The wrist joint is the most important joint of the upper limb. There is practically no hand action that we would perform without movement in this joint. An injury or fracture of any of the bones of a joint can disable any person from active life for a long time, both at work and in everyday life.
Treatment, as a rule, involves long-term immobilization of the arm from the elbow to the fingers with a plaster cast. It is very important to begin proper rehabilitation exercises after the cast is removed.
A specially designed exercise program for self-rehabilitation will help you effectively and quickly relieve pain and restore full range of motion in the wrist joint.
I recommend undergoing 2-3 sessions of rehabilitation massage from a qualified specialist to relieve muscle spasms and tensions.
Clothes should be loose, it is advisable to remove shoes. Perform all exercises (especially the first days) smoothly and gradually. Remember the important principle: “Endure mild pain, do not allow severe pain.”
Perform these exercises daily for at least 2 weeks.
Stretching exercises
Supination and pronation
Bend your elbow 90 degrees and press it close to your body.
Turn your forearm palm up and hold for 15 seconds. Then smoothly and carefully turn your palm down and also hold for 15 seconds. During the exercise, the elbow should be pressed to the body. 2 sets of 15 reps. Do stretching exercises until the pain subsides and your hand gets used to the stress (at least 1 week is recommended). Next, you need to add exercises to strengthen your wrist muscles.
Strengthening exercises
Rehabilitation
The program is designed to strengthen bones, restore lost functions, restore self-care and work activity. It is also important to work with a psychologist, then the patient will be able to adapt socially. In order to recover quickly, treatment of musculoskeletal diseases should be carried out on a clinical basis.
Diet
Proper nutrition is the basis for rapid healing of bone tissue. Such rehabilitation after a fracture of the radius includes eating plenty of food that contains magnesium, calcium and vitamin D.
The diet should include:
- fish and seafood;
- milk, cottage cheese, sour cream and cheese;
- eggs, broccoli, bananas;
- figs, peas, legumes.
The diet should be varied, you should eat 5-6 times a day in small portions. You should not abuse chocolate, alcohol and coffee; such products interfere with the digestion and absorption of certain substances. To create a daily schedule, you can contact a nutritionist.
Physiotherapy
Exercises should be selected by a doctor; loads should be treated with caution, because they can cause harm. Any approaches should be done at rest, with the forearm lying on the table. At the initial stages of rehabilitation after a fracture of the radius, the following movements can be performed:
- alternately lifting each finger and then the entire palm;
- spreading your fingers to the sides and returning to the starting position;
- carefully clench your fist with moderate force and relax your hand;
- circular movements with each finger;
- “Take a pinch of salt and add salt.”
The purpose of such a warm-up is to restore function and prevent muscle atrophy due to immobilization in a cast. When performing exercise therapy, blood circulation improves, blood vessels dilate, and nutrition in the affected area is normalized.
At a later date, you need to visit a doctor. If the doctor sees that the bones have become stronger, he will prescribe additional exercises:
- circular movements with the brush;
- rotation of the forearm in and out;
- flexion at the elbow joint and straightening;
- circular shoulder warm-up.
Push-ups, pull-ups, working with dumbbells, barbells or exercise machines are strictly contraindicated. The orthopedist will recommend such loads only when you are sure that a strong bone callus has formed at the fracture site.
Recovery period
This is the final rehabilitation stage, where the focus is on increasing the range of motion in the joint, building muscle mass and restoring muscle strength, and mastering fine movements. During this period, the following loads on the limb are possible:
- Exercises with a skipping rope and a gymnastic stick;
- Hand training using a regular or gyroscopic expander;
- Weighted exercises, the use of dumbbells weighing 2-4 kg is allowed;
- Limb stretching;
- Honing everyday skills - tying shoelaces, opening locks and hinges, stirring food, etc.
Simplified classification of radial fractures in a typical location
Depending on the mechanism of injury, fractures are:
Flexion or Smith's fracture. With such a fracture, the point of impact falls on the dorsum of the wrist and the distal radius is displaced towards the palmar side.
Extensor or Koless fracture. With such an injury, the point of impact falls on the palm and, as a rule, bone fragments are displaced to the back. There is good blood circulation in the distal part of the radius, so with any fractures the bone heals quite quickly. Therefore, timely elimination of the displacement is necessary, otherwise the bone will heal in the wrong position.
