Fracture Rehab: who to see and what helps

Fracture Rehab · Kitchener, Waterloo & Cambridge

Once a broken bone has been set, put in a cast or fixed with surgery, rehab is the work of getting movement and strength back, alongside the fracture clinic or surgeon who decides when the bone can take load. How much formal treatment helps depends on the bone: exercise programmes after a hip fracture improve walking, while after a broken wrist or ankle, research has not shown that regular therapy sessions beat a well-taught home programme. At CARESPACE the first visit is with a physiotherapist, who assesses and treats you that day.

What fracture rehab is

While a fracture heals you will likely lose muscle strength and range of motion in the injured area. Rehab is the specific exercises that restore strength, joint motion and flexibility, started at the right time and stepped up as healing allows.

Timing is the hard part: pain usually stops long before the bone is solid enough to handle normal activity, so you may need to keep limiting what you do even after the cast or brace comes off. A bone that cracked from repeated loading, with no fall or blow, is covered on Stress Fractures.

What recovery usually involves

• A stiff, weak arm or wrist when the cast is removed; this can last several months or more
• Swelling, which is why you are told to rest and raise the limb
• Stiff muscles around a boot or cast, eased by gently moving the joints that are free

Why the bone broke, and when to ask about bone health

A fracture from a fall from standing height, or from less force than would break a healthy bone, is called a low-trauma fracture. For postmenopausal women, and men aged 50 and older, with a recent fracture, Canada’s osteoporosis guideline recommends access to a fracture liaison service, which assesses and treats osteoporosis; only a few parts of Canada have one. If that describes you, ask your physician or nurse practitioner about a bone health assessment, and see Osteoporosis.

Warning signs while a fracture heals

Call 911 if you have pain in your chest or back, shortness of breath or difficulty breathing, if you cough up blood, or if you pass out. The NHS, the UK’s health service, gives the same instruction to anyone with signs of a blood clot in a leg who has chest pain or feels short of breath, and clots are more likely after surgery or a spell of not moving much.

Call 911 or go to the nearest emergency department after a new fall or blow to the healing limb if it sits at an odd angle or has changed shape or colour, a bone is showing, a cut is bleeding heavily, the pain is severe, or your hand, foot, fingers or toes are numb, tingling, blue or white. Do the same if a broken hip that was repaired with a partial or full hip replacement moves out of place: it will be very painful and you will not be able to stand (see Hip Replacement Rehab).

Go to the nearest emergency department if you are in a cast or splint and:

• the cast seems tighter than usual, even after you have raised the limb and moved your fingers or toes
• your fingers or toes are numb, tingling, burning, cold, very swollen, or turning white or blue
• you cannot move your fingers or toes
• you have severe pain or pressure under the cast, burning or stinging skin under it, or pain that keeps getting worse
• fluid or discharge is coming through the cast, or a bad smell is coming from it

Nobody at CARESPACE can check what is happening under a cast; an emergency department can.

The emergency departments in Waterloo Region are:

• WRHN @ Midtown (formerly Grand River Hospital), 835 King St. W., Kitchener
• WRHN @ Queen’s Blvd. (formerly St. Mary’s General Hospital), 911 Queen’s Blvd., Kitchener
• Cambridge Memorial Hospital, 700 Coronation Blvd., Cambridge

If you cannot get there safely, call 911.

Get medical care the same day, from your fracture clinic, a physician or a nurse practitioner, or at an urgent care clinic or emergency department if you cannot reach them, for:

• signs of a blood clot in a leg: throbbing pain in one leg, usually in the calf or thigh, sometimes behind the knee or in the groin; swelling in one leg or the groin; red, blue, purplish or darkened skin around the painful area; or swollen veins
• a fever or very high temperature, or feeling hot, cold or shivery
• after an operation on the bone, other signs of infection: increased pain, swelling, warmth or redness at the incision; red streaks leading from it; or pus draining from it
• after an operation, pain that does not get better after you take your pain medicine, new or worse nausea or vomiting, or being unable to keep fluids down
• a cast that cracks, breaks, comes undone, gets wet, goes soft, rubs or feels too loose
• skin around the cast that turns red or raw, something stuck under the cast, or itching you cannot bear

These lists combine two Ontario hospitals’ cast-care sheets, Alberta’s going-home instructions after fracture surgery and NHS advice on broken arms, wrists and ankles, in Ontario terms. Your own hospital’s sheet about your wound or cast applies as well.

