This diagnosis has proven to be one of the most common, if not the most common, diagnosis that is referred to a hand therapist. Most often these injuries are caused by FOOSH (falling on the outstretched hand). Differential diagnoses include scaphoid fracture, strain, ligament injury or tendonitis. Two important concepts to consider when rehabilitating the wrist after this injury is the consideration of forearm motion and proper hand motion. The body will move where there is least resistance and, in many instances, the easiest movements are incorrect. For example, when teaching a patient to extend the wrist, it’s important to inhibit the digit extensors. I usually tell patients to imagine that they are holding a butterfly in the palm of their hand, so that they don’t overexert their digit flexors during wrist movement. If I see them trying to extend their digits, I gently fold their digits back into a gentle fist and then resume wrist extension movement. Additionally, forearm rotation is often impaired following injuries to the wrist. Anatomical research has taught us about the 80/20 rule. 80% of forearm rotation occurs at the proximal forearm/radial head region and only 20% occurs at the wrist. So, when retraining the forearm, it’s important not to strain the TFCC. A circumferential neoprene wrap is often helpful if the patient has overused this area prior to proper forearm ROM/training. It will be many months until the patient is able to tolerate weight bearing activities such as pushing up from a chair. Knowing these important concepts helps to assure a successful outcome following a distal radius fracture.
Erica Montgomery, OTR/L, CHT
If you have had a fall or a distal radius fracture, contact us for a free consultation. To request an appointment, click here, or call directly to one of our three locations during regular business hours:
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Disclaimer: The information in this blog is intended to be informational only, and is not intended to be used in lieu of medical care. Consult a doctor or a physical therapist before attempting treatment on your own.