A broken leg can be difficult for both children and parents.
One day your child may be running, climbing, playing sports, or keeping up with friends, and suddenly they are dealing with a cast, brace, crutches, or restrictions on their normal activities. While children can be remarkably resilient after injuries, parents often have questions about what happens once the bone has healed. Will my child start walking normally again on their own? Is it normal for them to limp after getting a cast off? Do they need physical therapy after breaking a leg?
The answer depends on the child, the type and location of the fracture, how long movement was restricted, and how your child is moving after they have been cleared to return to activity. Some children gradually return to their previous level of function without additional treatment. Others may benefit from pediatric physical therapy after a broken leg to restore strength, flexibility, balance, walking mechanics, and confidence.
If your child has recently broken a leg, understanding what recovery can look like and knowing which signs to watch for can help you determine whether a physical therapy evaluation may be beneficial.
What Happens to a Child’s Leg While It Is in a Cast?
When a child breaks a bone, the priority is allowing that bone to heal properly. Depending on the injury, treatment may involve a cast, brace, boot, surgery, crutches, or restrictions on how much weight the child can place through the injured leg.
These precautions are important for healing, but they also mean that your child may use their injured leg much less than usual for a period of time.
Children normally build strength through everyday movement. Walking through school, running on the playground, climbing stairs, jumping, playing sports, and simply getting up and down from the floor all require their muscles to work.
When a leg is immobilized or a child cannot put their usual amount of weight through it, those muscles are not being challenged in the same way. As a result, weakness, stiffness, decreased balance, and changes in movement can occur during recovery.
These changes do not necessarily mean something has gone wrong. They can be a natural result of having the leg immobilized. The question is whether your child is able to gradually regain normal movement after their health care provider determines that it is safe to do so.
Does Every Child Need Physical Therapy After a Broken Leg?
Not every child who breaks a leg will need physical therapy. Children often recover well, and some are able to gradually return to their usual activities after the bone heals and they receive appropriate medical clearance.
However, other children may have more difficulty returning to normal movement.
Whether physical therapy is recommended may depend on factors such as the severity and location of the fracture, the amount of time the leg was immobilized, whether surgery was required, your child’s age, their previous activity level, and how they are moving after the injury.
A child who returns to walking, running, climbing, and playing normally may have different needs than a child who continues to limp or avoids using the injured leg.
Pediatric physical therapy can help identify lingering movement limitations and provide a structured plan for safely rebuilding the skills your child needs.
Is It Normal for My Child to Limp After Getting a Cast Off?
One of the most common concerns parents have after a leg fracture is seeing their child limp.
After spending weeks in a cast or with restrictions on movement, it is not unusual for a child’s walking pattern to look different at first. Their muscles may be weaker, their joints may feel stiff, and they may have become accustomed to protecting the injured side.
Some children are also nervous about putting weight through the leg again. Even after they have been medically cleared, they may remember that walking or standing hurt when the injury first occurred.
A temporary change in walking may improve as the child becomes stronger and more comfortable using the leg. However, a limp that persists, becomes more noticeable, or prevents your child from returning to normal activities may be worth evaluating.
A pediatric physical therapist can look at the way your child walks and determine whether weakness, stiffness, balance problems, pain, or movement habits may be contributing to the limp.
Why Is My Child Still Favoring One Leg?
After an injury, children quickly learn how to protect the area that hurts. They may shift more weight onto the uninjured leg, take shorter steps, avoid bending a joint, or use their arms and trunk differently to compensate.
These strategies are useful while an injury is healing. The problem is that some compensations can remain even after the child is allowed to use the leg normally again.
Your child may continue placing more weight on the uninjured side simply because that pattern has become familiar. In other cases, weakness or stiffness may make it genuinely more difficult to use the injured leg normally.
Physical therapy can help determine why your child is favoring one side and provide activities designed to encourage more balanced and confident movement.
Can a Broken Leg Cause Muscle Weakness?
Muscle weakness is a common concern following a period of immobilization or reduced activity.
If your child has been unable to use the injured leg normally, the muscles in that leg may not be as strong as they were before the fracture. The muscles around the hips, knees, ankles, and core all contribute to normal walking and physical activity, so weakness may affect more than just the area immediately surrounding the broken bone.
