Breaking News for Broken Bones: You Could--And Should Walk Sooner After a Fracture

The standard advice for a broken leg or ankle used to be simple: don’t walk on it for six weeks. Total rest. Crutches. Maybe even a scooter.

Over a million people in the U.S. break bones in their lower limbs each year. For a long time, doctors leaned toward “better safe than sorry.”

New evidence indicates that this cautious approach might slow recovery. Getting on your feet sooner can be a good thing.

Early weight-bearing--gently walking or putting pressure on the leg earlier-- often leads to faster healing and fewer long-term issues. Outside of a few complex cases, walking on a healing fracture earlier doesn't increase complications and offers significant benefits.

Why it helps to move

When you're completely immobilized, muscles weaken shockingly quickly and bone strength fades.

Just as astronauts lose 10% of their bone density in space because there’s no gravity pushing on them, people stuck in bed or on crutches for weeks lose muscle and bone because they’re not using them.

Doctors now recognize this balance. With a bone aligned and held in place, the goal is for the body to form new bone tissue (called a callus) across the fracture. The sooner that happens, the sooner the bone itself takes over.

Too little movement results in no callus formation, while too much prevents the bone from knitting back together.

Once a fracture is stabilized, with either a cast or with surgery employing plates, rods, or screws, the body can start healing right away. Gentle weight on the leg can help that process along.

One major trial found that people who'd broken femurs (the thigh bone) and started walking sooner had no more issues than those who waited 6 weeks.

A large study on ankle fractures found the same thing: early walkers healed just as well and reported better ankle function at 6 weeks and 4 months post-surgery.

Immobility can be devastating for frail patients

Some patients don't have the dexterity and strength to navigate with crutches, so they stay in bed, leading to serious problems such as blood clots and pneumonia.

A study of hip fracture patients found that 9% of them died within 30 days of breaking a hip and 30% died within the first year.

Early weight-bearing in hip fractures decreases mortality rates and has become standard practice.

Early weight-bearing worked for me

When I broke my foot, I was advised by people who'd experienced a broken foot that I should expect the foot to hurt for months, if not years.

I wore the boot for stability and used crutches and a scooter but as soon as it wasn't too painful to stand on, I added little things like doing single-leg hinges and kickstand squats on that leg.

In 6 weeks I was out of the boot and had no residual pain.

Of course, that was just my experience--"your mileage may vary." 😉

Takeaway

Bones respond to movement and load.

That’s true in training and healing.

In the case of a fracture, discuss weight-bearing options with your surgeon.

Aim not for pushing through pain, but about smart, guided progress.