All fractures require recovery time and a rehabilitation program which should be designed to meet the individual’s needs.

Rehabilitation involves exercises, hydrotherapy, walking aids and pain relief.

Spinal Fractures

Hydrotherapy is a good way to start exercising again following a spinal fracture. It is important to exercise initially under supervision, eg. a physiotherapist, to reduce the risk of further injury.

Avoid activities that involve bending forward from the waist especially whilst carrying objects because it increases the risk of compression fractures of the spine.

The pain from spinal or vertebral crush fractures usually lasts 6 - 8 weeks and should resolve as the fracture heals. However, permanent changes to your posture can lead to chronic pain.

Hip Fractures

Rehabilitation is essential and generally begins 1-2 days after the operation. Exercise is crucial for rehabilitation after a hip fracture. Rehabilition, depending on your age and fracture type, may continue in a rehabilitation hospital, as an outpatient, or at home.

State Osteoporosis Foundations run osteoporosis Self-Management Programs for people who have osteoporosis and fractures. These courses also include sections on pain management and falls prevention strategies. Contact your state office for more information.

Wrist Fractures

Most wrist fractures require a cast for about 6 weeks. Exercises are recommended for the fingers and shoulder whilst the cast is on, to prevent muscle wasting and reduced flexibility during this time. After removal, a physiotherapist can advise on wrist rehabilitation exercises.

Hydrotherapy

Hydrotherapy is a good place to start your rehabilitation program after a fracture. You can do strengthening exercises in the water, and the warmth and buoyancy make slow, gentle movements easier.
Note: Hydrotherapy will not prevent bone loss or build bone strength. See Exercises for strong bones.

Fall prevention

A third of people aged over 65 fall every year and 10 -15% of those falls lead to a fracture. Falls are responsible for 90% of hip fractures and 50% of vertebral fractures in older people. For someone with osteoporosis, even a minor fall or injury can lead to a fracture, so preventing falls is very important. Falls are also more likely in people with poor leg muscle strength, poor balance or poor eyesight. Be aware of the following to reduce the risk of falling and preventing further injury:

• Muscle strength
• Balance
• Eyesight
• Footwear
• Around the home

Muscle strength

• Do regular physical activity, including exercises for balance, strength and posture as recommended by your physiotherapist.
• Tai Chi and other regimes that promote muscle strength, flexibility, balance and coordination are good for falls prevention. Some studies have shown that people who regularly practice Tai Chi can almost halve their risk of falls.
• Ask for a referral to a 'Falls Prevention' or 'Falls and Balance' class or clinic through your doctor or health centre.

Balance

Poor balance can occur because of weak muscles, changes in blood pressure or heart rate, medications, ear problems and even poor diet.
To improve balance:

• Let your doctor know if you have any dizziness or light-headedness, especially after taking any of your medications.
• Follow a healthy diet that includes calcium-rich foods such as dairy products, tinned fish (with bones) and plenty of fresh fruit and vegetables.
• Make sure you stay well hydrated by drinking plenty of water throughout the day.
• Ask your doctor or physiotherapist about specific balance exercises. You can also ask them about special 'falls and balance' classes.
• Use a walking aid if needed for balance.
• Consider putting in handrails by stairs, baths and toilets.

Eyesight

Eyesight can deteriorate with age, making the eyes less sensitive to small details such as things on the floor, uneven ground and steps.
It is important to:

• Make sure that your home is well lit so you can see where you are going at all times.
• Have your eyes tested yearly by an optometrist.
• If you wear glasses, make sure you use them as directed, and be careful when going up and down stairs if you wear bifocals or trifocals.
• Wear sunglasses outside to minimise glare and squinting.

Footwear

Poorly designed shoes can contribute to falls. Try to:

• Wear shoes with a broad heel and non-slip soles. (Avoid high-heeled shoes.)
• Choose shoes that offer good foot support.

Around the home

Most falls occur in the home, but removing potential hazards may prevent many from occurring.

• Declutter rooms, make clear paths for walking and move obstacles such as furniture away from the paths.
• Improve uneven floor surfaces such as shag pile carpets or damaged lino floors.
• Make sure mats, rugs and carpet edges are lying flat or remove them.
• Remove electrical cords from walking areas.
• Avoid walking on slippery or wet surfaces.
• Make sure rooms are well lit.
• Take care getting in and out of bed ­ go slowly and use a bedframe if needed.
• Install a handrail on at least one side of any stairs, baths, showers and toilets.
• Consider safety strips on edges of outdoor stairs.
• Be aware of pets when you are moving about.