Physiotherapy for a fractured fibula

The fibula fracture is a bone injury to the outer, lower leg forming tubular bone, usually caused by external force or extreme bending of the foot. The narrow fibula is much more frequently affected by fractures than the adjacent shin bone. The most common form of fibula fracture is located just above the ankle joint.

Healing time

The healing of a bone is a rather long process, depending on the type of fracture, complications and the individual condition of the patient. It takes about six weeks until new fibers have formed and the fracture site grows together. After that, the new fibers have to harden to be able to withstand loads later on, which can take up to three months. A whole year can pass before the fracture is fully healed.

Can I have an unnoticed fibula fracture?

In addition to the cause of external force, constant overloading and minimal recurring injuries to the bone tissue can lead to fatigue fracture, which usually occurs on the shaft. It is only a small crack and can actually occur unnoticed. The problem of an unnoticed fracture of the fibula is that the structures are not sufficiently protected and treated. There is therefore a risk that the bone parts do not grow together correctly and a so-called false joint is created, which limits the stability of the bone.

Physiotherapeutic intervention

After suffering a fracture of the fibula, the patient is usually referred to a physiotherapist, with whose cooperation a way to stimulate the body to heal is worked out. An adapted behavior suitable for everyday life is learned and later an active exercise program is developed to return to the old functional ability and sport. The treatment is based on the body’s own wound healing phases:

  • First there is the inflammatory phase, in which all cells flow to the site of injury, cleaning up corpuscles and temporary fibres close the wound.

    Due to the increased metabolism, bleeding into the tissue injury and clean-up work, swelling, redness and overheating occur during this phase, which lasts only a few days. Here the leg is mainly elevated, cooled and relieved.

  • This is followed by the proliferation phase. Here the temporary tissue is replaced by slowly forming new tissue and bone fibers.

    Structures still need to be spared, but the new fibers require adapted stimuli to develop in a certain direction. Mobilization as well as specific pressure and tensile loads protect against adhesion and point the newly formed tissue in the right direction. In addition, surrounding joints are mobilized, muscle chains that are tensed by the injury are massaged, spread, loosened and stretched.

    Static muscle exercises, without putting too much strain on the structures or moving them around, can be performed more and more to protect against loss of strength.

  • The last phase in the body’s own wound healing is the remodelling phase. The tissue has completely rebuilt itself, the fracture has grown together. The task now is to stabilize this in order to return to its old function. Work is done actively and under full load. In the following, some exercises are presented.