A fractured foot can occur from many traumatic events, such a falling down the stairs, a car accident or dropping a heavy item on your foot. Other conditions such as avascular necrosis can result in a fracture when the bone is not receiving adequate blood circulation. As with any fracture, the severity and completeness of the fracture as well as any associated dislocation or tendon or ligament rupture greatly affect the extent of the damage and long-term issues.
Acute Phase
A physical therapist (PT) will provide crutch education for younger, healthy patients who have suffered a significant bone fracture requiring a period of non-weight-bearing. Your PT will demonstrate how to safely use crutches to ambulate and navigate stairs. Make sure to use your arm strength rather than resting your arm pits on the crutches to avoid shoulder strain. For severe fractures, especially those requiring surgery, a hospital stay may be required. While at the hospital, your PT will teach you how to ambulate with a walker to facilitate your safe return to home if possible.
Rehabiliation Facility Stay
For elderly patients with dementia, patients with several medical complications or patients with the most severe fractures, an inpatient stay at a rehabilitation facility may be required. If you have external pins placed in your foot for a dislocated severe fracture, your occupational therapist (OT) will teach you how to dress yourself over your pins without displacing them. For all non-weight-bearing patients, daily activities such as dressing, bathing, cooking and cleaning will be challenging. Your OT will provide you with adaptive self-care equipment and teach you how to complete functional activities from a wheelchair or walker.
Range of Motion
Once your cast has been removed along with any external pins, your orthopedic surgeon will allow your PT to complete range-of-motion activities with your fractured foot. Your PT will conduct flexion and extension to your ankle, as well as clockwise and counterclockwise rotation. Stretching your toes into flexion and extension will further prepare your foot for weight-bearing ambulation. Modalities provided by your PT such as ultrasound, electrical stimulation and infrared heat will encourage further healing and reduce pain.
Weight Bearing and Strengthening
Once your fracture has healed adequately, your orthopedic doctor will direct your PT to initiate strengthening and weight bearing on your affected foot. Your physician will prescribe weight bearing as tolerated at this time, and you will progressively place more pressure through your foot while standing and ambulating until you can bear full weight. Once fully weight bearing, your PT can initiate strengthening with exercise bands, pulleys and weighted exercises. Many PTs add Pilates to your exercise routine to further strengthen stabilization muscles and improve your balance.
