Fracture Recovery: Complete Guide to Bone Healing and Rehabilitation

A fracture is one of the most common musculoskeletal injuries. While the bone heals naturally over time, proper rehabilitation is essential to restore full function, strength, and mobility. This guide covers the entire recovery journey from injury to full activity.

The Bone Healing Process

Bone healing occurs in three overlapping phases. Inflammatory phase (days 1-5): a blood clot forms around the fracture site and inflammatory cells clean up damaged tissue. Reparative phase (weeks 2-6): soft callus forms, then hardens into woven bone. Remodelling phase (months to years): woven bone is remodelled into strong, organised bone.

Immobilisation Phase

During immobilisation (cast or splint), the priority is protecting the healing bone. However, immobilisation causes muscle atrophy, joint stiffness, and reduced circulation. Physiotherapy during this phase focuses on maintaining movement in uninjured joints, reducing swelling, and preventing complications.

Post-Cast Rehabilitation

When the cast is removed, the joint is often stiff, weak, and swollen. Rehabilitation focuses on regaining range of motion, reducing swelling, strengthening surrounding muscles, and improving function. This phase takes 4-12 weeks depending on the fracture and patient factors.

Return to Full Activity

Return to sport or heavy activities typically requires 3-6 months for upper extremity fractures and 4-8 months for lower extremity fractures. Bone remodelling continues for months to years, so gradual loading is important.