Orthopedics focuses on the musculoskeletal system. Learn about the diagnosis, treatment, and rehabilitation of bone, joint, ligament, and muscle conditions.
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The cast comes off, or the surgeon says the bone is healed. In addition to being a time for celebration, this marks the beginning of a new challenge. The limb that emerges is often stiff, weak, and possibly a bit scaly or hairy. It doesn’t look or feel like it used to. This condition is normal. The bone has healed, but the muscles have atrophied (shrunk) from disuse, and the joints have tightened up.
Rehabilitation is the bridge back to normal life. It is the process of waking up the limb, regaining motion, and rebuilding strength. This phase is just as important as the treatment phase. Without proper rehab, a healed fracture can still leave you with a stiff, painful, or weak limb that limits your activities. This section provides a roadmap for recovery, from the first tentative movements to returning to sports.
Physical therapy (PT) is the cornerstone of recovery. A physical therapist is an expert in body mechanics. They will assess your range of motion, strength, and functional goals. They design a custom exercise plan to get you moving safely.
Early on, the focus is on mobilizing the joints. The therapist might use manual techniques—massage and gentle stretching—to loosen stiff tissues. They teach you exercises to do at home. Later, the focus shifts to strengthening and balance. PT isn’t just about the injured bone; it’s about the whole body. For a broken leg, they teach you how to walk without a limp. For a broken arm, they help you relearn how to reach and lift.
Stiffness is the enemy. After weeks in a cast, the joint capsule shrinks. Regaining full motion takes dedication. It involves daily stretching.
For example, after a wrist fracture, you will practice bending your wrist back and forth and turning your palm up and down. These movements might be uncomfortable at first, but “motion is lotion.” Moving the joint helps circulate the synovial fluid that lubricates it. The window for regaining motion is widest in the first few months, so starting early is key.
When you don’t use a muscle, the body breaks it down to save energy. This is atrophy. You might notice your injured arm or leg is visibly thinner than the other one. Rebuilding this muscle takes time and resistance.
You start with isometric exercises—tensing the muscle without moving the joint. Then you graduate to resistance bands, light weights, and bodyweight exercises. For a leg fracture, such activities might mean calf raises and squats. For an arm, it involves squeezing putty and lifting light dumbbells. Progressive overload—slowly increasing the difficulty—is the secret to building strength without reinjuring the bone.
Even after the bone heals, the soft tissues take longer. It is normal for the limb to swell, especially after exercise or at the end of the day. This process is because the veins and lymphatic system are “rusty” and need to get back up to speed.
Continue to elevate the limb when resting. Compression socks or sleeves can help manage swelling. Ice is still your friend; icing for 15-20 minutes after therapy can reduce inflammation. Occasional over-the-counter pain relievers might be needed, but relying on movement and ice is better for long-term management.
After being immobilized, the skin can be hypersensitive. Touching it might feel weird or even painful. It is called complex regional pain syndrome (CRPS) in severe cases, but mild sensitivity is common.
Desensitization techniques help. This process involves rubbing the affected area with various textures—such as cotton, silk, wool, and a soft brush—to retrain the nerves to recognize touch as normal rather than dangerous. Massage also helps desensitize the skin and break up scar tissue from surgery incisions.
Your body is still remodeling the bone for months after the cast comes off. It needs fuel. Continue to prioritize a diet rich in calcium and protein.
Protein is the building block of the bone’s framework and the muscles you are rebuilding. Calcium and vitamin D harden the new bone. Hydration is also crucial for tissue elasticity. Avoid excessive alcohol and continue to avoid smoking, as your bone is still in a vulnerable remodeling phase.
The return to full activity is gradual. The bone might be healed enough for walking, but not for the high impact of running or jumping. Your doctor will give you a timeline.
Typically, you start with low-impact activities like swimming or stationary cycling. Then you progress to jogging and finally to cutting and jumping sports. The key is to pay attention to your body’s needs. A little soreness is expected, but sharp pain means stop. Rushing back too soon can lead to a re-fracture or stress fracture because the bone hasn’t fully hardened yet.
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This is a very common phenomenon. It is believed that changes in barometric pressure affect the pressure inside the joint or bone, stimulating the nerves. It is usually harmless and tends to improve over a year or two.
“Clinical healing” (cast off) happens in weeks, but full structural remodeling takes a year or more. You might feel 90% normal after 3-6 months, but that last 10% of strength and endurance takes the longest.
Yes. Once the acute inflammation is gone, heat is great for loosening up stiff muscles and joints before stretching or therapy. Use ice after exercise to cool it down.
Fear of re-injury is normal. It helps to trust your physical therapist and your X-rays. Start with small, controlled movements to build confidence. Mental recovery is part of the process.
With proper rehab, most people regain a normal gait. However, if the fracture involved a joint surface or resulted in a leg length discrepancy, a slight permanent alteration might occur. Shoe lifts or orthotics can often correct this.
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