Ok so this is something of a rant. I make no apologies for that because frankly I am fed up with having to deal with the inadequacies of what passes for treatment of broken wrists, arms, legs and ankles etc. Over the last year or so, as a practice, we have experienced a constant stream of people consulting us, of their own volition, to ask advice following a fracture.
The typical scenario is this. On returning to fracture clinic any form of splinting is removed, often crutches are simultaneously taken away, and the only advice given is to 'use the limb normally' and all will be well. No follow up physio advice or treatment is provided. A couple of patients recently when asked about physiotherapy were told this was unnecessary and to 'just walk' . This was despite the fact that one person had had her entire leg from thigh to foot immobilised for almost six months and another chap his lower leg for three months. They had barely been putting the foot to the ground let alone walking on the leg. It is a scandal because for every one of those well informed, and financially able, people who realise they need help there are many others who implicitly trust the advice they have been given and/or cannot afford to source treatment outside the NHS.
It is my experience that anyone who has had part of the arm or leg immobilised for four weeks or longer should see a physiotherapist. This may be a one off visit to explain what is normal - the time frame involved, the gradual way to reintroduce exercises and activities, what can be ignored and what needs to be addressed. For other people a more intense and protracted course of treatment may be required. The essential thing is to get GOOD ADVICE EARLY, do not wait. You will be richly rewarded. Prompt treatment reduces the chance of ongoing problems. If concerned about expense think rationally about it. That forty quid or so will give you a better return than a meal out and a few beers at the pub. It will get you back to work and sport faster and with less pain. You will be a nicer person to know once you are no longer suffering so much discomfort, weakness and stiffness. It is an investment for your future, making it less likely that you develope problems in that joint as you get older.
Why, you may ask, are patients not routinely referred to physiotherapy ? As I expect many of you have guessed it is to do with the bottom line. Over the past 5 years physiotherapy posts have reduced dramatically in the health service - current graduates are having enormous difficulty getting jobs. It is madness. With an ageing population and pressure for people to stay as mobile & as fit as possible, to have shorter and shorter periods as in- patients, the health service cuts the very profession that can help. My naturally cynical nature feels this is because physiotherapists are a soft option. They are not perceived as being directly linked to the more emotive subjects - coronary disease, cancer, childhood illness - and do not have as much political clout of doctors so are easier to sideline.
I warned you this was a rant!!! But I feel this is an important issue which has not been given the oxygen of publicity. Perhaps you will give it some consideration and spread the word to any family, friends and colleagues that have had the misfortune to end up in fracture clinic.