Is fracture casting needed before physiotherapy?

A cast or splint can protect a healing fracture and limit movement while the bone is stabilised. Physiotherapy may still begin during this period with safe activities, such as moving joints that are not immobilised, controlling swelling, practising safe transfers, or learning to use crutches.

Once the fracture team confirms that healing and stability allow more movement, therapy can progress to restoring joint range, strength, balance, and function. Starting forceful exercise or removing protection early can disrupt the treatment plan, so the therapist needs the fracture details and any weight-bearing limits.

Bring your imaging reports or discharge instructions to physiotherapy and explain the injury date, cast or splint type, pain, swelling, and any change in sensation. Follow the prescribed limits for weight-bearing and movement. Keep the cast protected and use walking aids exactly as demonstrated.

Ask the physiotherapist to show which exercises are allowed now and which should wait. A home programme should fit the current healing stage and be changed when the fracture team updates your restrictions.

Seek urgent care for new numbness, severe pain, pale or blue fingers or toes, inability to move them, sudden shortness of breath, or a fall that affects the injured limb. Contact the fracture team promptly if swelling or pain is worsening, the cast becomes damaged, or you cannot follow the prescribed weight-bearing plan.

Ask when physiotherapy should start, which movements are safe before cast removal, when weight-bearing can change, what signs suggest delayed healing, and how the therapist and fracture team will coordinate your progression.