Physiotherapy for Colles Fracture

What is colles fracture?

A Colles fracture is a complete fracture of the distal radius bone in the forearm with dorsal displacement of the wrist, typically sustained by falling onto an outstretched hand (FOOSH). It is particularly common among older adults with underlying osteopenia or osteoporosis in India, frequently occurring from slips on wet bathroom tiles or unpaved streets. Following 4 to 6 weeks in a plaster cast or surgical fixation with a volar locking plate, patients invariably experience severe wrist joint stiffness, restricted forearm turning (pronation and supination), finger puffiness, and diminished grip power. Post-immobilization physiotherapy focuses on gentle passive and active joint mobilisations, edema reduction, tenosynovial gliding, and graded resistance training to safely restore independence in carrying groceries, preparing meals, and personal care.

How physiotherapy helps

• Radiocarpal and ulnar joint mobilisations
• Forearm pronation and supination retraining
• Active finger and thumb tendon gliding drills
• Progressive grip strength with exercise putty
• Edema management and wrist extension loading

Common signs

• Significant stiffness in the wrist joint, limiting backward bending (extension) and forward bending (flexion) after cast removal
• Difficulty rotating the forearm to turn the palm up (supination) or down (pronation)
• Marked weakness in hand grip, making it difficult to hold a glass, open taps, or carry objects
• Residual swelling and dull aching around the wrist joint and base of the thumb
• Stiffness and reduced flexion in the fingers due to prolonged splinting

Clinical rehabilitation framework

Evidence-informed clinical progression and starter exercise targets for colles fracture.

Frequently asked questions

Related conditions & care

Carpal Tunnel SyndromeCarpal tunnel syndrome develops when the median nerve becomes compressed as it passes through the carpal tunnel on the palmar side of the wrist. Increased pressure within the tunnel, often linked to repetitive wrist bending, sustained gripping, fluid retention, or inflammatory changes, causes tingling, numbness, and burning pain in the thumb, index, middle, and radial half of the ring finger. For mild to moderate presentations, conservative physiotherapy focuses on relieving nerve compression, reducing flexor tendon friction, and preserving hand function.

OsteoporosisOsteoporosis means the bones have become less dense and more likely to break. Physiotherapy helps with safe, weight-bearing and strengthening exercise that supports bone and muscle, and with balance training that lowers the risk of falls and fractures. Your physiotherapist tailors the exercises so they are safe for your bones, and advises which loaded spinal flexion or twisting movements to avoid where fracture risk is high.

Repetitive Strain Injury (RSI)Repetitive strain injury (RSI) refers to cumulative musculoskeletal pain and tissue strain affecting muscles, tendons, and nerves in the neck, shoulder, forearm, or wrist. It frequently arises from sustained posture, repetitive typing, smartphone use, manufacturing assembly, or manual instruments. Physiotherapy identifies the mechanical drivers of strain, relieves localised muscle and tendon tension, and corrects workstation ergonomics, movement patterns, and load pacing so symptoms do not keep recurring.

Clinical guides & articles for colles fracture

Evidence-informed articles, recovery timelines, and home care advice from our clinical library.