By Hannah Whitcombe
Simply put, a fracture (or broken bone), is a partial or complete break to a bone or cartilage. The healing time may depend largely on the extent and type of the fracture, however, all fractures follow a similar process of healing.
Usually, a fracture occurs from direct mechanical trauma, in an otherwise healthy bone. However, other settings where a fracture may occur include;
- osteoporosis or osteopenia (differing degrees of low bone density)
- a lesion that has occurred within the bone that weakens its structure over time such as a cyst or a cancer that has spread from other areas
- repetitive stress to a bone, often seen in runners and most frequently occurring in the long bones of the feet (the metatarsals).
Signs and Symptoms
If a fracture is suspected for any reason, a visit to A & E is a must!
An x-ray will be performed to confirm the diagnosis, but signs and symptoms may include;
- an audible sound at time of injury
- pain and swelling to the affected area
- deep throbbing pain, often well localised (specific to site of injury)
- sharp pain when pressed upon
- being unable to use that area of the body
Dealing with injury of any kind can be a difficult and frustrating process, and learning to rest and let nature take its course can be a challenge, especially to those of us who are ordinarily very active!
Hence, two of the most frequently asked questions are ‘How long will it take to heal?’, and ‘Can I do anything to speed up the process?’. So, let’s start there!
How long will it take to heal?
To get an idea of how long a bone will take to heal, we need to understand the stages of healing and the likely time frame for each stage. There are three main stages to the healing process; inflammatory, reparative and remodelling.
The Inflammatory Stage
This is the body’s initial response to tissue damage. During this time, and almost immediately after injury, inflammation occurs due to the increased blood flow to the area.
A haematoma (blood clot) is formed to surround the ends of the broken bone and healing begins!
At this stage, pain is likely to be sharp and severe. Pain medication will almost certainly be required, but it is a good idea to stop the anti-inflammatories as soon as possible as inflammation is a vital part of the healing process.
The Reparative Stage
During this stage, a soft callus is formed, which is a weaker form of bone. Pain and inflammation will be significantly reduced but using the area will likely cause sharp pain.
The Remodelling Stage
At this stage, new bone is formed, which replaces the soft callus. After about 6-8 weeks, you will most likely be able to use the area as normal, though pain may be felt with more strenuous activity. However, remodelling of bone may continue for 8 years+, where it continues to get stronger with use.
There may be times, when healing takes longer and surgery may be required. This is more likely in certain settings and risk factors include;
- low bone density (osteoporosis or osteopenia)
- poor nutritional status
- poor management during the healing stage
Can I do anything to speed up my recovery?
A fracture will require time to heal. Your body is amazing at what it does and has a process for everything! It is your job to support those processes by providing the body with everything that it needs to do its vital work. You can help by ensuring good nutrition, sufficient rest and optimum circulation.
A well balanced diet in a usually healthy individual will most definitely ensure a swift and uncomplicated recovery!
But there are certainly a few nutrients that should be increased in the event of a fracture, either by consuming more food sources of these nutrients or by consuming nutritional supplements (probably best to do both!). These include;
- Vitamin D and Calcium
- Vitamin K2
- Vitamin C
- Omega 3
Though this can be challenging, I would advise complete rest for the first 2-3 days. Following this, you want to avoid using the affected area for normal activities for up to 6 weeks. However, to avoid stiffness, ask your physician for simple mobility exercises that you can do during this time. Usually, you will be given advice on appropriate exercises that you can do at home.
In Osteopathy, we say that ‘The rule of he artery is supreme’, meaning that optimum blood flow is paramount to healing.To ensure optimum blood flow, we need to move! So, make sure you follow the advice of your physician and move where practicably possible!
In addition, if you are not in a hard cast and have access to the area, you can try something called ‘contrast bathing’ often referred to as ‘hot and cold therapy’. To do this, all you need is a hot water bottle and a bag of frozen veg wrapped in a cloth or tea towel. You apply the heat (or hot water bottle) to the affected area for 3-5 minutes, followed by the cold (frozen veg) for 1-2 minutes. This can be repeated several times for best results (3 cycles is usually recommended) and can be done multiple times throughout the day. This will stimulate blood to the area and ensure optimum healing.
How and when can I return to normal activity?
- You can return to normal activity as soon as the pain allows
- You are encouraged to keep up some form of exercise during all stages of healing but you may need to get creative with a new exercise regime, being careful to avoid any additional stress to the affected area
- Build up slowly. Be patient with yourself and ensure that you do not overdo it in the early days or you may just set yourself back
- It is usually best to wait for your follow-up x-ray before attempting anything too ambitious (the follow-up x-ray will likely take place 6 weeks post-fracture)
Can manual therapy help?
In the early stages, manual therapy such as osteopathy is probably best avoided. But, going forwards it can be a great part of your recovery! It is unlikely that we will have any affect on your broken bone but we can certainly help in the following ways;
- By preventing stiffness to the surrounding area
- By avoiding likely compensatory patterns that occur during pain avoidance
- By offering continual assessment
- By providing rehabilitative exercises
- By offering advice on dietary and other lifestyle factors