Wrist Fracture Rehabilitation — What Happens After the Cast Comes Off Matters
Table of Contents
If your wrist won't move after the cast comes off
After 4–6 weeks of casting following a wrist fracture (especially a Colles' fracture — distal radius fracture), the bone has healed but the joint remains stiff. During the casting period the joint capsule contracts, surrounding muscles atrophy, and tendon gliding decreases — leaving you unable to move your wrist freely. Rehabilitation at this stage determines the final functional recovery.
Typical problems after the cast
- Joint stiffness: Reduced range of motion in all directions of the wrist — flexion, extension, pronation, and supination
- Muscle atrophy: Forearm muscle mass decreases and grip strength can fall to 30–50% of the unaffected side
- Swelling: Swelling in the hand and fingers persists for several weeks even after the cast is removed
- Finger stiffness: Finger joints that were immobilized along with the wrist also become stiff and hard to grip
- Hypersensitivity to pain: After prolonged immobilization, even light touch can feel uncomfortable
Recovering ROM (range of motion)
The first goal of rehabilitation is to restore the wrist's range of motion. Chuna joint mobilization gradually stretches the contracted joint capsule, and acupuncture relaxes the surrounding muscles to encourage active movement.
- Chuna joint mobilization: Begin with Grade I–II and gradually increase the range
- Acupuncture: Stimulate acupoints around the joint to reduce swelling and promote blood flow
- Active exercises: Repeated wrist flexion, extension, and radial/ulnar deviation on a tabletop
Grip strength rehabilitation
Once a certain amount of ROM is recovered, grip strengthening begins. Resistance is gradually increased: sponge squeezes → rubber ball squeezes → hand grip device. Always verify that the fracture has fully united before progressing, and reduce intensity if pain occurs.
Recovery timeline
Generally, 80% ROM recovery takes 6–8 weeks, and functional recovery of grip strength takes 3–4 months. Patients who undergo active rehabilitation have significantly better final function than those who don't, so we recommend starting Korean medicine rehabilitation immediately after the cast is removed.