Beginner Wrist and Hand Rehabilitation Post-Fracture
An 11-week beginner program targeting post-fracture recovery for the upper limb wrist and hand, including carpal tunnel, tendons, distal radius, and ulna, using a rower and resistance band.
Professional rehabilitation program designed for effective recovery and pain management.
Key facts at a glance
- Body part
- upper-limb · wrist-hand
- Injury type
- post-fracture
- Level
- beginner
- Duration
- 11
- Sessions/week
- 2
- Minutes/session
- 45
- Evidence level
- moderate
- ICD-10
- S62
- Cost tier
- moderate
Program Overview
This beginner program is for adults recovering from a wrist or hand fracture who have been cleared to start gentle rehabilitation, including support for related tissues such as the carpal tunnel area, tendons, and the distal radius and ulna. Its goal is to gradually restore wrist and hand movement, strength, and everyday function over 11 weeks, while protecting the healing bone. You will work at a comfortable pace, and your clinician will guide progression based on how you respond.
Before You Start
Talk with your clinician before beginning and follow any restrictions you've been given. Do not start if your wound is opening or separating (wound dehiscence), or if the area is hot, very swollen, or acutely inflamed. Stop and call your clinician if pain steadily worsens, swelling increases, you feel numbness or tingling in the thumb, index, or middle finger, or your splint no longer fits well. Always keep your spine in a neutral, comfortable position, and avoid overloading the wrist. These are general safety points, not medical clearance.
Weekly Structure
The plan runs 11 weeks with two sessions per week of about 45 minutes each. You'll use a rower and a resistance band alongside simple hand and wrist exercises. It moves through phases in plain terms: first protecting the wrist and controlling pain and swelling, then gently getting the wrist moving, then building strength and everyday function. Your clinician decides when you move to the next phase based on the progression criteria, not just the calendar.
What a Typical Session Looks Like
Start with a gentle warm-up, such as a short, easy row on the rower with light effort and a neutral spine, plus heat to the wrist if advised. The main work includes tendon gliding, gentle wrist range-of-motion exercise, joint mobilization guided by your clinician, and light resistance-band strengthening. Cool down with gentle stretching and ice after exercise if recommended. Keep everything pain-free or only mildly uncomfortable, and never push through sharp or increasing pain.
Tracking Progress
Your clinician uses progression criteria, such as pain levels, swelling, movement range, and grip strength, to decide when you are ready to move to the next phase. You'll also track outcome measures like the DASH questionnaire, grip and pinch strength, wrist range of motion, the 9-Hole Peg Test for dexterity, and a pain scale. These show your recovery over time and help your team adjust the plan safely. Progress varies from person to person, so don't compare yourself to others.
Recovery and Self-Care
Use heat before exercise and ice after if your clinician advises, and wear your removable splint as directed. Rest the wrist when it feels irritated, and build activity gradually. Red flags to report promptly include worsening or persistent pain, new numbness or tingling, increasing swelling, wound changes, or a splint that feels too tight. These general self-care steps support healing but do not replace your clinician's advice.
