Bone Fractures: The Critical Role of Exercise in Recovery

Bone fractures are a common injury, but with proper care and rehabilitation, bones can heal and regain strength. Strength exercise is a crucial component of this healing process, aiding in bone regeneration and restoring mobility and function.

How can a bone fracture?

Bones can fracture when placed under a load or force that they can’t tolerate. The load tolerance is subjective, person to person, and can vary based on the individual medical presentation and clinical history. Age it is only a circumstance that at the current moment in our society is seen as an increase the chance of fracture, but if we learn to age by keeping our feet via strength training, age would not be anylonger a risk component.

Indeed, during the aging process, the bone can become weaker if not stimulate to positive stress, such as load active loads. The less load they received, the less the bone would keep regenerating, due to a slower metabolism. Therefor, as explained in other blogs, strength training is a key to longevity and better health.

How can bone fractures heal?

When a bone fractures, the body initiates a complex healing process involving several stages:

1. Inflammation: Immediately after the fracture, blood clots form, initiating the healing process.

2. Soft Callus Formation: Fibrocartilaginous tissue begins to bridge the fracture gap.

3. Hard Callus Formation: The soft callus is replaced by a hard bony callus made of woven bone.

4. Remodelling: The bone gradually remodels into its original shape and structure.

This process can take several weeks to months, depending on factors like age, overall health, previous clinical history, medication intake and the severity of the fracture. 

Even thought there is nothing that can speed up the recovery, as this is a body natural process, there are things that can be done to assist the recovery and ensure that the healing happens as smooth as possible. Exercises is one of those factors, which are part of the healing journey, but have to be incorporated under supervision, to ensure not to aggravate the presentation.

The Role of Exercise in Bone Regeneration

As mentioned above, and in other blog exercises, specifically strengthening exercises, are a positive load for the body tissues, including bone, which can help stimulate the regeneration of those tissues. Obviously, different phases of healing require and can accept different types of strength exercises. So yes, you would not start with a single-leg jump on a broken tibia

• Stimulates Bone Formation: Mechanical stress from exercise promotes osteoblast activity, leading to new bone formation.
• Enhances Strength and Flexibility: Regular movement prevents joint stiffness and muscle atrophy;
• Improves Balance and Coordination: Reducing the risk of future falls and fractures.

A systematic review by Kuijlaars et al. (2019) highlighted that physical therapy exercises, whether home-based or supervised, significantly improve functional mobility and strength post-fracture.

Recommended Exercises for Recovery

At Melbourne Massage and Treatment, I offer assistance with bone fracture recovery exercises throughout the Myotherapy and Fitness class treatment plan.

What I would focus on, too, when aiming for recovery, would be:

• Weight-Bearing Exercises: Including walking or gentle jogging (if we are talking about lower limb injury), to stimulate bone growth;

• Resistance Training: Using bands or light weights to strengthen muscles supporting the bone, or the joint to which the bone is attached.

• Flexibility and Balance Exercises: Again, using weights and machinery, we aim to strengthen the muscles that control your overall equilibrium and stability to prevent further falls and reduce the risk of injury;

• Plyometrics which is most often towards the end of a recovery process from anytype of injury, where we focus on motion that are more close to return to daily activity, and we load your tendon as springs, as per can be doing jumping on the spot or repetitive explosive motions with arms.

Clinical Evidence Supporting Exercise in Recovery from Bone Fractures

Research, as already mentioned in the Kuijlaars et al. (2019) systematic review, shows the benefits of incorporating exercise into fracture rehabilitation, and below we look into more details about what exercises have to offer in terms of recovery:

• Improved Healing Rates: Patients engaging in structured physical therapy often experience more robust bone healing (Song, 2022).

• Reduced Complications: Regular movement decreases the risk of complications like deep vein thrombosis or joint stiffness (Ruan et al., 2023).

• Enhanced Quality of Life: Maintaining physical activity levels improves overall well-being and independence (Mahindru et al., 2023).

What to consider when doing exercises post-bone fractures.

While exercise is beneficial, it is always important to approach the recovery process with care:

• Follow Medical Advice: Always adhere to the guidelines provided by healthcare professionals.

• Avoid Overexertion: Pushing too hard can hinder healing or cause re-injury. Going hard or going home is not how recovery works.

• Monitor Pain Levels: Some discomfort is normal, but sharp or persistent pain should be addressed immediately. Pain-wise, on a scale of 0 to 10, we usually aim to get you to experience a comfortable discomfort, based on your worst pain experienced as max treshold.

Recovery from an injury, including bone fracture, is a personal journey, and therefore is unique to everyone how quick it can be and what are the consideration to take in place during the exercises recocery.

 

FAQs – Bone Fractures Recovery and Strength Training

1. How do bones fracture?
Bones can fracture when exposed to forces they cannot tolerate. This tolerance varies from person to person, depending on factors like health history, bone density, and physical condition. While age is often seen as a risk factor, it’s more about reduced activity levels. With consistent strength training, the risk of fractures can be lowered significantly, regardless of age.

2. How does a fractured bone heal?
Bone healing occurs in four key stages:

• Inflammation: Blood clots form to protect and initiate healing.

• Soft Callus Formation: Fibrous tissue bridges the fracture.

• Hard Callus Formation: New bone begins forming.

• Remodelling: The bone reshapes to its original form.
  This process varies in duration based on the severity of the fracture and individual health factors.

3. Can exercise speed up bone healing?
While exercise doesn’t “speed up” healing directly, it supports the body’s natural repair process by improving circulation, preventing muscle loss, and stimulating bone regeneration through mechanical stress. The right exercise can ensure smoother and stronger recovery outcomes.

4. What kind of exercise is safe after a fracture?
It depends on the phase of healing and the specific injury. In general:

• Early phase: Gentle mobility and isometric exercises.

• Mid phase: Light resistance and functional movements.

• Later phase: Plyometrics and weight-bearing activities to restore full function.
  All exercises should be tailored and supervised.

5. Why is strength training important after a bone fracture?
Strength training applies controlled stress to bones, activating osteoblasts—the cells responsible for bone formation. It also strengthens the surrounding muscles and improves joint stability, reducing the risk of future injuries.

6. What role does balance training play in recovery?
Balance and coordination exercises help prevent falls, especially after lower limb fractures. Improved proprioception (body awareness) enhances stability and reduces the likelihood of re-injury during daily movements.

7. Are there risks to exercising too soon after a fracture?
Yes. Exercising too early or with too much intensity can worsen the injury or delay healing. It’s essential to follow a graduated rehabilitation plan designed by professionals like a myotherapist or physiotherapist, adjusting based on pain tolerance and healing progress.

8. Can I return to normal activity after a fracture?
Yes, most people can return to full function with the right rehabilitation. Strength, flexibility, and endurance often recover over time, especially with guided physical therapy. A gradual and structured plan, often ending with functional or sport-specific training like plyometrics, ensures safe return to daily life or athletic activity.

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