Distal Radius Fracture ORIF — Complete Exercise Program

Hand & Wrist Elevation and Swelling Control

Keeping the hand above heart level and pumping the fingers — the most important thing you do in the first fortnight.

What it helps: Controls the swelling that is the main cause of stiffness after hand and wrist surgery. A swollen hand cannot make a full fist, and fingers left stiff in the first weeks are much harder to free later than the wrist itself is.

1. Rest the hand higher than your heart. Sitting, prop it on pillows or on the back of a sofa; standing, rest it on the opposite shoulder; lying down, support the whole forearm on cushions.
2. With the hand up, slowly make a loose fist and open it fully, spreading the fingers.
3. Repeat the slow fist-and-open several times, then let the hand rest in the raised position.
4. Come back to it regularly through the day rather than doing one long session.

Tips:

• Above the heart is the part that matters. A hand resting on your lap or in a sling at waist height is not elevated, and this is the commonest reason swelling does not settle.
• The fist-and-open is a pump: muscles squeezing push fluid back up the arm. Elevation alone works, but elevation with movement works far better.
• A hand that is puffy and stiff first thing in the morning usually means it spent the night down; support it on pillows in bed.

Commonly done as every hour while awake sets of 10 slow fists, daily.

Finger Range of Motion

Gentle bending and straightening to keep the finger joints moving.

What it helps: Keeps the finger joints moving through their full range — preserving the bend and straighten you need to grip, pinch, and use your hands for everything.

1. Open the hand wide, fingers straight.
2. Make a full fist, then open again.
3. Bend each finger one at a time toward the palm, then straighten.

Tips:

• Smooth, comfortable motion through the whole range.
• Do it often through the day, especially when the hand feels stiff.

Commonly done as 2–3 sets of 10, daily (several times).

Tendon Gliding (Finger Glides)

A sequence of finger positions that keeps the tendons sliding smoothly through the hand and wrist.

What it helps: Keeps the finger tendons sliding freely through their sheaths and the carpal tunnel — preventing stiffness and catching, and keeping the hand smooth and supple.

1. Start with fingers straight.
2. Bend just the top two knuckles into a "hook," then straighten.
3. Make a full fist, then straighten.
4. Bend the big knuckles only into a "tabletop," then straighten.
5. Make a "straight fist" (fingers curled but knuckles flat). Move slowly through each.

Tips:

• Move smoothly through the whole sequence.
• Gentle and controlled — these keep the tendons gliding, not strengthening.

Commonly done as 2–3 sets of 5–10 of each, daily.

Thumb Range of Motion

Gentle thumb movements that keep the base of the thumb mobile.

What it helps: Keeps the thumb's wide range — reaching, pinching, and opposing to the fingers — which is behind nearly every grip and pinch task the hand does.

1. Move the thumb out away from the palm, then back.
2. Touch the thumb tip to each fingertip in turn (opposition).
3. Make gentle circles with the thumb. Keep it comfortable.

Tips:

• Smooth, pain-free motion.
• Opposition (thumb to fingertips) is the key everyday motion to keep.

Commonly done as 2–3 sets of 8–10 each, daily.

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Pendulum Swings

Gentle, relaxed swinging that eases the shoulder into motion without the muscles having to work.

What it helps: Coaxes the shoulder through gentle motion with the muscles relaxed — keeping the joint moving and easing stiffness when active movement is still uncomfortable.

1. Lean forward and support your good arm on a table or chair, letting the sore arm hang down relaxed.
2. Let the arm swing gently — small circles, then forward-and-back and side-to-side — using a gentle sway of your body, not the shoulder muscles.
3. Keep it loose and pain-free, like a relaxed pendulum.

Tips:

• The movement comes from rocking your body, not from working the shoulder.
• Keep the swings small and comfortable.

Commonly done as 2–3 sets of 1–2 min, a few times a day.

Gentle Neck Isometrics

A steady, held press against your own hand — strengthens the neck with no movement.

What it helps: Strengthens the deep muscles that support and steady your neck without moving it — a safe, comfortable way to build the support that eases neck pain.

1. Sit tall with a gentle chin-tuck. Place your palm on your forehead.
2. Press your head lightly into your hand and your hand back into your head — a steady, comfortable push with NO movement of the neck.
3. Hold, relax, and repeat. Do the same with the hand on the back of the head, then each side.