What the evidence says about fracture rehab

• Hip fracture: up within a day. Ontario’s quality standard for hip fracture, written for adults aged 50 and older having surgery after a low-energy break such as a fall from standing height, says they should be mobilized, putting as much weight on the leg as is comfortable, within 24 hours of surgery and every day after. Its rehabilitation programme includes balance, strengthening and walking training, education on preventing falls, and an ongoing exercise programme once formal rehabilitation ends.
• Hip fracture: exercise after discharge works. A 2022 Cochrane review included 22 trials (2,626 people) of mobility treatment after hospital discharge and found a small, meaningful improvement in mobility and walking speed, on high-certainty evidence. Walking, balance and everyday-movement training improved mobility (high certainty); strength training may improve walking distance (low certainty).
• Broken wrist: sessions have not been shown to beat a home programme. A 2015 Cochrane review of 26 trials (1,269 people, not pooled) judged the evidence insufficient to say which approach is best. In four small trials, adding routine physiotherapy or occupational therapy to home-exercise instructions after the cast came off made no clinically important difference, and after plate surgery two small trials favoured a structured home programme that began with coaching. All of it was low-quality evidence.
• Broken ankle: earlier loading after surgery. A 2024 Cochrane review found that putting weight on the ankle early after surgery probably leads to very slightly better function (5 studies, 890 people), and that a removable support that allows exercise may help too (6 studies, 677 people), though neither difference may be large enough to matter. Neither is likely to raise the risk of another operation. On physical therapy techniques after a broken ankle, it found too little evidence to judge.
• Weight-bearing is decided fracture by fracture. The UK’s NICE guideline says to advise immediate weight-bearing as tolerated for a fracture on one side of the ankle that does not need surgery.
• Food and supplements. Ontario’s hip fracture standard says nutritional intake should be assessed after surgery, with protein and high-energy supplements provided if required. For people who eat a balanced diet and are not on osteoporosis medicine, Canada’s osteoporosis guideline says supplements of calcium, vitamin D and protein are likely to have little to no effect on fractures.

What your fracture clinic or surgeon looks after

Setting the bone, the cast, splint or boot, any surgery and its wound, the X-rays that show healing, pain medication, and how much weight or load the limb may take and when. CARESPACE does not provide these.

How each CARESPACE service helps after a fracture

Physiotherapy

While you are in a cast, a physiotherapist can show you how to keep the free joints moving. Once the cast is off or the surgeon allows it, they can measure the stiffness and weakness that is left, set exercises to restore it, and progress walking, balance and stairs after a leg or hip fracture. For a wrist or ankle, a few visits to teach and progress a home programme may be all you need.

See our physiotherapy team →

Occupational Therapy

An occupational therapist can work on using the hand again for dressing, cooking and work, and on managing one-handed in a cast. The wrist trials found no clinically important gain from adding routine occupational therapy or physiotherapy to home-exercise instructions, and one trial of hand therapy during the cast (17 people) gave very low-quality evidence of better hand function, so book it for a task you are stuck on. After a hip fracture, rehabilitation includes therapy for independence in self-care, changes to the home and education on safety, all work an occupational therapist can do.

See our occupational therapy team →

Kinesiology

A kinesiologist can run the ongoing exercise programme that should follow formal hip fracture rehabilitation: supervised strengthening, balance and walking work, stepped up over time. Balance and functional training can also reduce falls in adults over 50, which matters when a fall caused the break.

See our kinesiology team →

Nutrition & Dietitian

A Registered Dietitian can assess whether you are eating enough, and enough protein, while you heal; after hip fracture surgery that assessment is part of the provincial standard. You leave the first visit with a plan. Orthopaedic surgeons advise a diet rich in calcium and vitamin D for bone strength; ask a pharmacist, physician or nurse practitioner before starting a supplement.

See our nutrition team →

Other services people ask about

Massage therapy: none of the reviews we read tested massage for fracture recovery. A sore, swollen or discoloured calf after a fracture is a warning sign, not a reason for massage.

Where most people start

With a physiotherapist. You do not have to wait for the cast to come off. Bring what the fracture clinic told you: how much weight or load is allowed, and the date of your next X-ray. For a child’s fracture, ask when you book who sees children: this page draws on advice for adults.

How your team works together

The fracture clinic decides how much load the bone can take and when the cast comes off, and your physiotherapist fits the exercises to that. For a wrist or ankle fracture, one practitioner is often the whole team. After a hip fracture, an occupational therapist, a kinesiologist and a Registered Dietitian each have a part.

Browse by service: physiotherapists, occupational therapists, kinesiologists and registered dietitians.

What to expect at your first visit

1. The break and the plan so far. Which bone, when, cast or surgery, and what the fracture clinic has allowed.
2. What you can do now. Movement of the free joints, grip or walking, swelling, and how you manage at home.
3. How it happened, including questions about balance if a fall caused it.
4. Treatment that day and exercises matched to the stage of healing.

