IN SHORT
A pelvic fracture can cause pain, leg weakness, and difficulty walking, standing, and managing everyday activities. Even after the bone heals, older adults may continue to struggle with mobility and independence. Rebuilding leg strength, balance, and endurance can help restore everyday function and support a return to daily activities. Recovery takes time and depends on the fracture, healing, and medical guidance.
A pelvic fracture can change everyday life in an instant. Getting out of bed, standing from a chair, or walking to the bathroom may suddenly become painful and difficult. For families, it can be hard to watch a parent struggle with movements that once felt effortless.
Even after a pelvic fracture begins to heal, weakness, pain, and difficulty with everyday activities can remain. Regaining independence takes more than allowing the bone to heal. It also takes rebuilding the strength, balance, and endurance needed to move with greater confidence.
Understanding Pelvic Fractures in Older Adults
The pelvis is a group of bones that supports the body's weight and connects the spine to the legs. A pelvic fracture occurs when one or more of these bones break.
In older adults, pelvic fractures can happen after a fall or even a relatively minor injury, particularly when bones have been weakened by osteoporosis.
Some fractures are stable and can heal without surgery. Others are more complex and may require surgery or specific restrictions on movement and weight-bearing. The type and severity of the fracture, the person's overall health, and the treatment plan all influence recovery.
Weight-bearing instructions are especially important. Some people are allowed to walk and put weight through their legs as tolerated, while others may need to limit how much weight they put on one or both legs. These instructions must guide when and how standing, walking, and strengthening exercises begin.
Why a Pelvic Fracture Can Lead to Leg Weakness
A pelvic fracture can make putting weight through the legs painful. Depending on the injury, a person may spend more time in bed or a chair, walk less, and stop their usual exercise routines.
When activity decreases, the muscles throughout the body can weaken. The hips, thighs, glutes, and calves may lose strength, making everyday movements increasingly difficult.
The muscles around the hips and legs help support the body during standing, walking, and transfers. When these muscles become weaker, getting up from a chair may require more effort. Walking may become slower and less steady. Everyday activities may begin to require help from a family member or caregiver.
This creates a difficult cycle: pain makes movement harder, reduced activity contributes to weakness, and weakness makes everyday movement even more challenging.
Breaking that cycle requires a gradual, individualized approach to rebuilding strength and mobility as healing allows.
Why Recovery May Continue After Medicare Therapy Ends
Medicare-covered physical therapy helps older adults recover from illness, injury, and surgery. But therapy can end while an older adult is still struggling to walk, stand from a chair, or manage everyday activities.
The end of Medicare-covered therapy does not necessarily mean recovery is complete. Understanding why therapy ends and what options may remain can help families plan for continued care.
Read the full article to understand why Medicare therapy can end while your loved one still needs help and what options may be available next.
Read more: Medicare Physical Therapy Ended. What Happens Now?
How Leg Strength Helps Restore Everyday Function
Leg strength plays an important role in everyday movement. The muscles in the thighs, hips, glutes, and calves help us stand from a chair, walk, climb stairs, and change positions.
After a pelvic fracture, these movements may require much more effort than they did before. As strength improves, everyday activities may become more manageable and require less assistance. Leg strength is essential for everyday activities that allow older adults to live independently. Standing from a chair, getting in and out of bed, climbing stairs, and walking safely all require strong legs. When leg muscles weaken, everyday movements become harder and may require help from someone else.
Walking alone does not build all the strength needed to maintain independence. Building and maintaining functional leg strength helps older adults stay mobile and manage daily activities.
Read the full article to discover how declining leg strength affects independence and how targeted strengthening can help older adults maintain everyday abilities.
Read more: Leg Strength and Independence: What Older Adults Need to Know
Why Walking Alone May Not Be Enough
Walking is important for staying active and maintaining endurance, but it may not provide enough resistance to rebuild weakened leg muscles.
Strength training works those muscles against resistance, helping build the strength needed for everyday activities like standing, climbing stairs, and walking.
Both walking and strengthening have a role in recovery. Walking helps maintain activity and endurance, while targeted strengthening works the muscles needed for everyday movement.
Balance training is also important. Improving leg strength alone does not eliminate the risk of falling, but combining strength and balance exercises can help improve physical function and support safer movement.
For some people, a walker or wheelchair may be necessary during recovery or for longer-term safety. Using an assistive device is not a failure. The goal is to preserve as much safe, independent movement as possible.
Research on rehabilitation after pelvic fragility fractures identifies mobility, daily activities, pain, and quality of life as important recovery outcomes. However, evidence supporting specific exercise programs remains limited.
Exercise After a Pelvic Fracture Must Be Individualized
Many older adults become afraid to exercise after a pelvic fracture. They may worry that moving too much will make the injury worse or cause another fracture.
That fear is understandable, especially when movement has been painful.
