Fractured wrist therapy exercises. Information for patients MSK Outpatients

Transcription

1 Fractured wrist therapy exercises Information for patients MSK Outpatients

2 Why have I been given this leaflet? You have broken (fractured) a bone at your wrist which has been treated with a cast or an operation. Distal Radial Fracture Scaphoid Ulna The advice and exercises described in this leaflet are to help your recovery. If you have any questions about these exercises you can contact the therapy Department on: page 2 of 12

3 Now my plaster / wrist support has been removed, what can I do? It is normal to feel some pain after a plaster or wrist support has been removed because your hand hasn t moved normally for some weeks. This will gradually settle down as your movement improves and the wrist becomes less stiff. When you first start moving your wrist it might be helpful to take some simple pain relief medication. This can give you the confidence to exercise and use your hand. Always read the label when using over-the-counter medication and, if you are in any doubt, speak to your pharmacist or GP. If your pain becomes severe or continuous, you should contact your GP. If you have been given a splint following your cast removal wear it as you have been advised. Can I wash my hand? Yes, once any wound has healed you can start to wash your hand in warm water and soap. The skin is often dry and flaky and it is helpful to use moisturiser for the first few days. page 3 of 12

4 Is it normal to experience swelling? Swelling is common and will make movement more difficult than normal. Swelling will reduce more quickly by: high elevation rest with your elbow up at shoulder height, with your hand upright, as often as possible; open and close your fingers, then spread your fingers apart and together to boost the circulation. Do this regularly throughout the day. How can I improve my movement? Doing your exercises regularly throughout the day will help this to happen more quickly. Using gentle heat can help make this easier. You can do this with warm water soaks, a hot water bottle wrapped in a towel or a wheat bag. Do not use heat on a swollen wrist or if sensation is reduced as it makes it difficult for you to feel when it is too hot. page 4 of 12

5 Helpful Exercises Exercise 1a [ ] At the edge of a table, bend your wrist backwards as far as is comfortable with your fingers relaxed. Try and hold this for 5 seconds. Then bend your wrist forward with your fingers relaxed, try to hold for 5 seconds. Relax and repeat 5 times. You can repeat this every 1-2 hours during the day. Exercise 1b [ ] You can add pressure to this exercise with your other hand to further stretch the movement. page 5 of 12

6 Exercise 1c [ ] Rest your arm on the table using your other arm. Hold the hand flat and try and raise your elbow. Try and hold this for 5 seconds. Exercise 1d [ ] Bend your wrist backwards as far as is comfortable using your other hand to help. Try and hold this for 5 seconds. page 6 of 12

7 Exercise 2a [ ] Next, with your elbow tucked at your side try and turn your hand from a palm downwards position to palm upwards as far as you can. Try to hold for 5 seconds. Move from the palm upwards position to the palm downwards position as far as you can. Try to hold for 5 seconds. Relax and repeat 5 times. You can repeat this every 1-2 hours during the day. Exercise 2b [ ] You can add pressure to this exercise with your other hand to further stretch the movement. Exercise 3 [ ] Make a fist and then spread your fingers and thumb as wide as you can. page 7 of 12

8 Exercise 4 [ ] Try and stretch your thumb across to the bottom of your little finger. You can assist this movement with your other hand. Is it normal to get pain when I exercise? It is normal to get some discomfort or pain when you exercise. It should not be severe and any pain after exercise should be bearable. Your skin should not feel hot or inflamed and the swelling should not get worse after you exercise. If your pain following exercise does not settle within 2 hours of exercising then you may benefit from: doing shorter bursts of exercise. doing more gentle exercise and increasing gradually as the pain allows. discussing your pain relief with your GP. If you still find your pain severe or unmanageable or are concerned about any lack of improvement over time you should consult your GP. page 8 of 12

9 Can I use my hand for everyday tasks? Driving You can return to driving when your cast has been removed and you have enough movement and strength to grip. Be sure you can control your car safely. You may wish to discuss this with your insurance company to ensure you have valid insurance. If you have been unable to drive for over 3 months you need to inform the DVLA. Returning to normal everyday activities Personal care such as washing and dressing and holding a knife and fork will normally help get your hand and wrist moving. Gradually increase activities in order to allow the bone to heal. Avoid lifting heavy objects such as the kettle and saucepans for the first few weeks. The shape of your wrist It is not unusual for a fractured wrist to change shape. As the bone heals there is sometimes a bump where the fracture was and this can sometimes take months to settle. In some cases the wrist never returns to its previous shape. How long will my recovery take? Different people recover at different speeds. Most people will have some level of stiffness that can take months to completely go. During this time you will find you are able to use your hand more and more normally. You may still get intermittent pain with certain activities for some time. page 9 of 12

10 Commonly the last thing to return is the ability to bear your weight down through a flat hand with your wrist bent back This may take months to become a comfortable position, but this is normal following this type of wrist injury and should improve with time. Finally Although the information in this booklet is based on current knowledge and best practice in managing typical conditions, all individuals and injuries are different. This may mean your symptoms do not follow a normal and predictable course. If this is the case and you have any concerns please contact your GP or therapist about your best course of action. If you have any questions about your exercises contact the Therapy Department on page 10 of 12

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12 Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit Registered Charity No Alternative formats can be available on request. Please Sheffield Teaching Hospitals NHS Foundation Trust 2018 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. PD7881-PIL3238 v2 Issue Date: May Review Date: May 2021