Phase I: Early Recovery and Motion (0–2 Weeks)

Immobilisation:

• Soft dressing or removable wrist splint for comfort

• Splint may be removed regularly for exercises and hygiene

Precautions:

• Avoid forceful gripping and lifting

• Avoid impact loading through the wrist

• Avoid repetitive forearm rotation if painful

Therapy:

• Early wrist and forearm active range of motion exercises as tolerated

• Finger, elbow, and shoulder mobilisation

• Oedema control and wound care

• Gentle tendon gliding exercises

• Functional hand use for light activities

Criteria to Progress:

• Healing wounds

• Controlled pain and oedema

• Improving wrist and forearm motion

Phase II: Progressive Motion and Function (2–6 Weeks)

Immobilisation:

• Discontinue splint as tolerated

Precautions:

• Avoid forceful loading and repetitive impact activities

• Gradually increase activity based on symptoms

Therapy:

• Progress to full wrist and forearm range of motion

• Gentle strengthening exercises

• Grip strengthening

• Functional and task-specific rehabilitation

• Progressive return to activities of daily living

Criteria to Progress:

• Functional range of motion

• Minimal pain and swelling

• Improving strength and endurance

Phase III: Strengthening and Functional Recovery (6–12 Weeks)

Precautions:

• Avoid sudden increases in loading

Therapy:

• Progressive strengthening of wrist and forearm musculature

• Functional strengthening exercises

• Return to unrestricted daily activities

• Endurance and conditioning exercises

Criteria to Progress:

• Good strength and control

• Minimal symptoms

• Functional use of the hand and wrist

Phase IV: Return to Function and Activity (3–6 Months)

Precautions:

• Gradual return to higher-demand activities

Therapy:

• Progressive strengthening and endurance training

• Functional and recreational rehabilitation

• Return to sport-specific activities as appropriate

• Criteria for Return to Activity

• Full range of motion

• Good strength and endurance

• No significant pain or swelling

General Recommendations

Work:

• Desk-based work may resume after 1–2 weeks depending on comfort.

• Manual work typically from 4–6 weeks depending on recovery and job demands.

Driving:

• It is important that you are medically fit to return to driving and you feel safe to control the vehicle and take evasive action if needed.

Sports and Leisure:

• Lower-limb activities may resume as comfort allows.

• Light hand use may resume as tolerated within the first 1–2 weeks.

• Progressive return to functional and gym activities from 4–6 weeks.

• Higher-demand wrist loading, racquet sports, or impact activities typically from 6–12 weeks or longer with full recovery and surgeon clearance.

Disclaimer: This protocol is intended as a general rehabilitation guide only. Rehabilitation progression should always be individualised and may be modified by A/Prof Ernstbrunner and the treating rehabilitation team based on the patient’s clinical progress, surgical findings, and individual circumstances.