However, prolonged inactivity can contribute to muscle weakness, reduced endurance, and greater difficulty with everyday activities. Appropriate movement and exercise can be an important part of recovery when guided by the person's healing stage and medical needs.
Some people are allowed to put weight through their legs as tolerated, while others may need to limit or avoid weight-bearing for a period of time. The appropriate approach depends on the fracture, its stability, and the treatment plan.
A physical therapist can help determine which exercises are appropriate and how to progress safely within the medical team's instructions.
An individualized strengthening program may include exercises that build leg strength, improve balance, and gradually restore functional movement. Some activities may be performed lying down or seated, while others may progress to standing and walking as the person's abilities and medical guidance allow.
Exercises should be adjusted based on pain, fracture stability, healing, weight-bearing restrictions, balance, strength, and other medical conditions.
The goal is not to push through pain or rush recovery. The goal is to gradually rebuild strength while protecting the healing pelvis.
Bone Health Matters After a Pelvic Fracture
Many pelvic fractures in older adults occur after a fall or relatively minor injury, particularly when osteoporosis has weakened the bones.
A pelvic fracture may be an opportunity to discuss bone health with a healthcare provider. Depending on the person's circumstances, this may include an osteoporosis evaluation, assessment of fracture risk, and a discussion about treatment to help protect bone health.
Preventing future fractures also involves looking at factors that contribute to falls, such as balance, leg strength, medications, vision, and safety around the home.
Building Strength Takes Time and Consistency
Recovering from a pelvic fracture takes time. Although some pelvic fractures heal over several weeks to a few months, rebuilding strength, balance, and endurance can take considerably longer. Recovery varies based on the type of fracture, its treatment, and the person's overall health.
Progress often happens gradually. Standing from a chair with less effort, walking with greater confidence, or needing less help with daily activities can all be meaningful signs of improvement.
The right frequency, intensity, and progression of strengthening, balance, and functional training depend on the person's healing, weight-bearing instructions, abilities, and medical needs.
Strength takes consistent work - and it takes time.
Frequently Asked Questions
How can I help my parent regain strength after a pelvic fracture?
Start by talking with their healthcare provider about what movement and exercise are appropriate for their stage of healing and weight-bearing restrictions. A physical therapist can assess strength, balance, and mobility and develop an individualized program to help your parent work toward everyday functional goals.
Why is my parent still having trouble walking after a pelvic fracture?
Healing the bone does not automatically restore the strength lost during a period of reduced activity. Weakness in the hips, thighs, glutes, and calves can make standing, walking, and other daily movements more challenging. Rebuilding strength and balance may help improve physical function.
Can you walk with a pelvic fracture?
Some people can walk with a pelvic fracture, while others need assistance or restrictions on how much weight they can put through their legs. It depends on the location and stability of the fracture and the treating medical team's instructions. Walking should follow the person's prescribed weight-bearing plan.
When can I start strengthening exercises after a pelvic fracture?
The timing depends on the type of fracture, its stability, healing progress, and weight-bearing restrictions. Some people can begin gentle movement early in recovery, while others need to wait before progressing to certain exercises. A physical therapist can help determine which activities are appropriate within the medical team's guidance.
How long does it take to regain strength after a pelvic fracture?
Bone healing and regaining strength are different processes. Some people begin improving within weeks, while rebuilding strength, balance, and endurance may take several months or longer. Recovery varies from person to person.
Can I continue physical therapy after Medicare-covered therapy ends?
Yes. Older adults may choose private-pay physical therapy for continued strengthening and balance training after Medicare-covered therapy ends. Tandem Strength & Balance provides individualized, in-home physical therapy to help people continue working toward their functional goals.
Helping Older Adults Regain Strength and Independence
For many older adults, the need to build strength continues after the fracture has healed and insurance-covered therapy has ended. Families may still be looking for help with walking, standing, balance, and everyday activities.
Tandem Strength & Balance® was created for this stage of recovery. We provide private-pay, in-home physical therapy focused on functional leg strength, balance, and continued exercise.
With more than 25 years of experience, our physical therapists work one-on-one with each client, developing an individualized program around their abilities and the activities that matter most to them.
Whether the goal is moving around the home with greater confidence or maintaining the ability to live independently, we help clients continue working toward those goals.
Healing the fracture is the beginning. Building strength helps you keep moving forward.
Get Strong. Stay Strong. Stay Independent.
Research references
- Carter C, et al. Rehabilitation after pelvic fragility fracture in older adults: a scoping review. Osteoporosis International. 2025. Read the study .
- Keene DJ, et al. Exercise for people with a fragility fracture of the pelvis or lower limb: a systematic review of interventions evaluated in clinical trials and reporting quality. BMC Musculoskeletal Disorders. 2020. Read the study .
- Clinical Guidelines for the Diagnosis and Treatment of Fragility Fractures of the Pelvis. Read the guidelines .
- Nagai Y. Rehabilitation of pelvic fracture. Journal of Physical Fitness and Sports Medicine. 2024. Read the review .