It’s hard enough to get through distal radius fractures and surgeries, but the frustration doesn’t stop there. When weeks have passed, and your wrist is still stiff, it’s natural to wonder, “When is this going to get better?” As an occupational therapist and certified hand therapist in Miami, I see distal radius fractures constantly, and I usually see them at their worst when people aren’t improving and are searching for answers. Here are the five most common reasons your wrist may be stuck and what you can do about each one.
1. You Started Therapy Too Late
This one is a bit of hindsight, but if you catch it early, you can nip it in the bud. One of the most common reasons people are still stiff is that they were too afraid to start moving and waited too long to begin therapy. The fear is understandable; you may think you need to wait until your incisions are fully healed. But in most cases, that’s not true.
When I worked alongside a hand surgeon, I would take down post-op dressings as early as day five to seven. With a well-performed surgery, movement can often begin almost right away. Even patients with more severe fractures or dislocations who are still in a cast can start therapy immediately. The body stiffens fast — fingers lock up, shoulders tighten — and the longer you wait, the harder every step of recovery becomes. If you’re not sure when to start, reach out to us and ask. Don’t let fear be the reason you fall behind.
2. Your Fingers Are Stiff
Here’s something that surprises many patients: your wrist stiffness may actually be coming from your fingers. Even if your fingers weren’t injured in the fracture, they stiffen up quickly, and because everything is connected through the hand and wrist, tight fingers equal a tight wrist.
The bones in your hand are held together by tissue that can become extremely restrictive. One technique I love: slide your fingers between your metacarpal bones. The thickness of your fingers helps stretch those bones apart and loosen the surrounding tissue. And instead of constantly making a full fist, which compresses everything right over where you broke, try a hook fist instead. Hold your big knuckles straight, then curl only your finger joints downward. This works the outer muscles while stretching the inner ones, releasing tension without overloading the wrist. These exercises look simple but are easy to do wrong, so make sure you’re executing them correctly.
3. You’re Missing Supination and Pronation
If your wrist still won’t flex or extend well, there’s a good chance you haven’t fully recovered the ability to turn your palm up (supination) and palm down (pronation). These two motions are foundational; without them, everything else in the wrist is harder.
To get rid of stiffness, you have to reach the end of the range of motion. That means actually arriving at the limit of your movement, not just getting close to it. Our bodies are smart — they compensate and make you feel like you’re doing more than you really are. As I always say, when you’re inside the jar, you can’t read the outside label. That’s why having a therapist objectively assess your movement matters so much. Practice palm-up and palm-down rotations with a towel roll under your arm to keep your elbow from compensating. Once you’ve restored those motions, combine them with wrist flexion and extension — that combination is essential for eliminating stiffness.
4. Your Shoulder Is Tight
This one catches people off guard. A tight shoulder can directly limit your wrist recovery. If you’re missing external or internal rotation, the ability to let your elbow fall forward or bring your arm back, your wrist will pay the price.
I always assess the shoulder when treating a distal radius fracture. At the first appointment, things may look fine, but by month three or four, if you’ve been compensating and not moving your shoulder properly, the joint capsule tightens and muscle imbalances develop. Suddenly, your wrist progress stalls. It’s even more critical for patients who had a shoulder problem before their wrist injury. Treating only the wrist in those situations will always fall short. Make sure whoever is treating you is looking at the full picture: fingers, wrist, forearm, and shoulder.
5. You’re Not Doing Enough – At Therapy or at Home
Let’s be honest. Sometimes the reason you’re not improving is that the effort isn’t matching the goal, whether that’s at therapy, at home, or both.
For post-surgical patients, I typically recommend three therapy sessions per week. If your sessions are cookie-cutter generic exercises with no attention to how everything connects and no clear milestones, you may not be getting what you need. A good therapist should be able to tell you exactly where you are, where you’re going, and what it will take to get there.
But the other side is just as important: even the best therapy won’t work if you go home and do nothing. Out of 168 hours in a week, therapy takes up maybe three. Everything else is on you. And what you’re doing at month one is very different from what you should be doing at month three or six. Wrist fractures take a minimum of three months to recover, and often longer. If weeks are going by with no change, look critically at both sides. And if your current therapist isn’t giving you clear answers or results you can feel — it’s okay to find a new one. You deserve a full recovery, and staying stuck should never be the accepted outcome.
Hoang (Juanita)
Owner, Occupational Therapist & Certified Hand Therapist
Hoang, also commonly known as “Juanita,” is the owner of Hands-On Therapy Services, where she has built her dream of a therapy-owned practice dedicated to helping people with injuries get the best possible outcome, whether they’ve had surgery or are looking to avoid pills, injections, and surgery altogether. As an occupational therapist and certified hand therapist, she brings deep expertise to every patient she sees. Hoang is also the author of all the free guides offered on the Hands-On Therapy website, as well as the internationally sold book The Hands-On Approach: How to Get Rid of Hand and Shoulder Pain Without Pills, Injections, and Surgery.
Carole
Occupational Therapist & Certified Lymphedema Therapist
Carole is an occupational therapist and certified lymphedema therapist originally from France, bringing a uniquely holistic, patient-centered approach to care through her extensive background as a licensed massage therapist and yoga instructor. Her passion is helping individuals regain their independence and improve their quality of life. Having lived and worked in Miami for over 25 years, Carole is trilingual fluent in English, French, and Spanish. Outside the clinic, she enjoys teaching and practicing yoga, volunteering at a local animal rescue, and cherishing time with her family, including her dog and two beloved cats.
Hands-On Therapy Services · Miami, FL · handsots.com
