Rehabilitation Exercises

Rebuilding strength, mobility, and confidence after a fracture takes the right exercises at the right time. This guide walks you through each recovery phase with targeted movements for every major body region.

Physical therapist guiding a patient through rehabilitation exercises after a fracture

Important Safety Notice

Always get clearance from your doctor or physical therapist before starting any exercise program after a fracture. Stop immediately if you experience increased pain, swelling, or unusual sensations. These exercises are general guidance and should be adapted to your specific injury, surgical procedure, and healing timeline by a qualified healthcare professional.

Recovery Phase Guide

Fracture rehabilitation follows a predictable progression. Knowing which phase you are in helps you choose the right exercises and avoid setbacks.

Early Phase

Protect and Mobilize

Weeks 2 to 4 post-injury

The bone is still fragile. The goal is to prevent stiffness and muscle wasting without stressing the fracture site.

  • Gentle range of motion in nearby joints
  • Isometric contractions (muscle tightening without movement)
  • Elevation and light pumping exercises to reduce swelling
  • Pain-free movement only
Mid Phase

Restore Movement

Weeks 4 to 8 post-injury

Callus formation provides stability. You can now work on regaining full range of motion and introducing light resistance.

  • Active range of motion through full available arc
  • Light resistance bands and small weights
  • Balance and proprioception training
  • Gradual weight-bearing progression (lower limb fractures)
Late Phase

Rebuild Strength

Weeks 8 and beyond

Bone union is confirmed on imaging. The focus shifts to restoring full strength, endurance, and return to normal activities.

  • Progressive resistance training
  • Functional movement patterns
  • Sport- or activity-specific drills
  • Impact and plyometric exercises (with clearance)

Exercises by Body Region

Select the body region closest to your fracture site. Each exercise includes the recommended recovery phase, difficulty level, and clear technique instructions.

Wrist and Hand

Wrist Flexion and Extension

Early 3 sets of 10 reps

Rest your forearm on a table with your hand hanging off the edge. Slowly bend your wrist up and down through a comfortable range. Move smoothly and avoid jerking motions. Hold each end position for two seconds.

Grip Strengthening

Mid 3 sets of 15 squeezes

Squeeze a soft therapy ball or rolled towel and hold for five seconds, then slowly release. Focus on engaging all fingers evenly. Progress to a firmer ball as grip strength improves over the coming weeks.

Finger Walks

Early 2 sets of 5 walks per direction

Place your hand flat on a table. Walk your fingers forward slowly, stretching the hand open, then walk them back. This encourages tendon gliding and prevents adhesions in the healing wrist or hand.

Therapy Putty Exercises

Late 5 minutes, various grips

Use therapy putty to perform pinches, spreads, and full-hand squeezes. Work through different resistances (soft to firm) as your hand strength returns. This builds fine motor control and grip endurance for daily tasks.

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Shoulder and Upper Arm

Pendulum Swings

Early 3 sets of 30 seconds each direction

Lean forward with your good hand on a table for support. Let the injured arm hang freely and gently swing it in small circles, side to side, and forward and back. Gravity provides a gentle stretch without loading the fracture.

Wall Walks

Mid 3 sets of 8 reps

Stand facing a wall at arm's length. Place your fingertips at waist height and slowly walk them up the wall as high as comfortable. Hold at the top for three seconds, then walk back down. Track your progress by marking your highest point.

Isometric Rotator Cuff

Early 3 sets of 10 holds (5 sec each)

Stand with your elbow bent at 90 degrees and pressed into your side. Push your hand outward against a door frame or wall without actually moving. Hold for five seconds, relax, and repeat. Then push inward against the opposite side.

Resistance Band External Rotation

Late 3 sets of 12 reps

Anchor a light resistance band at elbow height. Stand sideways, hold the band with the far hand, elbow bent at 90 degrees and tucked to your side. Rotate your forearm outward against the band, then return slowly. Keep your elbow pinned to your ribcage throughout.

Scapular Squeezes

Mid 3 sets of 12 reps

Sit or stand with arms at your sides. Squeeze your shoulder blades together as if pinching a pencil between them. Hold for five seconds, then release. This activates the postural muscles that support shoulder alignment during recovery.

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Ankle and Foot

Alphabet Tracing

Early 2 sets, full alphabet

Sit with your leg elevated. Use your big toe to trace each letter of the alphabet in the air. This moves the ankle through every plane of motion without bearing weight. Go slowly and make each letter as large as comfortable.

Towel Scrunches

Mid 3 sets of 10 scrunches

Place a towel flat on the floor. Sit in a chair with your foot on the towel. Use your toes to scrunch the towel toward you, then push it back out. This strengthens the intrinsic foot muscles that support the arch and improve stability.

Seated Calf Raises

Mid 3 sets of 15 reps

Sit with your feet flat on the floor. Slowly raise your heels as high as you can while keeping the balls of your feet on the ground. Hold at the top for two seconds and lower slowly. Progress to standing calf raises when cleared for full weight-bearing.

Balance Board Training

Late 3 sets of 30 seconds

Stand on a wobble board or balance disc with both feet. Try to keep the edges from touching the ground. Start near a wall or counter for support. Progress to single-leg balance as your proprioception and ankle stability improve.