You may notice that one leg looks smaller than the other after a cast is removed. Your child may also have more difficulty with activities that require strength, such as climbing stairs, getting up from the floor, squatting, jumping, or running.
Once your child has been medically cleared for appropriate activity, pediatric physical therapy can provide a gradual approach to rebuilding strength safely and effectively.
What About Stiffness After a Cast Is Removed?
Along with weakness, children may experience joint stiffness after having a leg immobilized.
The specific areas affected will depend on the location of the injury and the type of immobilization used. A child may have difficulty bending or straightening the knee, moving the ankle, or comfortably placing the foot on the ground.
Stiffness can affect walking and other activities. For example, limited ankle movement may cause a child to take shorter steps or change how the foot contacts the ground.
A physical therapist can assess your child’s range of motion and flexibility and determine whether specific exercises or activities may help restore normal movement.
It is important to follow medical guidance regarding when and how movement should be restored. Physical therapy after a fracture should always respect the healing process and any precautions provided by your child’s physician.
Can Balance Be Affected After a Broken Leg?
Balance requires input from several systems in the body, but strength and the ability to confidently place weight through both legs are important parts of maintaining stability.
After a leg fracture, your child may have spent several weeks avoiding weight on the injured side. They may have used crutches, a walker, or another device to move around. When they begin using the leg again, balance may initially feel different or more challenging.
You might notice that your child is hesitant on stairs, unstable when standing on the previously injured leg, or less confident on uneven surfaces.
Pediatric physical therapy can incorporate balance activities that gradually challenge your child as their strength and confidence return.
How Can Physical Therapy Help After a Broken Leg?
Pediatric physical therapy after a leg fracture is individualized to your child’s specific needs. Treatment does not look exactly the same for every child because fractures, activity levels, and recovery timelines vary.
After your child has received the appropriate medical clearance, a physical therapist may evaluate their walking pattern, strength, flexibility, balance, coordination, range of motion, and ability to complete age appropriate activities.
Depending on what the evaluation identifies, physical therapy may focus on:
- Restoring strength in the injured leg
- Improving joint mobility and flexibility
- Improving balance and coordination
- Helping normalize walking mechanics
- Gradually rebuilding endurance
- Improving confidence using the injured leg
- Preparing for running, jumping, sports, or playground activities
- Addressing compensatory movement patterns
For children, these goals can often be incorporated into games and functional activities rather than relying only on traditional exercises.
The goal is to help your child return to the activities they enjoyed before their injury as safely and confidently as possible.
What Does Pediatric Physical Therapy Look Like After a Fracture?
Physical therapy for children is designed with the child’s age, interests, and abilities in mind.
A younger child may work on strength and balance through games, obstacle courses, reaching activities, squatting, stepping, or play. An older child or young athlete may perform more structured strengthening, balance drills, agility activities, and sport specific movements when medically appropriate.
Pediatric physical therapy should meet your child where they are in the recovery process.
A child who has just been cleared to begin using the leg again will have different goals than a child who is walking normally but struggling to return to soccer, basketball, gymnastics, dance, or another activity.
As your child progresses, their physical therapist can gradually increase the difficulty of activities to help prepare them for their normal routines.
When Can My Child Return to Running and Sports?
For active children, returning to sports may be one of their biggest goals after a broken leg. They may feel ready to get back to practice as soon as the cast or brace comes off, but bone healing is only one part of returning to sports safely.
Your child may also need adequate strength, mobility, balance, coordination, and confidence.
Running, jumping, landing, cutting, and changing directions place greater demands on the body than normal walking. A child who can comfortably walk around the house may not yet be ready for the demands of a full practice or game.
The timeline for returning to sports depends on the injury and the recommendations of your child’s medical team. Your child’s physician should provide guidance regarding when higher impact activity is medically appropriate.
Once cleared, a physical therapist can help your child gradually rebuild the physical abilities needed for their specific sport.
What If My Child Is Afraid to Use the Injured Leg?
A broken bone can be a frightening experience for a child. They may remember the initial pain, the trip to the doctor or hospital, or the discomfort they experienced when trying to move after the injury.
Because of this, some children may remain hesitant even after the bone has healed.
They might say the leg feels strange, avoid putting their full weight through it, or become nervous when asked to run or jump.
