Broken leg (shin and tibial shaft) fracture rehabilitation

The NHS describes treatment depending on how severe the break is. A simpler fracture may be managed by avoiding the activity that caused it and taking the weight off the leg with crutches or a padded boot. Other fractures need a cast to hold the leg still. Serious fractures may be fixed with plates, rods or screws to keep the bones in position.

The shin bone, or tibia, is the main weight-bearing bone of the lower leg, and the page used here does not describe tibial shaft fractures separately from other leg breaks. Specific advice about nailing, plating or casting a tibia comes from your orthopaedic team, who will have seen the pattern of the break on imaging.

While the bone is at its most fragile, the priorities are to keep the leg supported, control swelling and avoid complications of being less mobile. Staying as active as the injury permits is part of that. NHS inform describes in other soft tissue injury guidance the idea that too much rest can slow recovery and that gentle movement should begin as soon as the injury allows.

The hospital will explain how much weight to put through the leg. For some fractures this means no weight at all for a period, for others partial or full weight in a boot. Use the crutches and aids as taught, and ask for a physiotherapy session on stairs if your home has them.

• Move the toes, and the hip and knee where the cast or boot allows, as often as you are advised.

• Keep to the weight-bearing instructions even if the leg feels better than expected.

• Check the skin around the cast edge and the circulation in your toes each day.

The NHS says physiotherapy may be needed after cast removal, lasting several months, to restore mobility and strengthen the leg. A leg that has been protected for weeks is typically weaker, with a thinner calf and stiff ankle and knee. Early work usually targets range of movement, then standing balance, then strength.

The pages used here do not set weekly targets, so progress is generally judged by function: standing, walking indoors without aids, managing stairs, then longer distances and uneven ground. Your physiotherapist will set the pace based on how the fracture is healing and what the surgeon recommends.

NHS inform's soft tissue injury advice, which is written for injuries without a break, offers a useful principle for graded activity: pain during activity should stay in a tolerable range, should settle quickly afterwards, and should be no worse the following morning. It describes scoring around 4 to 5 out of 10 during activity as acceptable and reducing intensity, pace or frequency if pain rises above 6 out of 10.

That guidance is for soft tissue injuries rather than fractures, so it does not replace a surgeon's instructions about when the bone can be loaded. Once weight bearing is permitted, though, it gives a practical way of judging whether a day's activity was too much.

The NHS says to use NHS 111 for worsening pain, fever, numbness, swelling or discolouration, or a cast that rubs, is wet underneath or has a bad smell or discharge. Go to A&E for a twisted or bent leg, bone through the skin, severe wounds, cold sweaty skin, a weak pulse, breathing difficulty, or discoloured toes.

Bone that is slow to unite, hardware that irritates, and stiffness are possibilities after any leg fracture, and a surgeon can discuss these in clinic. Leg and calf swelling or pain with breathlessness after an injury or period of reduced mobility is an emergency that needs 999.

The pages used here do not give dates for driving, work or sport after a broken leg, and these depend heavily on the bone, the fixation and which leg is involved. A desk worker and someone on their feet all day will have different timelines, and a right leg fracture raises particular questions about driving that your insurer and team can address.

Return to running or contact sport is generally discussed with the orthopaedic team once the bone has united on imaging and strength has been rebuilt. Rehabilitation should end when you can do what you need and want to do, not merely when the cast is off.