Physical Therapy Exercises and Walking After a Femur Fracture

A femur fracture, or broken thigh bone, is an injury that can result from high-energy trauma, such as a fall from height, a motor vehicle accident, or a direct blow to the leg.

Physical therapy is often needed for a femur fracture to heal properly. This will enable you to comfortably bear weight on your injured leg to stand up, walk, go up and down stairs, and exercise.

This article will review physical therapy exercises for a femur fracture, a recovery timeline, and tips for getting started.

Location and Pain Sensation of a Broken Femur 

A femur fracture is very painful. Pain can also radiate to the outside of the thigh, to the back of the hip, or into the groin. Putting weight on your leg to stand up or walk will be incredibly difficult and painful, if not impossible.

When to Begin Rehabilitation 

Rehabilitation for a femur fracture should start as soon as possible. Most femur fractures require surgery within 24 to 48 hours after injury to realign your bone so it can begin to heal. 

If you are allowed to bear weight on your injured leg, using a walker within the first 48 hours after surgery is important for your recovery. Early rehabilitation is important, as it is common to lose more than 50% of your leg muscle strength of the fractured leg within the first week of surgery.

If your femur fracture is severe, you may not be able to bear weight on your leg for six to 12 weeks. In these cases, you will need to use crutches or a wheelchair to get around. You will be instructed how to get in and out of chairs and on and off the toilet without standing on your injured leg.

A physical therapist will also provide safe exercises to maintain your leg's range of motion while you are not allowed to stand on your leg. 

Femur Fracture Physical Therapy Exercises

Exercises for a femur fracture include moving your hip through its full range of motion and increasing the strength of your glute and quadricep muscles. You will start with non-weight-bearing exercises and gradually progress as you can tolerate putting more weight on your leg.

Straight Leg Raise

Straight leg raises help improve the strength of your hip flexors to lift your leg and quadriceps to stabilize your knee.

To perform this exercise:

• Lie on your back with your uninjured leg bent and your injured leg extended.
• Contract your quadricep muscles of the extended leg to tighten your leg.
• Next, lift your leg while keeping your leg straight the entire time.
• Slowly lower your leg while keeping your knee straight.
• Repeat 10 to 15 times, then rest.
• Do three sets of 10 to 15 repetitions.

Bridges

Bridges help move your hip joint into extension and improve the strength of your glutes. These muscles support and stabilize your legs when walking, climbing stairs, and standing up. The glutes also provide strength and stability for your legs to help with balance.

To perform this exercise:

• Lie on your back with your knees bent and feet flat.
• Squeeze your glute muscles to lift your hips. Keep your back flat, and do not arch your back.
• Hold for three seconds at the top, then lower your hips back down.
• Repeat for 10 repetitions.
• Rest, then repeat for a total of three sets of 10 repetitions.

Clamshells

Clamshells help strengthen the glute muscles, specifically the gluteus medius muscles on the sides of the hips. These muscles keep you balanced when moving and changing directions.

To perform this exercise:

• Lie on your back with your knees bent and feet flat with a resistance band (a thick elastic band used to strengthen muscles) placed around your thighs above your knees.
• Keep your feet flat and push your knees out to the side against the band.
• Hold for three seconds, then bring your knees back together.
• Repeat for 10 repetitions, then rest.
• Do a total of three sets of 10 repetitions.

Standing Hip Extension 

This exercise helps strengthen your glute muscles.

To perform this exercise:

• Stand in front of a wall, table, counter, or chair for support.
• While standing on your uninjured leg and keeping your injured leg straight, slowly move the injured leg back directly behind you. Do not bend your knee or let your back arch.
• Hold for one second, then return to the starting position and rest.
• Repeat for a total of three sets of 10 repetitions.

Standing Hip Abduction

This exercise helps strengthen the gluteus medius muscles on the sides of the hips.

