Being in a cast for any length of time will cause muscles to atrophy, or shrink and weaken. Once the cast is removed, you will need to begin gentle stretching of the wrist and forearm. These stretches can be done by pulling the wrist backward into extension and pushing the wrist forward into flexion, holding each position for 10 to 15 seconds. You will also need to stretch the muscles that allow your hand to turn a doorknob. To do this, place your hand in the position it would be in when grasping a doorknob, then turn the wrist in a clockwise direction, holding for 10 to 15 seconds, then back in a counterclockwise direction, again, holding for 10 to 15 seconds.
Stretching of the thumb will also help you to regain the range of motion in your wrist and hand. Simply pull the thumb back toward the forearm as far as pain allows, holding for 10 to 15 seconds. Then push the thumb toward the base of the fifth finger and hold for 10 to 15 seconds.
To strengthen the muscles that have grown weak, you can use hand weights to perform wrist curls and wrist extensions. Sitting in a chair, place the forearms on a table with the palms of the hands facing up toward the ceiling. Grasping the weights, curl the wrists toward the forearms. Perform 10 repetitions of this exercise, then turn the forearm over so that the palms of your hands are facing down. Grasp the weight and curl the wrists backward toward the forearm. Perform 10 repetitions of this exercise. You should also incorporate squeezing a tennis ball for five seconds, repeating 10 to 15 times. Perform each of these exercises at least three times daily, slowly increasing the weight used and the number of repetitions performed.
All exercises should be pain free. It is always a good idea to follow up with a physician to ensure that it is appropriate for you to begin these exercises. The physician may refer you to an appropriate healthcare provider, such as an athletic trainer, to assist you with a progressive rehabilitation program.
(This answer provided for NATA by the King College Athletic Training Education Program.)
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