A broken wrist, often a fracture of the distal radius, is one of the most common bone injuries and typically requires immobilization in a cast or splint. After immobilization, the hand and wrist often become stiff, weak, and swollen, limiting the ability to use the hand for daily tasks. Physical therapy (PT) is the necessary next step, designed to systematically restore the lost mobility, strength, and function. The goal of this rehabilitation is to return the wrist as close as possible to its pre-injury condition, though the length of PT is highly individualized.
Variables That Influence Recovery Time
The duration of a physical therapy program cannot be standardized because it is determined by several factors related to the injury and the patient. The initial severity and type of the fracture play a large role in the healing timeline. A simple, non-displaced fracture that did not require surgery generally has a shorter recovery path than a complex or comminuted fracture involving multiple pieces or the joint surface.
Whether the injury required surgery also affects the commitment to physical therapy. Procedures like Open Reduction Internal Fixation (ORIF) often necessitate a longer, more intensive rehabilitation period to manage internal healing and scar tissue. The patient’s biological factors further influence recovery speed, as older adults experience a longer healing process compared to younger individuals due to slower tissue repair rates.
A patient’s overall health and the presence of other medical conditions, known as co-morbidities, can also slow down progress. Conditions such as diabetes, osteoporosis, or chronic pain may interfere with the body’s ability to heal and respond to therapy. Finally, adherence to the home exercise program directly impacts the timeline; a dedicated patient will likely progress faster than someone who attends only the clinic sessions.
Typical Timeline and Stages of Physical Therapy
The rehabilitation process is a progressive journey divided into three phases following fracture immobilization. The first phase, Initial Recovery/Mobilization, usually begins immediately after the cast or splint is removed, generally around weeks four to eight post-injury. The primary focus is managing pain and swelling, which are common after extended immobilization. The therapist introduces gentle, active and passive range-of-motion exercises and manual therapy techniques to combat stiffness and improve joint mobility.
The second phase, Strengthening, typically starts around weeks six to twelve, once sufficient bony healing has occurred and initial range of motion has improved. The focus shifts to rebuilding the muscle strength that atrophied while the wrist was immobilized. Exercises involve progressive resistance, starting with isometric holds and advancing to tools like therapy putty, small weights, and resistance bands to target grip strength and forearm muscles. The goal of this phase is to restore the endurance needed for daily activities.
The final phase, Functional Return, generally spans from three to six months post-injury and focuses on higher-level activities. This stage aims to restore coordination, dexterity, and endurance for complex or repetitive tasks. Therapy includes dynamic activities that simulate specific work, sport, or hobby-related movements, ensuring the wrist can tolerate varied loads and speeds. While formal clinic visits may decrease, the patient continues a structured, independent home program to solidify long-term gains.
Defining Successful Rehabilitation
A physical therapy program is considered successful when a patient meets objective functional milestones, not simply when a predetermined time has elapsed. One primary metric is achieving a near-normal range of motion in the affected wrist, measured against the patient’s uninjured wrist. Therapists use tools like goniometers to measure wrist flexion, extension, and forearm rotation.
Another objective criterion involves strength benchmarks. Using a hand dynamometer, therapists aim for the injured wrist to achieve approximately 80 to 90 percent of the strength measured in the uninjured hand. Meeting this bilateral strength comparison indicates that the muscular capacity to handle normal loads has been restored.
The ultimate measure of success is the patient’s ability to perform activities of daily living (ADLs) and functional tasks without pain or significant limitation. This includes the ability to manage personal hygiene, prepare meals, and return to work or recreational activities. When these measurable criteria—range of motion, strength, and functional independence—are consistently met, the physical therapist will recommend a formal discharge from active therapy.