To perform this exercise:

• Stand in front of a wall, table, counter, or chair for support.
• While standing on your uninjured leg and keeping your injured leg straight, slowly move the injured leg out to the side. Keep your body upright without leaning toward either side.
• Hold for one second, then return to the starting position.
• Repeat for 10 repetitions.
• Rest, and do a total of three sets of 10 repetitions.

Sit to Stand

This exercise helps strengthen the glute and quadricep muscles to improve your ability to bend down, squat, and get in and out of a chair.

To perform this exercise:

• Sit in a chair with a firm surface (using a soft chair or couch will make it harder to stand up).
• Lean your body forward, so your nose is aligned with your toes.
• Use your legs to push yourself up from the chair. Try not to use your hands to help you push up from the chair's surface.
• Squeeze your glutes at the top to fully extend your hips once standing upright.
• Hold for one second, then push your hips back and slowly lower yourself onto the chair without plopping down.
• Repeat for 10 repetitions.
• Rest, then repeat for a total of three sets of 10 repetitions.

Step-ups

Step-ups help improve the overall strength in your leg by targeting multiple muscle groups, including the hip flexors, quadriceps, and glutes. These muscles help lift your leg up. This also helps bear weight on your leg, especially while going upstairs.

To perform this exercise:

• Stand in front of a small step with handrails on each side.
• While holding onto the handrails, lift your injured leg up to place your foot on the step.
• Step up with the injured leg, then follow with the other leg.
• Then step down backward with the uninjured leg first, followed by the injured leg.
• Repeat for 10 repetitions.
• Rest, then repeat for a total of three sets of 10 repetitions.

Tools and Exercise Aids 

During recovery from a femur fracture, you will need crutches or a walker to help support your body weight and limit the pressure on your leg when walking. If you are not allowed to stand on your leg, you may need a wheelchair for the initial weeks following surgery.

Once you build up enough leg strength to support your weight and improve your balance, you may be able to progress to using a cane or no assistive device at all to help you walk.

Estimated Recovery Timeline 

A femur fracture can take three to six months or more to heal completely depending on the severity of your fracture. Your pain levels and ability to walk will typically improve well after one month of being able to put weight on your leg after surgery.

During your recovery, walking and standing for long periods of time will be difficult at first. This can impact your ability to work and engage in family and social activities. Make sure you attend regular physical therapy visits to ensure your leg heals properly. 

In most cases, you will need to attend physical therapy visits two to three times per week for up to three months. You should also expect to keep up with your progress by performing a home exercise program after your physical therapy sessions.

How to Find a Physical Therapist

Your healthcare provider may recommend you a physical therapist. You can also do an internet search for physical therapy practices near your home. Or you can use the "find a provider” search function on the website of your health insurance company to find physical therapists that accept your insurance. 

Physical therapists work at various locations, including private clinics, hospitals, and healthcare providers’ offices. At-home care services can be used to deliver physical therapy to people who have difficulty with transportation.

Insurance Coverage and Costs

The cost of your physical therapy visits will depend on your individual coverage. Most insurance companies approve a certain amount of visits at a time or per year, but these visits can often be extended if treatment is considered medically necessary.

Your health insurance may fully cover your visits, or you may have to pay a certain amount for each visit, such as a:

• Copay: A fixed amount of money per visit
• Coinsurance: A percentage of your visit cost
• Deductible: The entire cost of each visit until you meet your insurance deductible, after which your visits may be fully covered

Summary

Physical therapy for a femur fracture should start as soon as possible after surgery. Depending on the severity of your injury, you may not be able to bear weight on your leg after surgery and will need crutches, a walker, or a wheelchair to get around.

A physical therapist will work with you to improve your mobility, the strength of surrounding muscles, ability to walk, and balance with various leg exercises. 

A Word From Verywell

Getting up and moving after a femur fracture is important for recovery to help you return to your daily activities and movements. The more actively engaged you are in your rehabilitation process, the better the chance of a successful recovery.