Wrist and Hand Post-Fracture Rehabilitation for Intermediates

Program Overview This is a 23-week, twice-weekly, 20-minute rehabilitation guide for an intermediate wrist and hand program after a fracture. It combines exercise, manual therapy, splinting, electrical stimulation, and balance/proprioception work, with progression through four phases based on your clinician's assessment.

Who This Program Is For and Its Goal This program is for people recovering from a wrist or hand fracture who have moved past the earliest healing stage and are ready for structured, supervised intermediate work. The goal is to gradually restore wrist and hand movement, strength, grip, and everyday function while protecting the healing bone, with your clinician guiding each step.

Before You Start Talk with your clinician before beginning and confirm your fracture is stable enough for this phase. Have your splint fitted and your equipment set up safely. Ask your therapist to review each exercise with you first, and don't begin any phase until your clinician confirms you meet that phase's readiness criteria.

Safety Notes and When to Stop Because you have a recent fracture, avoid overloading the wrist and hand and always cool down after sessions. Stop and call your clinician if pain keeps increasing, if you feel numbness or tingling in the thumb and first fingers, if the wrist looks newly swollen or deformed, or if you cannot move your fingers normally.

Weekly Structure You'll do two sessions per week, about 20 minutes each, for 23 weeks. The plan moves through four phases, starting with gentle protected movement and building toward stronger, more functional work as your clinician confirms you're ready. Sessions stay short, so consistency matters more than intensity.

How the Plan Is Organized Sessions are short and frequent, using a mix of exercise, manual therapy, splinting, electrical stimulation, and proprioception work. You begin in an early protected-mobilization phase, advance to controlled motion, then strengthening, and finally advanced rehabilitation. Your clinician decides when you move forward using the criteria in segment 10.

What a Typical Session Looks Like Each session follows a warm-up, main work, and cool-down pattern. Expect gentle movement and tracking first, then your prescribed exercise and manual therapy work, finishing with calm range-of-motion and cooling down. Your therapist adjusts the mix as you progress and confirms which equipment is appropriate for your phase.

Warm-Up, Main Work, and Cool-Down Warm up with gentle wrist and finger movements and light proprioception tracking. Main work may include putty and finger-spring resistance, wrist curls, carpal and soft-tissue mobilization, NMES to the forearm, and splint use as prescribed. Cool down with slow range-of-motion and rest. Use only the equipment your therapist approves for your phase.

Tracking Progress Your clinician will track grip strength with a dynamometer, wrist motion with a goniometer, pinch strength, and your scores on the Boston Carpal Tunnel Questionnaire, Michigan Hand Outcomes Questionnaire, and DASH. These measures show how your movement, strength, and daily function are improving over the weeks.

How Progression Criteria Are Used Your clinician compares your results against phase criteria to decide when you advance, so progression is based on measured readiness rather than time alone. Outcome measures like grip and pinch strength, range of motion, and questionnaire scores guide these decisions and help catch problems early.

Recovery and Self-Care Between sessions, follow your splint schedule, keep the hand moving gently as advised, and avoid heavy gripping or loading until cleared. Rest, elevate when swollen, and keep doing your home exercises. Report any changes in numbness, swelling, or pain to your clinician promptly.

Pain, Rest, and Red Flags Mild soreness that settles with rest is common, but stop if pain increases or persists. Never push through sharp pain or new numbness. Seek care for sudden swelling, deformity, fever, or loss of finger movement. Your clinician can adjust the plan if symptoms change.