Ask a PT

156 Posts
 
Posted - 05/01/2008 :  22:27:28  Show Profile  Reply with Quote
Our user asked: "Hello, My 12 year old son broke his tibia (not fibula) on February 4th. He was in a full, then half cast(no surgery), and is now in a removable boot with instructions to walk on it without the boot occassionally without the boot. His orthopedic doctor recommended PT, but it is not covered by insurance and is very costly. I'm wondering if professional PT is really necessary. It seems like these exercises are pretty simple. Thank you!"

Ask a PT Response: "I am assuming your physician provided a home exercise program for your child to perform. You are right that the exercises are pretty simple. They often are in the beginning, as you don't want to do further damage to the fracture site. For a patient that has sustained a fracture to the tibia and has been non weight bearing, a gradual progression to full weight bearing is recommended. Exercises are prescribed by the physical therapist keeping this in mind. Typical examples for progression can include: Non weight bearing exercises - ankle pumps, AA/AROM exercises, isometric strengthening etc.. Partial weight bearing exercises - seated BAPS board use, partial lunges with support, partial side stepping with support, resistive strengthening with thera band, etc.. Full weight bearing exercises - partial lunges, parital squats, heel raises, step up/down etc... Manual therapy to the joints and muscles of the foot, ankle and knee may be performed as well. Progression of exercises is very important and having the patient do too much too soon could result in a set back. In your son's case, if you are able to, it may be a good idea to see a PT for at least one visit so that the PT can determine all the things your son may need to work on. Definitely make sure the PT prescribes a thorough home exercise program with progression and goes over proper walking mechanics with your son and yourself. Basically your son will need to relearn how to walk properly again. Regular checkups with the orthopedic surgeon is recommended as well to ensure there are no complications. If you have any other questions, please feel free to contact us."