Physical Therapy for child's broken leg recovery?

[Agilic]

Rip,

My 7 year old son fractured his tibia (from impact, just under the lower growth plate) and was hard-casted (from foot to above the knee) for 5 weeks. Upon getting the cast cut off (will be 2 weeks tomorrow) the ortho said that he would need a day or 2 to get the flexibility back in his calf and hamstring and then would be back to normal by the weekend. Cleared for sports, gym class the following Monday (9 days ago), etc. Well, this past weekend he finally started really being able to walk again (despite my best efforts to work with him). He still has a noticeable limp and can't jog yet. A bunch of people are in our ears about him needing physical therapy. Do you see any value in this for him to "learn to walk properly again", or would you guess that he'll naturally get himself back to normal over time? His tendency is to stick his leg and foot angled outward and use his leg as a crutch if we don't actively remind him to point his toe forward and keep his leg in; which causes his gait and hip to be noticeably off when he does.

I trust your take on this as much or more than anyone else's, and I obviously don't want to risk any long term issues with him. Appreciate your time!

[Mark Rippetoe]

So the question boils down to: Are Physical Therapists, in general, any better than Pediatricians? I think the best thing to do is push him hard enough that gait efficiency becomes more important than the instability. For example, have him push a prowler with enough weight that it's kinda hard.

[Will Morris]

Almost without exception, these are not cases where physical therapists are going to be of much utility. Despite the good intentions of your peer group, “learning how to walk properly” was not needed the first time he learned to walk, nor is it needed this time. Children heal and rehab from Orthopaedic injuries through play. Rip is right, but, you might find something he actually wants to do that has an element of play to it and you and your son engage in some friendly competition doing that. When he is engaged in play or competition and not thinking about his knee, he will very likely ambulate normally.

All that said, give him 6-8 weeks and see how he is doing then. My money is on him being perfectly normal.

[Agilic]

Thanks for the quick response! I have a home gym and no prowler. He was just barely too small for my airdyne on it's lowest setting, so I got a bicycle attachment to the back of my bike that he's been pedaling on to get some leg strength back. Any other ideas you can think of? I do have a 22 lb kids bar I could try to teach him to squat and deadlift with, but I'm not sure how well that would go.

[SouthernLifter]

Rip,

My 7 year old son fractured his tibia (from impact, just under the lower growth plate) and was hard-casted (from foot to above the knee) for 5 weeks. Upon getting the cast cut off (will be 2 weeks tomorrow) the ortho said that he would need a day or 2 to get the flexibility back in his calf and hamstring and then would be back to normal by the weekend. Cleared for sports, gym class the following Monday (9 days ago), etc. Well, this past weekend he finally started really being able to walk again (despite my best efforts to work with him). He still has a noticeable limp and can't jog yet. A bunch of people are in our ears about him needing physical therapy. Do you see any value in this for him to "learn to walk properly again", or would you guess that he'll naturally get himself back to normal over time? His tendency is to stick his leg and foot angled outward and use his leg as a crutch if we don't actively remind him to point his toe forward and keep his leg in; which causes his gait and hip to be noticeably off when he does.

I trust your take on this as much or more than anyone else's, and I obviously don't want to risk any long term issues with him. Appreciate your time!

How is physical therapy supposed to help you heal a broken bone? It is something that I have never understood, nor has any "graduate" been able to explain it to me.

[Jason Donaldson]

Thanks for the quick response! I have a home gym and no prowler. He was just barely too small for my airdyne on it's lowest setting, so I got a bicycle attachment to the back of my bike that he's been pedaling on to get some leg strength back. Any other ideas you can think of? I do have a 22 lb kids bar I could try to teach him to squat and deadlift with, but I'm not sure how well that would go.

For a seven year old, I would imagine that a length of rope tied in a loop with a cinder block or two would provide a field-expedient prowler substitute for what Rip's describing, and something he could help you build. If he doesn't know how to tie a square knot yet, teaching him that could be part of the fun.