In addition to these two main types, fractures can be open or closed. With open fractures, the integrity of the skin is compromised. With comminuted fractures, the integrity of the bone is disrupted in several places at once, as a result of which it turns out to be split into 3 or more parts.
The basic principles of treatment for a fracture of the distal radius are closed reduction (elimination of displacement) of the damaged parts and ensuring immobility of the hand, which is achieved by applying a fixing plaster cast or open reduction and installation of a plate and screws. After wearing a cast for a long time or after surgery, almost all patients experience partial atrophy of muscle tissue and a decrease in the range of motion of the joints.
Options for complications
Timely initiation of rehabilitation measures is an important factor in recovery after traumatic injuries. If the patient ignores the doctor and does not follow the recommendations, complications arise. The most common unfavorable situations are:
- Formation of persistent pain syndrome.
- Development of deforming osteoarthritis and ankylosis of the joint.
- Stiffness of structures.
- Formation of a false joint.
- Slowing of bone fusion, which requires surgical intervention with osteosynthesis.
- The appearance of avascular necrotic bone changes that must be removed.
Exercise therapy for a wrist fracture should be performed by a qualified specialist. Incorrect manipulations can lead to the appearance of Sudeck syndrome - trophic and vasomotor disorders, which are accompanied by osteoporosis and pain.
Nutrition during the rehabilitation period after radiation surgery
It is very important that during the rehabilitation period after a fracture, the patient’s body receives a sufficient amount of vitamins and minerals, namely calcium, phosphorus, fluorine, silicon, ascorbic and nicotinic acid, vitamins A, E, B, D. After all, they are necessary for the formation of new bone fabrics.
For a speedy recovery, doctors advise sticking to a dairy-vegetable diet, eating as much fish, cottage cheese, greens, nuts and bran bread as possible.
The duration of rehabilitation of the wrist joint is individual in each case and depends on the type of fracture, the age of the victim, and concomitant diseases.
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Types of fractures
In the structure of injuries to the wrist bones, fractures are:
- isolated - one of 6 bones is damaged;
- combined - several structural units are simultaneously affected.
According to statistics, up to 90% of fractures occur in the area of the scaphoid bone. Next in frequency are injuries to the lunate and pisiform bones. The remaining osteoid tissues rarely break. The mechanism of occurrence of the pathology occurs when hitting a hard surface with a fist or the edge of the palm, as well as during a fall with emphasis on the hand or a direct blow.
Massage
In addition to exercise therapy, massage is prescribed; you only need to visit the office of a professional specialist with a medical education. Timely warm-up will provide a rush of blood and improve tissue trophism, preventing muscle wasting. Sessions are scheduled 2-3 times a week, the average course is 10-14 days. The doctor recommends the timing.
If the patient is in a cast, the collar area is warmed up to improve blood flow to the immobilized limb. After removal, the forearm is warmed up, the duration of the sessions and the intensity of the warm-up increases as the wound heals.
Physiotherapy
To speed up rehabilitation after a fracture, physical treatment is prescribed; even if the radius is damaged with displacement, such methods show high effectiveness. The patient may be prescribed:
- electrophoresis;
- UHF;
- warming up;
- ultrasound treatment;
- thermal procedures with paraffin, etc.
Such restoration will ensure rapid fusion of bones. To form a strong callus, the patient should not forget to eat properly and do therapeutic exercises.
Tekar therapy
For complete rehabilitation of the arm after a fracture of the radius, the patient will benefit from a new method of radio wave therapy. With this effect, energy is transferred without radiation, which ensures deeper penetration. After several sessions, pain and swelling are reduced, and tissue regeneration is accelerated.
The waves also affect the muscles, preventing their atrophy. This method of recovery will perfectly complement the recovery program and shorten the rehabilitation period.
A set of exercises at the stage of immobilization in a cast
When the cast allows you to move your fingers, you can do the following exercises:
- Bend and straighten unfixed fingers.
- Connect your thumb with the rest of your fingers.
- Using a healthy hand, bend the nail phalanx of the injured hand.