What you can do at home

• Rest and raise the limb whenever you can; keep a hand above the elbow, on a pillow at night.
• Move your fingers or toes for a few minutes every 30 minutes, and exercise the joints next to the injury that are not held by the cast.
• Keep the cast dry, and never push anything under it to scratch.
• Put no weight on the limb, and do not drive or lift heavy things, until you have been told it is safe.
• Once a broken ankle has healed, use it as normal: moving it stops it getting stiff.
• In a Waterloo Region winter, treat icy steps, driveways and parking lots as off limits while you are in a cast or boot.

How long recovery takes

A broken arm or wrist usually takes around 6 to 12 weeks to recover from, and a broken ankle usually takes 6 to 8 weeks to heal, though both can take longer. American orthopaedic surgeons say some fractures, in the fingers for example, heal in three to four weeks, while others take six to eight weeks, several months (three to six on average) or longer. The sources give no figure for recovery from a hip fracture.

Fracture rehab in Kitchener, Waterloo and Cambridge

Kitchener. Physiotherapy in Kitchener, Kinesiology in Kitchener and Nutrition in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.

Waterloo. Physiotherapy in Waterloo, Kinesiology in Waterloo and Nutrition in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.

Cambridge. Physiotherapy in Cambridge and Nutrition in Cambridge. Location: Hespeler Road.

The city pages linked above show the locations and practitioners for each service, with their next availability.

Common questions

When should I start physiotherapy after a fracture?

You can start while the cast is on, for the joints it leaves free; the broken area itself waits for the fracture clinic’s go-ahead. Hip fracture surgery is different: Ontario’s standard has people up and putting weight on the leg within 24 hours.

Do I need physiotherapy after a broken wrist?

A physiotherapist can help with the stiffness and weakness left when the cast comes off. Trials have not shown routine sessions doing better than a home programme you have been taught, so a short run of visits is a reasonable way to use it.

When can I put weight on a broken ankle?

When your surgeon or fracture clinic says so; they also set how long the boot or cast stays on. The research on early weight-bearing after ankle surgery is reassuring, but the decision depends on your fracture.

I broke a bone in a minor fall. Should I be checked for osteoporosis?

Ask a physician or nurse practitioner, above all if you are a postmenopausal woman or a man aged 50 or older: the Canadian guideline recommends access to a service that assesses and treats osteoporosis after a recent fracture.

Where can I get fracture rehab in Cambridge?

Start with Physiotherapy in Cambridge; Nutrition in Cambridge is there as well. Book online or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.

Do I need a referral?

No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →

Sources

• Ontario Health. Hip Fracture: Care for People With Fragility Fractures. Quality standard, 2024 update, with its full text.
• Fairhall NJ, Dyer SM, Mak JCS, Diong J, Kwok WS, Sherrington C. Interventions for improving mobility after hip fracture surgery in adults. Cochrane Database of Systematic Reviews, 2022.
• Handoll HHG, Elliott J. Rehabilitation for distal radial fractures in adults. Cochrane Database of Systematic Reviews, 2015.
• Lewis SR, Pritchard MW, Parker R, et al. Rehabilitation for ankle fractures in adults. Cochrane Database of Systematic Reviews, 2024.
• Morin SN, Feldman S, Funnell L, et al., for the Osteoporosis Canada 2023 Guideline Update Group. Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update. CMAJ, 2023.
• National Institute for Health and Care Excellence. Fractures (non-complex): assessment and management (NG38). 2016.
• Hôpital Montfort, Ottawa. Caring for your cast. Hospital cast-care sheet (form 4100268, 16-04); file posted March 2026.
• Lakeridge Health. Cast or Splint Care. Emergency department discharge instructions, revised July 2016.
• MyHealth.Alberta.ca. Open Reduction With Internal Fixation of a Limb: What to Expect at Home. Care instructions adapted under licence from Healthwise; current as of July 31, 2024.
• Waterloo Regional Health Network. Hip Replacement Guidebook. Hospital guidebook, WRHN @ Midtown; file posted June 2026 (the sign of a hip that has moved out of place).
• NHS. Broken arm or wrist (reviewed October 2026), Broken ankle (reviewed November 2025) and DVT (deep vein thrombosis) (reviewed April 2026).
• American Academy of Orthopaedic Surgeons. Fractures (Broken Bones). OrthoInfo.

Related conditions

Osteoporosis
Stress Fractures
Hip Replacement Rehab
Ankle Sprains
Sarcopenia (Age-Related Muscle Loss)

Ready to book?

Book online with a physiotherapist, or call 519-208-2273 and our Central Reception Team will match you with the right person and the closest location.

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