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Knee and Lower Leg

Quad Sets

Early 3 sets of 10 holds (5 sec each)

Lie on your back with your leg straight. Tighten the muscles on the front of your thigh by pushing the back of your knee into the bed or floor. Hold for five seconds, then release. You should see your kneecap shift slightly upward when the muscle engages.

Straight Leg Raises

Mid 3 sets of 10 reps

Lie on your back. Tighten your quad, then lift the entire leg about 12 inches off the surface while keeping the knee locked straight. Hold for three seconds at the top, then lower slowly. This builds quad strength without bending the knee joint.

Heel Slides

Early 3 sets of 10 reps

Lie on your back with legs straight. Slowly slide your heel toward your buttocks, bending the knee as far as comfortable. Hold for two seconds, then slide back to the starting position. Use a towel under your heel on a smooth surface to reduce friction.

Step-Ups

Late 3 sets of 10 reps per leg

Stand in front of a sturdy step (15 to 20 cm high). Step up with your injured leg, pressing through the heel to straighten fully at the top. Slowly lower back down with control. Hold a railing for balance if needed. Increase step height as strength allows.

Terminal Knee Extension

Mid 3 sets of 12 reps

Loop a resistance band behind your knee and anchor it at knee height behind you. Stand with a slight bend in the knee. Straighten your knee fully against the band's resistance and hold for two seconds. This targets the last 20 degrees of extension, which is often the hardest to regain.

Guided physical therapy session for fracture rehabilitation Patient performing knee rehabilitation exercises with a supportive brace
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Hip

Clam Shells

Mid 3 sets of 12 reps per side

Lie on your side with knees bent at 45 degrees and feet together. Keeping your feet touching, lift your top knee as high as you can without rolling your pelvis backward. Hold briefly at the top and lower with control. This targets the gluteus medius, a key hip stabilizer.

Bridging

Mid 3 sets of 10 reps

Lie on your back with knees bent and feet flat on the floor, hip-width apart. Push through your heels to lift your hips until your body forms a straight line from shoulders to knees. Hold for five seconds at the top and lower slowly. Avoid arching your lower back.

Side-Lying Hip Abduction

Late 3 sets of 12 reps per side

Lie on your uninjured side with both legs straight. Keeping your top leg straight and toes pointing forward (not up), lift it about 30 degrees. Hold for two seconds and lower slowly. Add an ankle weight when the movement becomes easy to build progressive resistance.

Standing Marches

Early 3 sets of 20 marches

Stand holding onto a counter or sturdy surface. Slowly lift one knee toward your chest as high as comfortable, then lower it. Alternate legs in a marching pattern. Keep your trunk upright and avoid leaning. This encourages hip flexion and weight shifting in a safe position.

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Spine

Pelvic Tilts

Early 3 sets of 10 reps

Lie on your back with knees bent and feet flat. Gently flatten your lower back into the floor by tightening your abdominal muscles. Hold for five seconds, then release. This activates the deep core stabilizers that protect the healing vertebra without any spinal movement.

Bird-Dogs

Mid 3 sets of 8 reps per side

Start on all fours with your hands under shoulders and knees under hips. Simultaneously extend your right arm forward and left leg backward, forming a straight line. Hold for three seconds, return to start, then switch sides. Keep your spine neutral and avoid rotating your hips.

Dead Bugs

Mid 3 sets of 8 reps per side

Lie on your back with arms reaching toward the ceiling and knees bent at 90 degrees. Slowly lower your right arm overhead and left leg toward the floor simultaneously. Return to start and switch sides. Press your lower back firmly into the floor throughout the movement.

Prone Extension (Gentle)

Late 3 sets of 8 reps

Lie face down with your hands beneath your shoulders. Slowly press up, lifting your chest off the floor while keeping your hips down. Rise only as high as comfortable. Hold for three seconds, then lower. This restores extension mobility in the thoracic and lumbar spine. Only attempt after your doctor confirms adequate healing.

Frequently Asked Questions

Gentle range-of-motion exercises for joints above and below the fracture can usually begin within the first week, even while in a cast. Active rehabilitation of the fracture site typically starts once X-rays confirm early callus formation, usually at 4 to 6 weeks for upper extremity fractures and 6 to 10 weeks for lower extremity fractures. Your orthopedic surgeon or physical therapist will clear you based on imaging and clinical examination.
After cast removal, begin with gentle wrist flexion and extension, moving the wrist up and down within a pain-free range 10 to 15 times, three times daily. Progress to forearm rotation (pronation and supination) by turning your palm up and down while the elbow stays at your side. Grip strengthening with a soft therapy ball or putty typically begins at 6 to 8 weeks, gradually increasing resistance as comfort allows.
Start with non-weight-bearing exercises like seated ankle pumps, quad sets, and straight leg raises to prevent muscle atrophy during immobilization. Once cleared for weight bearing, progress through partial weight bearing with crutches or a walker before transitioning to full weight bearing. Pool-based exercises (aquatic therapy) are particularly useful because water buoyancy reduces load on the healing bone while allowing early strengthening.
Yes, maintaining fitness in uninjured areas is strongly encouraged and may actually speed fracture healing by improving overall circulation and reducing inflammation. For a lower extremity fracture, upper body strength training and seated cardiovascular exercise (arm ergometer) are safe and beneficial. For upper extremity fractures, stationary cycling, walking, and lower body strengthening can all continue, provided the injured arm is properly protected.
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Fracture & Bone Health Specialist
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