Tips:

• Light pressure — about 20–30% effort. This is not a strength test.
• No actual neck movement: the head stays still while the muscles work.
• Keep the gentle chin-tuck throughout.

Commonly done as 5 each direction sets of Hold 5–10 seconds, daily.

Walking Program

Short, frequent walks build endurance and confidence.

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Wrist Range of Motion

Gentle bending and side-to-side motion to keep the wrist moving freely.

What it helps: Keeps the wrist moving through its full range — preserving the bend, straighten, and side-to-side motion you use for everyday hand tasks.

1. Rest the forearm on a table, hand off the edge. Bend the wrist up, then down, through comfortable range.
2. Then move the hand side to side (toward the thumb, then the little finger).
3. Finally make slow circles. Keep the forearm still.

Tips:

• Smooth, comfortable motion — don't force the ends.
• Keep the forearm supported so only the wrist moves.

Commonly done as 2–3 sets of 10 each, daily.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck the elbow at your side, bent 90°, holding a light weight or a hammer by the handle.
2. Slowly rotate the forearm to turn the palm up, then down, through comfortable range.
3. Keep the elbow pinned to your side.

Tips:

• Holding a hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.

Commonly done as 2–3 sets of 10–12 each way, most days.

Wrist Deviation (Side-to-Side)

Strengthens the muscles that move the wrist toward the thumb and little-finger sides.

What it helps: Strengthens the side-to-side wrist muscles — important support for the thumb-side tendons and for steady, controlled wrist use.

1. Rest the forearm on a table with the hand off the edge, thumb up, holding a light weight or hammer.
2. Slowly raise the hand toward the thumb side, then lower with control.
3. Keep the forearm still; the motion is at the wrist.

Tips:

• Light resistance, controlled motion.
• A hammer held toward the head adds gentle, adjustable load.

Commonly done as 2 sets of 10–12, most days.

Tendon Gliding (Finger Glides)

A sequence of finger positions that keeps the tendons sliding smoothly through the hand and wrist.

What it helps: Keeps the finger tendons sliding freely through their sheaths and the carpal tunnel — preventing stiffness and catching, and keeping the hand smooth and supple.

1. Start with fingers straight.
2. Bend just the top two knuckles into a "hook," then straighten.
3. Make a full fist, then straighten.
4. Bend the big knuckles only into a "tabletop," then straighten.
5. Make a "straight fist" (fingers curled but knuckles flat). Move slowly through each.

Tips:

• Move smoothly through the whole sequence.
• Gentle and controlled — these keep the tendons gliding, not strengthening.

Commonly done as 2–3 sets of 5–10 of each, daily.

Finger Range of Motion

Gentle bending and straightening to keep the finger joints moving.

What it helps: Keeps the finger joints moving through their full range — preserving the bend and straighten you need to grip, pinch, and use your hands for everything.

1. Open the hand wide, fingers straight.
2. Make a full fist, then open again.
3. Bend each finger one at a time toward the palm, then straighten.

Tips:

• Smooth, comfortable motion through the whole range.
• Do it often through the day, especially when the hand feels stiff.

Commonly done as 2–3 sets of 10, daily (several times).

Median Nerve Glides

Gentle gliding movements that keep the median nerve moving freely through the wrist.

What it helps: Keeps the median nerve gliding smoothly through the carpal tunnel — easing the irritation behind carpal tunnel tingling without over-stretching a sensitive nerve.

1. Start with a gentle fist, wrist neutral.
2. Open the fingers straight, then bend the wrist back so the palm faces forward and fingers point up.
3. Gently add a thumb stretch with the other hand if comfortable, then return. Move slowly through the sequence.

Tips:

• Gentle gliding — never a hard stretch, which can irritate a sensitive nerve.
• Stop short of strong tingling; ease back if symptoms increase.

Commonly done as 2–3 sets of 5–10, daily.

Hand & Wrist Elevation and Swelling Control

Keeping the hand above heart level and pumping the fingers — the most important thing you do in the first fortnight.

What it helps: Controls the swelling that is the main cause of stiffness after hand and wrist surgery. A swollen hand cannot make a full fist, and fingers left stiff in the first weeks are much harder to free later than the wrist itself is.

