Helping your Wrist to Recover after being in a Cast

  • Reference Number: HEY-255/2014
  • Departments: Orthopaedics

Introduction

This leaflet has been produced to give you general information about your wrist following removal of your cast.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Caring for your skin

Following removal of your cast you are likely to notice that your skin is very dry. To improve this it is advised that you place your hand and forearm in warm water for 5 – 10 minutes. The dry skin should then rub off easily with a towel, do not be tempted to rub too vigorously as you may damage the skin. Once your arm is dry apply moisturising cream to the affected area. Repeat this process daily until your skin returns to normal.

Pain and swelling

Now that your plaster has been removed, it is common to experience aching in the hand, wrist or forearm. However, try to use the hand as normally as possible. You may feel some stiffness and, in cold weather, often it may appear blue in colour.

Swelling may occur for several months therefore you must elevate your hand, when resting. To do this sit on a chair and place your elbow on cushions so that it is level or slightly higher than your shoulder. In this position point your hand towards the ceiling then open and close your hand as this will help to reduce any swelling.

If your wrist is swollen at the time your cast is removed you may have been given a tubigrip support to wear. The tubigrip will normally be applied in a double layer which has it fold near your fingers and finishes just below your elbow.

Please note the following points:

  1. The two ends of the tubigrip should not meet; allow a 3 – 4 cm difference to prevent circulatory problems.
  2. Do not allow the tubigrip to wrinkle up in places again to prevent circulatory problems.
  3. Take the tubigrip off when you go to sleep and re-apply when you wake up.
  4. Remove the tubigrip if your fingers become blue, more swollen, numb or if you have pins and needles.

Exercises

It is important that you start to exercise your wrist as soon as you can after your cast has been removed. By exercising and regaining normal movements the feeling of stiffness and pain should gradually reduce.

Wrist exercises will be most effective if practiced regularly and not just once per day. You should try to practice the exercises below 3 to 4 times every day:

1. Rest your forearm on a table with your hand over the edge.

Exercises - Part 1 - Step 1

Using your wrist only, move your hand down towards the floor. Hold for 10 seconds.

Now move your wrist up towards the ceiling. Hold for 10 seconds.

2. Rest the palm of your hand on a table.

Exercises - Part 1 - Step 2

Without moving your forearm, slide your hand one way until you feel a stretch. Hold this for 10 seconds.

Now slide your hand the opposite way, feel a stretch again and hold for 10 seconds.

3. Bend your elbow and tuck it into your side.

Exercises - Part 1 - Step 3

Now turn your palm as far as possible upwards and feel a stretch. Hold for 10 seconds.

Now turn your hand back over again without moving your elbow. Feel the stretch again and hold for 10 seconds.

You may find that your fingers and elbow joint feel stiff too. Doing the exercises below will help to improve this:

1. Touch your thumb to the tip of each finger.

2. Make a tight fist.

Exercises - Part 2 - Step 2

Ensure your knuckles are bent to a right angle and hold 10 seconds.

Now fully straighten the fingers and hold for 10 seconds.

3. Hold your hand with the palm of your hand facing upwards.

Exercises - Part 2 - Step 3

Touch your thumb to the base of your little finger and hold for 10 seconds.

Now stretch the thumb out the opposite way and hold for 10 seconds.

4. Bend your elbow up towards you as far as possible.

Exercises - Part 2 - Step 4

Feel it stretching and hold for 10 seconds.

Now straighten it out as far as you are able, feel the stretch and hold for 10 seconds.

Lifting

Do not lift heavy objects or containers of hot liquid, until you feel confident that your hand and wrist feel strong enough to do so.

Physiotherapy

Unless you decline or have almost full range of movement immediately after your cast has been removed, you will be referred to physiotherapy out-patients to continue your rehabilitation.

At this appointment you will be assessed further. Initially you will be asked a series of questions which are all designed to help your physiotherapist plan the best course of treatment for you. You will then be examined and so it is advisable that you wear loose clothing, so this can be done properly.

Following your assessment, the physiotherapist will choose from a range of treatment techniques dependant on your progress up to that point. In addition the physiotherapist will ensure you have exercises to practice at home. These exercises are vitally important to ensure you give yourself the best chance of a full recovery.

The aim of rehabilitation will be to get you back to normal life as quickly as possible. However, as every patient’s injury, lifestyle and recovery varies; it can be hard to give definite timescales for this and so should be discussed individually with your physiotherapist.

Contact numbers

If you have an urgent query regarding your symptoms, following the removal of your cast, please telephone the fracture clinic. If however the query is related to physiotherapy please contact the physiotherapy team.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:
Fracture Clinic: (01482) 674099.
Physiotherapy team: (01482) 674880.

You may be asked to leave a message; please clearly state a brief reason for the phone call, your full name, address and telephone number and someone will get back to you as soon as possible.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.