Distal Radius Fracture Exercises: Broken Wrist Recovery Guide

A distal radius fracture—commonly called a broken wrist—is one of the most common fractures, typically occurring from falling onto an outstretched hand. Whether treated with a cast or surgery, proper rehabilitation is essential for regaining wrist strength and mobility.

Understanding Distal Radius Fractures

Types of Fractures

Colles fracture:

• Most common type
• Wrist bends backward (dorsal angulation)
• "Dinner fork" deformity

Smith fracture:

• Less common
• Wrist bends forward (volar angulation)
• "Garden spade" deformity

Barton fracture:

• Involves the wrist joint surface
• May need surgery

Other considerations:

• Intra-articular (involves joint) vs. extra-articular
• Displaced vs. non-displaced
• Associated ulna fracture (both bones)

Treatment Options

Cast/splint immobilization:

• Non-displaced or minimally displaced fractures
• Typically 4-6 weeks
• May use removable splint

Surgical fixation (ORIF):

• Displaced fractures
• Intra-articular fractures
• Unstable fractures
• Plate and screws most common

Healing Timeline

• Bone healing: 6-8 weeks typically
• Full recovery: 3-6 months
• Maximum improvement: Up to 1 year

Phase 1: During Immobilization (Weeks 0-6)

What's Immobilized

Typically includes:

• Wrist and forearm
• Thumb may be free or included
• Fingers should be FREE

Goals:

• Maintain finger mobility
• Preserve shoulder and elbow function
• Control swelling
• Prevent stiffness

1. Finger Range of Motion

Critical—do these religiously.

How to do it:

1. Make a full fist
2. Spread fingers wide
3. Touch thumb to each fingertip
4. 20-30 repetitions
5. Every 1-2 hours while awake

2. Tendon Gliding Exercises

Sequence (5 positions):

1. Fingers straight
2. Hook fist (bend middle and end joints)
3. Full fist
4. Table top (bend at knuckles only)
5. Straight fist

Do: 10 complete sequences, 4-6 times daily

3. Thumb Exercises (If Free)

How to do it:

• Touch thumb to each fingertip
• Move thumb away from hand
• Circle thumb
• 15-20 repetitions each

4. Elbow Range of Motion

How to do it:

• Bend and straighten elbow fully
• Rotate forearm if allowed (check with doctor)
• 20-30 repetitions
• Several times daily

5. Shoulder Exercises

How to do it:

• Pendulum exercises
• Shoulder circles and shrugs
• Active shoulder motion all directions
• Prevent "frozen" shoulder

6. Elevation

How to do it:

• Keep hand above heart level
• Especially first 1-2 weeks
• Reduces swelling
• Wiggle fingers to pump fluid

Phase 2: Early Post-Immobilization (Weeks 6-8)

After Cast Removal or Post-Surgical Clearance

Expect:

• Significant stiffness
• Weakness
• Some swelling
• Sensitivity

Goals:

• Begin wrist range of motion
• Manage swelling
• Start gentle strengthening

7. Warm Water Exercises

How to do it:

1. Soak hand in warm water 5-10 minutes
2. Perform ROM exercises in water
3. Water supports movement
4. 2-3 times daily

8. Wrist Flexion/Extension

How to do it:

1. Rest forearm on table
2. Gently bend wrist down
3. Return to neutral
4. Gently bend wrist up
5. 15-20 repetitions
6. Don't force—gravity-assisted initially

9. Wrist Radial/Ulnar Deviation

How to do it:

1. Forearm supported, thumb up
2. Tilt wrist toward thumb (radial)
3. Tilt wrist toward pinky (ulnar)
4. 15-20 repetitions
5. Start with small movements

10. Forearm Rotation

How to do it:

1. Elbow at side, bent 90°
2. Slowly rotate palm up
3. Then rotate palm down
4. 15-20 repetitions
5. Often very stiff—be patient

11. Wrist Circles

How to do it:

1. Support forearm on table
2. Circle wrist slowly
3. Clockwise 10 times
4. Counterclockwise 10 times
5. Start small, progress range

12. Light Grip Exercise

How to do it:

• Soft ball or putty squeezes
• Very light pressure
• 2-3 minutes
• Progress as tolerated

13. Scar Massage (If Surgical)

How to do it:

1. Wait until incision fully healed
2. Apply lotion to scar
3. Massage across scar
4. Moderate pressure
5. 5 minutes, 2-3 times daily

Phase 3: Progressive Mobility (Weeks 8-12)

Goals:

• Achieve full range of motion
• Progress strengthening
• Return to light activities

