Physiotherapy for lower limb fracture

What to expect after removing the cast

In order to help your fracture heal, the decision may be made to immobilise your leg or foot by placing it into a cast for a set period of time. This is typically around 4-6 weeks.

This will be decided by your orthopaedic doctor. After your cast is removed, you will probably have dry flaky skin, altered sensation, joint stiffness, muscle weakness and some swelling.

This leaflet will provide advice and exercises to help with these effects.

Skin Care

After your cast is removed it is helpful to massage non-perfumed moisturiser over your leg.

This will help hydrate the dry skin while also providing a positive touch to an area that has not been touched or moved for a period of time.

This will help with dry skin and sensory concerns

Exercises

The following exercises will help reduce swelling and stiffness and increase your joint movement.

Carry out these exercises regularly and gradually work through them. The exercises get harder as you work through the leaflet so it may be a few weeks before you can manage them all.

Exercises may feel difficult at first but should not be painful. If an exercise is painful, you should stop and try again later.

Exercise 1

Circle and paddle your ankles back and forth 10 times each as regularly as you can throughout the day.

This can be done while you are lying or sitting.

Exercise 2

• Lie on your back and draw your feet under your knees.
• Keep your knees hip-width apart.
• Lift your hips up high.
• Hold for 5 seconds at the top then slowly lower down.
• Repeat 10 times

Exercise 3

• While sitting in a chair point your toes up and kick your foot up to straighten your knee.
• Hold for 3 seconds at the top.
• Slowly lower back down.
• Repeat 10 times.

 

Exercise 4

• Start on all fours.
• Straighten your knees while trying to keep your heels on the ground.
• Hold for 20 seconds.
• Slowly lower down onto your knees.
• Repeat 3 times.

Exercise 5

• Stand with your feet wider than your hips and with your toes pointing out slightly.
• Bend your knees and push your hips back into a squat.
• Keep your chest up.
• Push back up into standing.
• Repeat 10 times

Exercise 6

• Balance on one leg.
• Aim to reach 30 seconds without wobbling.
• If too tricky at the start, stand by a table for support.
• If too easy, try throwing and catching a ball or passing it under your leg.

Activity Ideas

Your doctor will give you advice on returning to activity and sports. Here is a list of activities you can try to encourage to regain full function:

• Short walks
• Swimming
• Cycling
• Animal walks
• Gardening
• Squashing things with your foot

When to seek further help?

Your child may limp a little for many weeks after their cast is removed, especially in younger children and after increased activity.

If your child reports the following complaints after 3 – 4 weeks of following the advice in this leaflet please call the physiotherapy team to discuss further assessment:

• Ongoing pain which stops your child from taking part in normal activities
• Difficulty returning to normal function
• Ongoing stiffness.

Call our self-referral number on 0131 312 1079 Monday-Friday between 08:30-16:30.