Your tibia is the large bone of your lower leg that connects your thigh bone to your foot. The end of this bone closest to your foot is vulnerable to fracture as a result of forceful trauma to your foot or lower leg. This can be a debilitating injury, taking several months to heal. Physical therapy is highly recommended after any bone fracture and is intended to prepare your body to be able to return to physical activity. Before physical therapy following a lower tibia fracture, your foot and lower leg must be immobilized until the bone itself heals. This process can take eight to 10 weeks, after which physical therapy can begin.
Flexibility Therapy
After weeks or months of immobilization, the muscles, tendons, and ligaments that cross your ankle joint may have become stiff and inflexible. This can limit your mobility and cause discomfort when walking or performing other routine tasks. Your physical therapist will begin rehabilitation by manually stretching and manipulating your foot and ankle complex in effort to stretch the structures that cross your ankle. This will help return elasticity to your ankle joint, which is crucial to returning to normal activity after a lower tibia fracture.
Deep Tissue Massage
During the months that your foot was immobilized and your tibia bone was healing, scar tissue may form on your tendons and ligaments around your ankle joint. Scar tissue consists of a network of collagen fibers that help close and repair damaged soft tissues in your body, but can also lead to pain, discomfort, and a loss of mobility and range of motion due to their location around your ankle joint. Therefore, your physical therapist may employ deep tissue massage techniques that are designed to break up the collagen tissue around your ankle and realign it with the surrounding tissues of your ankle. Breaking and realigning the collagen fibers in your ankle will increase your range of motion while decreasing any lasting pain or discomfort as a result of collagen buildup.
Strength Training
The muscles that support and control movement in your foot and ankle are often affected by a break in your lower tibia bone. These muscles may atrophy, or loose size and strength, as a result of the tibia fracture. Restrengthening the muscles of the foot and lower leg are an important part of physical therapy and usually begin after you have regained sufficient flexibility and range of motion in your foot and ankle complex. Your physical therapist will provide you with a strength training program for your lower leg muscles that may involve the use of your own body weight, resistance bands, free weights, or weight machines that are designed to build strength and size in the muscles affected by your injury.
Long-Term Rehabilitation
Your actual physical therapy program usually lasts about six to eight weeks following the removal of your leg cast. At this time, you may be allowed to return to normal activity by your physician. However, your physical therapist may provide you with a long-term rehabilitation program. This program typically consists of the same flexibility and strength training exercises you performed during physical therapy, and you may be instructed to continue these exercises for up to a year. This is to ensure the muscles, ligaments, and tendons that were affected by your lower tibia fracture remain strong and flexible, which will decrease the risk of reinjury.
References
- "Therapeutic Exercise: Foundations and Techniques"; Carolyn Kisner and Lynn Colby; 2007
- "Introduction To Physical Therapy"; Michael A. Pagliarulo; 2011
