The wrist is a complex joint where 15 different bones meet, each of which performs its own specific function. All of these bones play an important role, and if a problem or injury occurs in any one of them, it can affect the way that the entire wrist moves and functions. The radius is a bone of the forearm that connects the elbow to the wrist, and it’s the most commonly injured bone in this region. When the term “broken wrist” is used, it usually refers to fractures of the distal part of the radius, where it meets the wrist. Distal radius fractures—as these injuries are called—are often serious and may require surgery, but regardless of what treatment is needed, physical therapy will be essential to ensure that you have a complete recovery.
The radius is located on the thumb side of the wrist and is the larger of the two bones that make up the forearm. Along with the ulna, these bones permit movements of the elbow, hand, and wrist, and the distal radius takes on a large portion of the loads upon the wrist. This is one of the main reasons the distal radius is so vulnerable to fractures. Distal radius fractures are the most common fractures in the arm and are some of the most common fractures in the entire body. In fact, of all the fractures that are seen in the ER, about one-sixth involve the distal radius.
The vast majority of distal radius fractures occur after falling and landing with the hands outstretched, which is often called a “fall on an outstretched hand,” or FOOSH injury. Falls in sports like soccer and basketball, as well as biking, skateboarding or rollerblading accidents can all lead to a distal radius fracture if the person lands with enough force. Older individuals with osteoporosis are also at an increased risk for distal radius fractures because their bones are more fragile and can therefore break from even a minor fall.
After experiencing a distal radius fracture, a person will usually experience immediate pain, swelling, tenderness, and bruising. Many individuals will also have a wrist that hangs in an odd or bent way (called a deformity), as well as difficulty moving the wrist and fingers. Upon examination, these injuries are usually classified as follows:
- Type 1: a “nondisplaced” fracture in which the bone is broken but still rests in a normal position
- Type 2: a fracture where a fragment of bone is shifted from its normal position
- Type 3: the most serious type of fracture, with multiple breaks of the bone or bones
How physical therapy can help you recover from any type of distal radius fracture
In most cases, type 1 and 2 fractures are treated non-surgically with a cast being worn for a period of time until the bone heals, while type 3 fractures are usually treated with a surgical procedure to repair the fractured bone. But regardless of which type of treatment is used, a course of physical therapy will be necessary to help you regain the range of motion, function, and strength of your wrist. To give you an idea of what this process looks like, below are some highlights of a typical treatment program for a broken wrist:
- While the wrist is still in a cast: during this period of time, your physical therapist will likely prescribe some gentle exercises the keep the shoulder, elbow, and fingers moving so that these parts of the arm don’t lose their abilities while the wrist is immobilized
- After the cast is removed/after surgery: once the cast is removed, the wrist usually feels stiff and the arm feels weak, so your physical therapist will prescribe treatments to address these issues and restore the function of your wrist with the following:
- Hands-on techniques (manual therapy) to help your joints and muscles to move more freely with less pain
- Ice and heat therapy to address the pain in your wrist
- Stretching and strengthening exercises to help you regain your ability to move your wrist normally
- Exercises that are specific to the sport or physical activity you’re involved in to help you more quickly return to the things you love
A broken wrist is often a serious injury that can set you back for a while, but seeing a physical therapist during the recovery period will help ensure that you’re making your way back to full strength in the safest and fastest manner possible. So if you’ve recently broken your wrist, the best choice you can make is to contact your local physical therapy clinic to find out how treatment will fit into your recovery process and when you can start.