When a foot fracture occurs, active individuals often seek low-impact ways to maintain fitness while the bone heals. Swimming seems ideal because the water supports the body and reduces stress on the injury. However, the decision to enter the pool with a broken bone is complex, depending entirely on the specific fracture type and the treatment method chosen by a medical professional. Safety is the primary concern, requiring an understanding of immediate risks before considering aquatic activity.
Immediate Safety: Determining If Swimming Is Permitted
The first step before considering swimming is a consultation with the treating physician, typically an orthopedist. They will determine the stability of the fracture and whether any water exposure is permissible. A primary concern is the traditional, non-waterproof cast, which must not be submerged under any circumstances.
If a conventional fiberglass or plaster cast gets wet, the cotton padding retains moisture, leading to skin maceration, irritation, and potentially severe infection beneath the cast. Plaster casts can also degrade and fall apart when wet, compromising immobilization. Absolute contraindications for swimming include any open wounds, surgical incisions, or external pins near the fracture site due to the high risk of bacterial infection.
A patient may be permitted to swim if the fracture is stable and managed with a removable device, such as a walking boot or brace. The activity is generally approved only if the device can be taken off before entering the water. Clearance is based on the bone being stable enough to withstand the gentle movement of swimming without the support device.
Protecting the Injury: Waterproofing and Stroke Modification
If a doctor approves swimming, specific measures must be taken to protect the healing site and prevent re-injury. If a cast must remain on, some physicians may apply a specialized waterproof cast, which uses a non-absorbent, synthetic liner (like Gore-Tex) instead of cotton padding. This cast allows water to drain and air-dry, enabling swimming in a controlled pool environment.
Alternatively, specialized cast covers made of rubber or polyurethane create a vacuum seal to prevent water ingress for non-waterproof casts. These covers are watertight and can be submerged, unlike standard shower covers. Even with a waterproof cast or cover, swimming in natural bodies of water (oceans or lakes) is often discouraged because sand, dirt, or debris can get trapped inside the cast and cause skin problems.
Once in the water, the primary focus must be on stroke modification to eliminate use of the injured foot. This involves utilizing a pull buoy, a figure-eight shaped foam float placed between the thighs to provide leg buoyancy. The pull buoy keeps the lower body elevated, allowing the swimmer to focus entirely on upper-body dominant strokes (freestyle or backstroke) using only the arms and core for propulsion.
Avoid movements that place unexpected stress on the foot, such as pushing off the pool wall to start a lap. Swimmers must enter and exit the pool cautiously, avoiding slippery edges or uneven surfaces that could lead to a fall and re-injury.
Swimming’s Role in Fracture Rehabilitation
Swimming and aquatic therapy are frequently recommended later in the recovery timeline for lower limb fractures due to water’s unique properties. Water buoyancy provides a non-weight-bearing environment, significantly reducing impact and stress on the healing bone and surrounding joints. This allows for the initiation of mobility exercises much earlier than would be possible on land.
The hydrostatic pressure exerted by the water helps manage and reduce swelling, a common post-injury issue that can delay recovery. Water pressure increases circulation, helping to deliver necessary nutrients and oxygen to the injury site, which aids the bone healing process. Gentle movements in the water also help to restore the ankle and foot’s range of motion, combating stiffness without the risk of impact trauma.
The natural resistance of water provides a safe medium for rebuilding muscle strength around the foot and ankle. This low-impact exercise allows individuals to maintain cardiovascular fitness, offsetting the sedentary effects often associated with long fracture recovery periods. This transition to aquatic rehabilitation must only begin after the acute phase of healing and under the explicit guidance of a physical therapist or doctor.