14. Wrist Stretches

Flexion stretch (prayer position):

1. Press palms together
2. Lower hands toward waist
3. Keep palms together
4. Hold 30 seconds
5. 3-5 repetitions

Extension stretch (reverse prayer):

1. Press backs of hands together
2. Raise toward chin
3. Hold 30 seconds

15. Individual Wrist Stretches

Flexion:

1. Extend arm, palm up
2. Use other hand to bend wrist down
3. Hold 30 seconds

Extension:

1. Extend arm, palm down
2. Use other hand to bend wrist back
3. Hold 30 seconds

16. Forearm Rotation Stretch

Supination:

1. Hold stick or dowel with both hands
2. Rotate to palm up position
3. Hold 30 seconds

Pronation:

1. Rotate to palm down position
2. Hold 30 seconds

17. Wrist Curls with Light Weight

Flexion:

1. Forearm on table, palm up, wrist over edge
2. Hold 1-2 lb weight
3. Curl wrist up
4. 3 sets x 15 repetitions

Extension:

1. Same position, palm down
2. Lift wrist up
3. 3 sets x 15 repetitions

18. Grip Strengthening (Progressive)

How to do it:

• Progress putty resistance
• Hand grippers
• Ball squeezes
• 3 sets x 15 repetitions

19. Pinch Strengthening

How to do it:

• Pinch putty between fingers and thumb
• Various grips
• 15-20 repetitions each grip

Phase 4: Strengthening (Weeks 12+)

Goals:

• Full strength restoration
• Return to normal activities
• Sport-specific training

20. Progressive Wrist Resistance

How to do it:

• Progress weight in curls (3-5+ lbs)
• Use resistance bands
• All directions: flexion, extension, radial/ulnar deviation
• 3 sets x 12-15 repetitions

21. Forearm Strengthening

Supination/pronation with weight:

1. Hold hammer or dumbbell at end
2. Rotate forearm against resistance
3. 3 sets x 15 repetitions each direction

22. Push-Up Progression

How to do it:

1. Wall push-ups first
2. Progress to incline
3. Then floor push-ups
4. Use push-up handles if wrist extension painful
5. 3 sets x 10-15 repetitions

23. Weight Bearing Activities

How to do it:

• Quadruped holds (hands and knees)
• Planks when ready
• Yoga/pilates wrist positions
• Progress gradually

24. Sport-Specific Training

Return timelines:

• Lifting: 3-4 months
• Golf/tennis: 3-4 months
• Contact sports: 4-6 months
• Gymnastics: 6+ months

Special Considerations

If Surgical (ORIF with Plate)

• Hardware is permanent unless problems
• May feel plate under skin
• Cold sensitivity common initially
• Follow surgeon's specific protocol

Older Adults

• Bone density may be reduced
• Healing may take longer
• Focus on function over perfect anatomy
• Fall prevention important

Severe Fractures

• Longer immobilization
• Slower progression
• May never achieve full ROM
• Focus on functional goals

Warning Signs

Contact your doctor if:

• Increasing pain
• Numbness or tingling (carpal tunnel possible)
• Finger stiffness not improving
• Signs of infection (if surgical)
• Hardware feels loose or prominent

Complications to Watch For

Stiffness: Most common—commit to exercises Carpal tunnel: Nerve compression from swelling Malunion: Bone heals in poor position Arthritis: Long-term risk CRPS: Complex regional pain syndrome (rare)

Daily Exercise Schedule

During Cast:

• Finger exercises: Every 1-2 hours
• Tendon gliding: 6 times daily
• Shoulder/elbow: 3-4 times daily
• Elevation: Frequently

Post-Cast Week 1-4:

Morning:

• Warm water soak: 5-10 minutes
• ROM exercises in water
• Gentle stretches

Throughout Day:

• ROM exercises every 2 hours
• Finger exercises continue

Evening:

• Full ROM routine
• Light strengthening
• Ice if swollen

Post-Cast Week 4+:

• Strengthening: 3x weekly
• ROM/stretching: Daily
• Progressive activities

Key Takeaways

1. Keep fingers moving — During cast and after
2. Stiffness is common — Dedicated exercise overcomes it
3. Forearm rotation often slowest — Be patient
4. Strengthen progressively — Don't rush heavy activities
5. Full recovery takes months — 3-6 months typical
6. Better outcomes with therapy — Consider hand therapy referral

Distal radius fractures are common and treatable. With consistent exercise during and after immobilization, most people regain excellent function. The key is keeping fingers moving during cast wear, then committing to range of motion and strengthening afterward. Your wrist can return to normal—it just takes time and effort.