A Colles’ fracture refers to a fracture around the wrist. Typically, it occurs due to a fall on an outstretched hand. Specifically, the fracture occurs at the end of a bone in the forearm called the radius (at the cortico-cancellous junction). Dorsal displacement and dorsal angulation are common characteristics of such a fracture. Falling on an outstretched hand can be a consequence of either tripping or losing balance, and it is the body’s defense mechanism against falling flat on one’s face. While this sort of fracture is not prevalent in younger patients, it is commonly seen in older patients, patients with osteoporosis, and those with any other form of bone disease.
The treatment of Colles’ fracture requires the application of a cast to facilitate compression and prevent motion in an effort to promote healing. In some cases, surgical correction may be required. Once pain and swelling is reduced, the objective of the healthcare team changes. The new priority is joint range of motion and restoration of muscle strength. This is where physical therapy plays an important role.
Physical therapy can help in the recovery of wrist fractures in several ways:
1. RICE: The use of Rest, Ice packs application, Compression and Elevation (RICE) is universally applicable after injuries to reduce the extent of injury and facilitate healing.
2. Therapeutic exercises: Muscles tend to lose tone, strength, and mass due to a period of inactivity. Stretching and range of motion exercises can minimize the phenomenon of ‘muscle atrophy’.
3. Massage therapy and Mobilizations: Manual therapy from a skilled physical therapy on the joint or on the surgical scar site is very helpful. This helps reduce pain, decrease swelling and improve blood flow to the area to improve healing.
4. Electrical stimulation: Used to improve muscle tone and strength, it can involve application of a tiny electric current on muscle fibers to stimulate muscle contraction.
5. Balance therapy: If a Colles’ fracture has occurred in an elderly patient due to loss of balance, then treatment is aimed at improving core strength and balance. At times, aids like a walking stick or Zimmer frame may also be provided.
Given the importance of the wrist in daily activities, the objective of physical therapy is to help regain full motion of the affected wrist. However, physical therapy can also help reduce swelling, controlling pain, improving strength, improving balance and regaining independence, especially in older patients. Physical therapy helps the healing process. Recovery from Colles’ fractures can be hampered by unnecessary and extreme motion after removal of the cast. This can be minimized or avoided under the supervision of a licensed physical therapist.
Physical therapy is important in the full recovery of wrist motion and strength after an injury. Expect the therapist to start with gentle mobilizations of the wrist and hand to improve joint circulation and encourage motion. As the pain subsides, the therapist will encourage (and supervise) gentle exercises to regain full function.
Our physical therapists will provide the care you need, when you need it. If you are hurt and in pain, there is a good chance that physical therapy can help you. Reach out to us today, and discovery why individuals across the community are experiencing the benefits of what physical therapy can do for you.
Dr. Daniel Skulavik, PT, DPT, OCS, is with Advanced Physical Therapy located in the Food Lion Shopping Center, Clinton.