Physiotherapy for Scaphoid Fracture Rehabilitation

What is a scaphoid fracture?

The scaphoid is the most commonly fractured carpal bone, typically injured from a fall onto an outstretched hand (FOOSH) during motorcycling, cricket, or slips on wet monsoon pathways across India. Due to its retrograde arterial blood supply entering from the distal pole, the proximal scaphoid is vulnerable to delayed union, non-union, or avascular necrosis. Following cast immobilization or percutaneous screw fixation, patients experience significant wrist stiffness and thumb grip weakness. Physiotherapy provides staged carpal mobilisations, active wrist flexion-extension, thumb carpometacarpal exercises, and progressive gripping protocols to return patients to work and sports.

How physiotherapy helps

• Carpal and radiocarpal joint mobilisations
• Active wrist flexion and extension exercises
• Thumb opposition and pinch grip strengthening
• Forearm pronation and supination drills
• Gradual loaded grip and weight-bearing return

Common signs

• Deep pain and tenderness in the anatomical snuffbox at the base of the thumb
• Marked wrist stiffness following weeks of plaster cast immobilization or surgical screw placement
• Pain provoked by pushing up from a chair or bearing weight through an extended wrist
• Reduced grip strength and difficulty turning doorknobs or wringing wet clothes
• Swelling over the radial aspect of the wrist joint that fluctuates with hand usage

Clinical rehabilitation framework

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

Frequently asked questions

Related conditions & care

Colles FractureA 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.

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.

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.

Trigger FingerTrigger finger (stenosing tenosynovitis) occurs when inflammation, thickening, or nodule formation on the flexor tendon restricts its smooth glide through the first annular (A1) pulley at the base of the finger or thumb. In India, repetitive gripping, heavy domestic activities (such as wringing clothes, chopping, and sweeping), manual tool use, and underlying conditions like diabetes commonly precipitate the condition. As the nodule catches within the tightened pulley sheath, the digit snaps, clicks, or locks in a flexed posture. Conservative physiotherapy combines custom MCP joint splinting to prevent pulley irritation, tendon gliding exercises, gentle deep friction massage, and ergonomic utensil adaptations to restore smooth, painless finger excursion.

Clinical guides & articles for a scaphoid fracture

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