1. Rest the hand higher than your heart. Sitting, prop it on pillows or on the back of a sofa; standing, rest it on the opposite shoulder; lying down, support the whole forearm on cushions.
2. With the hand up, slowly make a loose fist and open it fully, spreading the fingers.
3. Repeat the slow fist-and-open several times, then let the hand rest in the raised position.
4. Come back to it regularly through the day rather than doing one long session.

Tips:

• Above the heart is the part that matters. A hand resting on your lap or in a sling at waist height is not elevated, and this is the commonest reason swelling does not settle.
• The fist-and-open is a pump: muscles squeezing push fluid back up the arm. Elevation alone works, but elevation with movement works far better.
• A hand that is puffy and stiff first thing in the morning usually means it spent the night down; support it on pillows in bed.

Commonly done as every hour while awake sets of 10 slow fists, daily.

Elbow Range of Motion

Gentle bending, straightening, and forearm turning to keep the elbow moving freely.

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tips:

• Keep the upper arm still — the movement is at the elbow and forearm.
• Sore is okay; sharp is a sign to ease back.

Commonly done as 2–3 sets of 10 each, daily.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Wrist Curls

Strengthens the forearm muscles in both directions.

What it helps: Builds balanced forearm strength in both directions — the everyday strength behind a comfortable, capable wrist and grip.

1. Rest the forearm on a table, hand off the edge, holding a light weight.
2. Palm up: curl the wrist up, then lower with control (flexion). Palm down: lift the back of the hand up, then lower (extension).
3. Move smoothly through comfortable range.

Tips:

• Light weight, controlled motion.
• Build the forearm in both directions for balance.

Commonly done as 2–3 sets of 12–15 each, most days.

Hand Putty Exercises

All-around hand strengthening with therapy putty — grip, pinch, and spread.

What it helps: Builds all-around hand and finger strength — grip, pinch, and the muscles that spread the fingers — the foundation of strong, capable hands for daily tasks.

1. Squeeze the putty in a full fist, then release.
2. Pinch the putty between the thumb and each fingertip in turn.
3. Press the putty flat and dig individual fingers in; spread the fingers against a loop of putty.

Tips:

• Comfortable effort; full squeeze and full release.
• Putty comes in firmnesses — start soft and progress as you get stronger.

Commonly done as 2 sets of 10 each, most days.

Wrist Range of Motion

Gentle bending and side-to-side motion to keep the wrist moving freely.

What it helps: Keeps the wrist moving through its full range — preserving the bend, straighten, and side-to-side motion you use for everyday hand tasks.

1. Rest the forearm on a table, hand off the edge. Bend the wrist up, then down, through comfortable range.
2. Then move the hand side to side (toward the thumb, then the little finger).
3. Finally make slow circles. Keep the forearm still.

Tips:

• Smooth, comfortable motion — don't force the ends.
• Keep the forearm supported so only the wrist moves.

Commonly done as 2–3 sets of 10 each, daily.

Forearm Rotation

Strengthens the muscles that turn the palm up and down.

What it helps: Strengthens the muscles that rotate the forearm — the motion behind turning a key, a doorknob, or a screwdriver.

1. Tuck the elbow at your side, bent 90°, holding a light weight or a hammer by the handle.
2. Slowly rotate the forearm to turn the palm up, then down, through comfortable range.
3. Keep the elbow pinned to your side.

Tips:

• Holding a hammer toward the head end adds gentle resistance — slide your grip to adjust.
• Keep the elbow still; only the forearm rotates.

Commonly done as 2–3 sets of 10–12 each way, most days.

Thumb & Wrist Stretch

A gentle stretch for the thumb-side tendons of the wrist.

What it helps: Eases tension in the thumb-side wrist tendons — gently loosening the tight, irritated tendons that limit thumb and wrist use.

1. Hold the arm out, thumb up. Gently bend the wrist downward and toward the little-finger side until you feel a mild stretch along the thumb side of the wrist.
2. Hold gently; keep it comfortable.
3. You can tuck the thumb lightly into the palm first for a touch more — but never force it.

Tips:

• A gentle, mild stretch only — thumb-side tendons are easily over-stretched.
• Ease off if it sharpens.