Recovery phases
Edema resolved or minimal as measured by figure-8 circumference at wrist (within 2cm of unaffected side),Pain at rest ≤2/10 on VAS scale,Incisional healing complete (if surgical fixation),Wrist splint/cast intact and properly positioned,Neurovascular status intact with no signs of median nerve compression (no paresthesia in thumb/index/middle finger),Soft tissue around distal radius and ulna non-tender to palpation
→ Advance to: Phase 2: Early Mobilization
Pain with gentle movement ≤3/10 on VAS scale,No increase in swelling at carpal region,Tolerates wrist elevation without exacerbation,Able to perform digit flexion/extension exercises without pain,Forearm rotation (pronation/supination) pain-free to tolerance,Sleep disturbance from wrist pain minimal (<2 nights/week)
→ Advance to: Phase 2: Early Mobilization
Wrist flexion/extension arc ≥30° (measured with goniometer),Forearm pronation ≥70° and supination ≥70°,No tendon friction rub at flexor carpi radialis or extensor carpi radialis,Grip strength ≥20% of contralateral side (using Jamar dynamometer),No reproduced carpal tunnel symptoms with wrist positioning,Radiographic evidence of early fracture callus formation (cleared by physician)
→ Advance to: Phase 3: Strengthening
Wrist flexion/extension arc ≥45°,Finger flexion to full fist without limitation (tendon gliding intact),Wrist radial deviation ≥15° and ulnar deviation ≥25°,No pain with resisted forearm rotation (distal radioulnar joint stable),Carpal stability tests negative (no scaphoid/lunate shift),Tolerance to functional activities of daily living with affected upper limb
→ Advance to: Phase 3: Strengthening
Wrist flexion/extension arc ≥60°,Grip strength ≥35% of contralateral side,No provocative pain with scaphoid stress test,Full finger extension from flexed position (extensor tendon integrity),Wrist flexor and extensor endurance ≥30 seconds hold,Tolerance to light resistance activities without symptom flare
→ Advance to: Phase 3: Strengthening
Wrist flexion/extension arc ≥75°,Grip strength ≥50% of contralateral side,No pain with resisted wrist flexion (flexor carpi radialis/ulnaris),No pain with resisted wrist extension (extensor carpi radialis/ulnaris),Forearm supination/pronation strength 4/5 on manual muscle testing,Functional reach to midline of body without compensation
→ Advance to: Phase 4: Advanced Strengthening
Wrist flexion/extension arc ≥85°,Grip strength ≥60% of contralateral side,Pinch grip (key pinch) ≥50% of contralateral side,No median nerve symptoms with sustained wrist flexion (Phalen's test negative),Tinel's sign negative at carpal tunnel,Dexterity assessment (9-hole peg test) within 125% of unaffected side time
→ Advance to: Phase 4: Advanced Strengthening
Wrist flexion ≥60°, extension ≥50°,Grip strength ≥70% of contralateral side,Resisted wrist movements 5/5 strength,No ulnar-sided wrist pain with distal ulna loading,Tolerance to 30 minutes of repetitive upper limb activity,Work simulation activities tolerated without exacerbation
→ Advance to: Phase 5: Return to Function
Wrist range of motion within 10° of contralateral side,Grip strength ≥80% of contralateral side,Full composite fist and finger extension (tendon gliding complete),No pain with palpation of scaphoid, lunate, or distal radioulnar joint,Can lift objects up to 5kg without compensation,Patient-reported outcome improved by ≥15 points on DASH questionnaire
→ Advance to: Phase 5: Return to Function
Wrist range of motion within 5° of contralateral side,Grip strength ≥90% of contralateral side,Full return to activities of daily living without modification,No nocturnal symptoms in median/ulnar nerve distribution,Sustained grip endurance ≥60 seconds,Patient cleared for progressive return to work/recreational activities
→ Advance to: Phase 6: Maintenance & Discharge
Wrist range of motion equal to contralateral side,Grip strength ≥95% of contralateral side,No residual stiffness in carpometacarpal or interphalangeal joints,No provocative symptoms with heavy lifting or impact activities,Patient demonstrates independent home exercise program,Functional outcome scores meet patient-specific goals
→ Advance to: Discharge
Return to activity milestones
Pain-free basic activities of daily living
Week 3Wrist and finger range of motion full; no tenodesis limitation
Light functional activities and conditioning
Week 4Patient demonstrates correct hand therapy exercise technique
Moderate activity and sport-specific conditioning
Week 6Able to complete 5 minutes of light kitchen or desk activity
Full return to sport, occupation, and recreation
Week 11Scapulothoracic rhythm normalised: no winging on wall push-up
Precautions
- avoid-overloading
- maintain-neutral-spine
- stop-if-pain-increases
Contraindications
- wound dehiscence
- acute-inflammation
Pain management
- Cryotherapy (ice pack to wrist for 15-20 minutes, 3-4 times daily)
- Elevation with wrist in neutral (above heart level)
- Gentle soft tissue mobilization to forearm flexors/extensors
- Neuromuscular electrical stimulation (TENS) for median nerve desensitization
- Analgesic positioning (wrist splint in neutral at night)
Equipment & modalities
Frequently asked questions
How much pain is acceptable during exercises?
Can I skip the splint once I feel better?
What if I miss a session or fall behind?
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed October 6, 2026. · Read our editorial policy