Exercises should not cause discomfort or pain; if they occur, you should provide complete rest to your hand and, after a while, start exercising again.
If pain or tissue swelling does not go away, you should immediately consult your doctor.
Returning functionality
Keeping the arm in a fixed state for a long time, especially with a complex fracture with a displacement, has an extremely negative effect on its tissues. Because of this, a disruption occurs in the functioning of the nerve endings, and the functioning of the hand becomes difficult. It is no coincidence that after removing the plaster, the following changes can often be observed:
- bluish skin;
- significant limitation in mobility;
- pain when moving your hand;
- visual shortening of the injured limb in comparison with a healthy one.
It is impossible to immediately return to the normal rhythm of life after the cast is removed, and some more time is needed to develop the limb. The period lasts up to four weeks and may require not only exercise therapy, but also physical therapy.
To speed up the recovery process, your doctor may prescribe the following measures:
- rubbing;
- massage;
- exercise therapy;
- physiotherapy.
The main thing for the patient is not to violate medical recommendations, not to miss sessions and not to overload the sore arm. If you exercise a limb too intensively, this will not speed up the restoration of its functioning, but, on the contrary, will aggravate the situation and delay recovery.
Alternative techniques
Eastern medicine offers some techniques that help restore blood circulation in the affected tissues, relieve swelling from the tissues and reduce pain. For fractures of the hand and wrist, yoga asana exercises are recommended and should be performed daily. Gymnastics takes up to 5 minutes. It is necessary to fix the positions for 15-30 seconds in both directions.
- Take a side support lying down, leaning on a perpendicularly located forearm. The legs are in an extended position. The limb at the top is extended above the head.
- Feet shoulder-width apart, arms clasped behind your back - one limb on top and the other on bottom.
- Cross your forearms above your head and bend toward the floor in a standing position, with your forearms touching the surface of the support.
- The arms are extended above the head. The head is turned towards the hands. Perform a lunge on the leg bent at the knees, the other lower limb is extended back with emphasis on the inside of the foot.
Additionally, exercises with rubber balls and various types of elastic bands are possible:
Nutrition
Not only gymnastics and physical therapy, but also proper nutrition helps to speed up the fusion of bones and ensure their sufficient strength. It is important that the body begins to intensively synthesize collagen and receives sufficient calcium. The diet should contain the following products:
- vegetables;
- greenery;
- gray cereals;
- cheese;
- dairy products;
- nuts;
- fish;
- olives.
To increase the amount of sugar in the body, it is useful to eat ½ teaspoon of powdered eggshells 2 times a day.
You should not abuse strong tea and coffee, as well as alcohol during the recovery period. It is useful to exclude fried and fatty foods from your diet.
General principles of treatment
For a fracture of the radius, therapy will consist of several stages:
- First aid. Its task is to reduce pain, provide rest to the affected limb, and prevent damage to surrounding tissues. With a closed fracture, the limb is fixed in a safe position; with an open fracture, the bleeding stops and a bandage is applied to the site of injury. After this, the patient must be taken to a medical facility.
- First aid is provided at the scene of the injury or at the emergency room. The specialist assesses the condition of the victim, determines further treatment and measures to prevent complications.
- Qualified medical care is provided by a traumatologist. Its task is to restore the functional and anatomical integrity of the limb that has been injured.
Much depends on rehabilitation. Complete recovery is not only the restoration of bone structure, but also the complete restoration of limb function, including its mobility and sensitivity. Even if the treatment is completely correct, long-term immobility in the joints and muscles of the limb can lead to the patient having difficulty performing movements that were previously very simple. Recovery from injury is a long and complex process that requires patience from the patient. An important component of it is exercises for a fracture of the wrist joint. Let's take a closer look at them.
Main directions of gymnastics
A feature of the wrist bones is slow tissue regeneration. This occurs due to the small periosteal cover and the anatomical location of the bones. Therefore, for good fusion of fragments and callus formation, it is necessary to include physical activity as early as possible. Gymnastics includes:
- performing simple exercises while wearing a plaster cast;
- conducting a rehabilitation course of exercise therapy using auxiliary devices.
Important! Gradual physical activity accelerates the processes of natural osteosynthesis and accelerates the restoration of full function.