical term for any broken bone and ranges from a small non-displaced hairline crack right through to the nasty high trauma fractures that require surgery to fix the broken bone. For this reason the word fracture doesn’t necessarily mean your injury was small.
The doctor said the X-ray showed my fracture had healed, so why am I still in pain?
This is slightly more complex to answer as your fracture will require individual assessment to determine this reason. There are however, a few common reasons.
Firstly, the joint will be very stiff as a result of being immobilised in a cast and this stiffness can cause pain.
Secondly although when your cast is removed your fracture will be healed enough for you to start gently moving it, we know that it takes 3 months for that fracture to be healed enough for you to load it with too much weight, and 12-18 months before the bones have fully remodelled. This means that your body is still healing at this point.
Lastly, and perhaps most importantly, if you have had enough trauma to cause a fracture to the bone, you will undoubtedly have injured the soft tissues (muscles, cartilage, tendons and ligaments) around the area. Often these can be slow to heal if left untreated. In physiotherapy we often need to spend more time treating the injured soft tissues around the area than the fracture itself as these are often overlooked by the doctors whose primary concern is to manage your fracture.
Why is Physiotherapy Treatment Important?
Fractures often heal well, but there is a high rate of treatable complications such as tendon ruptures, damage to your nerves such as carpal tunnel syndrome at the wrist, ongoing joint stiffness and cartilage tears. These may not be identified by your doctor as often it is normal to still have pain when your cast is first removed and so sometimes complications are overlooked. An expert physiotherapy assessment can identify and check for any complications as well as treating them and helping to restore your normal range of movement, strength and function as quickly as possible.
What should I expect from my physiotherapist?
Your treatment will depend very much on the problems identified during your initial assessment, but may include a mixture of the following:
- Soft tissue massage, particularly to manage oedema and swelling
- Scar management if you had surgery to fix the fracture
- Ice therapy
- Stretching exercises to regain joint range of movement
- Joint manual therapy and mobilisations to assist you in regaining joint mobility
- Structured and progressive strengthening regime
- Balance and control work and gait (walking) re-education where appropriate
- Taping to support the injured area/help with swelling management
- Return to sport preparatory work and advice where required
There is never a good time to have sustained a fracture, but here at Lilliput Health we aim to get you back to full function as soon as possible.
If you have any questions or feel that Physiotherapy may benefit you then call our professional team of Physiotherapists at Lilliput Health on 01202 725090 today to discuss your individual needs.