The forearm is composed of two bones: the radius, which is the larger bone, and the ulna. The point at which these bones come into contact with the carpal bones in the hand is the wrist joint. In a distal radius fracture, the end of the radius near the wrist suddenly breaks. The culprit is some type of heavy force exerted upon the bone, often resulting from sport activity or a fall. Once the bone has been mended and the cast removed, a therapy program is initiated to return strength and mobility to the wrist.
Wrist Flexion and Extension
Flexion and extension are natural movements of the wrist that decrease and increase, respectively, the angle of the wrist joint in relation to the forearm. Since your wrist operates like a hinge, the joint should "swing" up and down. With your forearm stationary on a table and your hand hanging over the edge, gently bend your wrist down until you feel a minor stretch. After five seconds, return to the starting position and bend your wrist upward until you feel another stretch. You can perform this exercise with your hand palm up, which targets the flexors, or palm down, which targets the extensors. Once your wrist is capable of bearing greater pressure, you can use a dumbbell. Another variation is to grab one hand with the other and bend it up or down.
The wrist joint is more than a simple hinge. It also has the ability to bend from side to side. This is the basis of the wrist deviation exercise. Rest your forearm on a table and turn your hand to the thumb side. Hold for five seconds and return to the starting position. Turn your hand to the little-finger side and hold for five seconds. Perform three sets of 10 reps each.
Squeezing a rubber ball for five seconds increases grip strength by activating muscles in the wrist and forearm. You can also perform this exercise with a hand grip tool, but the flexibility of a soft rubber ball is far more mollifying to the recovering tissue and thus a better alternative. This exercise applies the same movements — flexion and extension of the fingers — as those used on the wrist. Perform three sets of 10 reps. Each squeeze counts as a single rep.
Wrist Pronation and Supination
Pronation and supination movements rotate the forearm, without a corresponding movement of the shoulder, so that the palm faces downward and then upward. With your arm resting next to your body, elbow at 90 degrees and palm out, flip your hand up until you feel a slight stretch. Hold for five seconds and turn your hand down. Keep repeating this movement. Perform three sets of 10 reps.
Light exercises typically begin in the days and weeks following surgery. Once the pain diminishes and mobility returns, you will engage in heavier strength training to restore strength and build muscles in the wrist. Most patients can resume light aerobic activity such as swimming a month or two after surgery. Vigorous activity such as skiing or football can begin in three to six months. A full recovery can take up to a full year.