Physiotherapy for upper limb fracture

What to expect after removing the cast or sling

To help your fracture heal, the decision may be made to immobilise your arm by placing it into a cast or sling for some time. This is typically around 4-6 weeks. This will be decided by your orthopaedic doctor.

After your cast is removed, you will probably have dry flaky skin, altered sensation, joint stiffness, muscle weakness and some swelling.

This leaflet will provide advice and exercises to help with these effects.

Skin Care

After your cast or sling is removed it is helpful to massage non-perfumed moisturiser over your shoulder and arm.

This will help hydrate the dry skin while also providing a positive touch to an area that has not been touched or moved for a period of time.

This will help with dry skin and sensory concerns.

Exercises

The following exercises will help reduce swelling and stiffness and increase your joint movement. Carry out these exercises regularly and gradually work through them.

The exercises get harder as you work through the leaflet so it may be a few weeks before you can manage them all.

Exercises may feel difficult at first but should not be painful. If an exercise is painful, you should stop and try again later.

Arm circles

• Start with your hands by your side with your palms facing forward.
• Bring your arms all the way up and over your head.
• Return to the starting position.

Prayer stretch

• Place your palms together just above your head and gently press them together.
• Keeping your palms in contact slowly bring them down in front of your body and hold at the bottom for 20 seconds.
• Repeat 5 times.

Quadruped Arm Raise

• Begin on your hands and knees.
• Raise one arm out in front of you. Try to keep your arm as straight as it will go.
• Repeat with your other arm.
• Repeat 10 times.

Child’s pose

• Sit back on your heels.
• Slide your hands forward to feel a stretch in your upper body and shoulders.
• Take a deep breath and walk your fingers forward to increase the stretch.
• Hold for 20 seconds.
• Repeat 3 times.

Knee Push-Up

• Start on your hands and knees.
• Keeping your back straight, slowly lower your nose to the floor.
• Straighten your arms and return to the starting position.
• Repeat 10 times.

Activity ideas to encourage the use of your arms

• Popping bubbles
• Arts and crafts
• Swimming
• Bat and ball games
• Animal walks
• Wall push-ups
• Skipping rope
• Push/pull toys (prams, trolleys)
• Building block towers on a table.

When to seek further help?

If your child reports the following complaints after 3 – 4 weeks of following the advice in this leaflet please call the physiotherapy team to discuss further assessment:

• Ongoing pain which stops your child from taking part in normal activities
• Difficulty returning to normal function
• Ongoing stiffness.