Confidence is an important part of returning to movement after an injury. Pediatric physical therapy can provide a controlled environment where children gradually practice using the injured leg again.
Starting with activities the child can perform successfully and gradually progressing to more challenging movements can help rebuild both physical ability and confidence.
How Do I Know if My Child Should See a Physical Therapist?
If you are unsure whether your child needs physical therapy after breaking a leg, pay attention to how they move once they have been medically cleared to resume activity.
You may want to consider a physical therapy evaluation if your child continues to limp, favors one leg, struggles with stairs, has difficulty balancing, appears weaker on the injured side, has persistent stiffness, or cannot return to their usual activities.
You may also notice changes when your child attempts more challenging movements. Walking may look normal, but running, jumping, hopping, or playing sports may reveal differences between the two legs.
Pain is another important consideration. Some discomfort or unusual sensations may occur during recovery, but persistent, worsening, or significant pain should be discussed with your child’s health care provider.
A physical therapist can evaluate your child’s functional movement, but medical concerns regarding bone healing or new symptoms should be addressed by the appropriate medical provider.
What Happens During a Physical Therapy Evaluation?
During a pediatric physical therapy evaluation, the therapist will learn about your child’s injury and recovery. This may include discussing how the fracture occurred, how long your child was immobilized, whether surgery was required, and what activity restrictions or medical clearances have been provided.
The therapist will also want to know what you and your child have noticed since returning to activity.
They may evaluate walking, range of motion, flexibility, strength, balance, coordination, endurance, and functional movement.
Depending on your child’s age and goals, the therapist may also observe activities such as squatting, climbing stairs, standing on one leg, running, jumping, or hopping when these movements are medically appropriate.
This helps identify specific areas that may be limiting your child’s recovery.
Can Physical Therapy Help My Child Get Back to Normal Activities?
The ultimate goal of rehabilitation is not simply for your child to perform exercises in a clinic. It is to help them return to meaningful everyday activities.
For one child, that may mean being able to climb the playground equipment without hesitation. For another, it may mean returning to soccer practice. Another child may simply want to walk around school without limping or getting tired.
Physical therapists use your child’s goals to help guide treatment.
As strength, mobility, balance, and coordination improve, therapy can progress toward activities that more closely resemble what your child does at home, at school, on the playground, or during sports.
Should I Just Wait for My Child to Start Walking Normally Again?
It can be reasonable for movement to look different initially after a period of immobilization, and not every temporary limp requires physical therapy.
However, you do not have to wait until a movement problem becomes severe before asking for an evaluation.
If your child’s walking is not gradually improving, if they continue avoiding the injured leg, or if you notice difficulty with activities they could easily perform before the injury, a physical therapy evaluation can help determine what may be limiting them.
Sometimes a child may only need guidance and a few exercises or activities to practice at home. Other children may benefit from ongoing therapy to restore their previous level of function.
An evaluation provides information that can help determine the appropriate next step.
Helping Your Child Recover After Breaking a Leg
Recovery from a broken leg involves more than waiting for the cast to come off. Your child’s bone needs time to heal, but their muscles, joints, balance, coordination, and confidence may also need time to recover.
Once your child’s medical provider has cleared them for appropriate activity, pay attention to how they walk, play, climb, run, and use both sides of their body.
If you notice continued limping, weakness, stiffness, balance problems, or difficulty returning to normal activities, pediatric physical therapy may be able to help.
At Empower Physical Therapy, our pediatric physical therapists work with children and families to help restore movement following injuries. Treatment is based on each child’s needs, abilities, and goals.
Whether your child wants to get back to running around the playground, participating in physical education at school, or returning to their favorite sport, pediatric physical therapy can help support the transition from healing to moving confidently again.
Empower Physical Therapy offers pediatric physical therapy at our Andover, West Wichita, and Newton locations.
📍 Andover
826 E. Founders Pkwy STE 100
Andover, KS 67002
📞 Phone: 316-348-2766
📍 West Wichita
10330 W. Central Ave #160
Wichita, KS 67212
📞 Phone: 316-640-3074
📍 Newton
715 Medical Center Dr. STE 300
Newton, KS 67114
Click here to schedule a pediatric physical therapy evaluation with Empower Physical Therapy.