Commonly done as 3 sets of Hold 15–20 sec, daily.

Finger Extension (Rubber Band)

Strengthens the muscles that open the hand and straighten the fingers.

What it helps: Builds the often-overlooked muscles that open the hand — balancing the strong gripping muscles and supporting smooth, comfortable finger movement.

1. Place a rubber band around the outside of your fingers and thumb.
2. Open the fingers and thumb apart against the band's resistance.
3. Slowly close back with control.

Tips:

• Use a band light enough to do smoothly.
• Controlled open and close — both directions matter.

Commonly done as 2 sets of 10–15, most days.

Stationary Bike

Builds motion and endurance with low impact.

What it helps: Keeps the joints moving and nourished while you build endurance — all with no pounding. One of the gentlest ways to stay active when a joint is sore.

1. Set the seat so pedaling is comfortable.
2. Pedal at an easy pace.
3. Increase your time gradually.

Commonly done as directed.

Eccentric Wrist Extension

Slow lowering of the wrist that rebuilds the tendons on the outside of the elbow (tennis elbow).

What it helps: Rebuilds the wrist-extensor tendons on the outside of the elbow through slow, controlled loading — the proven way to make tennis-elbow tendons stronger and more resilient.

1. Rest the forearm on a table, palm down, hand off the edge, holding a light weight.
2. Use your other hand to help lift the wrist up.
3. Let go with the helping hand and lower the weight down slowly over 3–4 seconds. Help it back up and repeat.

Tips:

• The work is in the slow lowering, not the lift.
• Start with a very light weight (even a soup can); add load only as it stays comfortable.
• Some mild ache during/after is normal with tendon work.

Commonly done as 3 sets of 10–15, daily (or every other day).

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Eccentric Wrist Flexion

Slow lowering of the wrist that rebuilds the tendons on the inside of the elbow (golfer's elbow).

What it helps: Rebuilds the wrist-flexor tendons on the inside of the elbow through slow, controlled loading — the proven way to strengthen golfer's-elbow tendons.

1. Rest the forearm on a table, palm UP, hand off the edge, holding a light weight.
2. Use your other hand to help curl the wrist up.
3. Let go and lower the weight down slowly over 3–4 seconds. Help it back up and repeat.

Tips:

• The work is in the slow lowering.
• Start very light and progress gradually; mild ache with tendon work is normal.

Commonly done as 3 sets of 10–15, daily (or every other day).

Hand Putty Exercises

All-around hand strengthening with therapy putty — grip, pinch, and spread.

What it helps: Builds all-around hand and finger strength — grip, pinch, and the muscles that spread the fingers — the foundation of strong, capable hands for daily tasks.

1. Squeeze the putty in a full fist, then release.
2. Pinch the putty between the thumb and each fingertip in turn.
3. Press the putty flat and dig individual fingers in; spread the fingers against a loop of putty.

Tips:

• Comfortable effort; full squeeze and full release.
• Putty comes in firmnesses — start soft and progress as you get stronger.

Commonly done as 2 sets of 10 each, most days.

Progressive Strengthening

Gradually increases strength as you recover.

What it helps: Gradually raises the challenge as you get stronger, so your body keeps adapting and improving rather than plateauing.

Commonly done as directed.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

Commonly done as able.

Strength Training

Maintains and builds long-term strength.

What it helps: Builds and maintains long-term strength to keep you active, resilient, and independent.

Commonly done a few times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Grip Strengthening

Builds hand and forearm grip strength with a ball or putty.

What it helps: Builds the grip and forearm strength behind almost every hand task — and supports the tendons at the elbow that grip relies on.

1. Hold a soft ball or therapy putty in your hand.
2. Squeeze firmly and hold a few seconds, then relax fully.
3. Work through comfortable effort; stop short of sharp pain.

Tips:

• Full squeeze, full relax — both matter.
• Grip work loads the elbow tendons, so build it gradually if you have tennis or golfer's elbow.

Commonly done as 2–3 sets of 10–15, most days.

Flexibility Exercises

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

Commonly done most days.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

Commonly done as able.

Low-Impact Recreational Activities

Enjoyable activities that protect your joint.

What it helps: Getting back to the activities you enjoy in ways that are kind to your joints — the whole point of building this strength.

Commonly done as you like.