Client Name:
Age:
Gender:
Date Generated:

Scaphoid Fracture Stiffness - 7 Week Rehab Plan

Generated by MMSx Authority Team

Overview: Scaphoid fracture stiffness refers to restricted range of motion and pain that commonly develop in the wrist and thumb after a fracture of the scaphoid bone (a small carpal bone on the thumb side of the wrist). This stiffness can be a result of the fracture healing, prolonged immobilization (casting), surgical intervention, inflammation, or scar tissue formation. This 7-week plan follows the NEEBAL framework (Neutral → Elasticity → Endurance → Balance → Activation → Load) to systematically guide recovery, focusing on managing pain and inflammation, protecting the healing bone, gradually restoring gentle and controlled pain-free wrist and thumb movement, strengthening surrounding muscles, and safely progressing to functional activities while integrating ergonomic and mindful movement strategies for long-term relief and prevention.

Pain Profile (10 Parameters)

Technical Name: Post-Scaphoid Fracture Stiffness, Wrist Contracture Post-Fracture, Scaphoid Nonunion (if healing complications)
Layman's Description: Stiffness and pain in the wrist, especially on the thumb side, after a small bone in the wrist (scaphoid) has healed from a fracture.
Common Triggers: Previous scaphoid fracture (often from falling on an outstretched hand), prolonged immobilization (casting), surgical intervention, inflammation during healing, scar tissue formation, fear of movement, inadequate early rehabilitation.
Synonyms / Alternate Names: Wrist fracture stiffness, post-cast wrist stiffness, post-op wrist stiffness, thumb-side wrist stiffness.
Movement Pattern Involved: Restricted active and passive range of motion in wrist (flexion, extension, radial/ulnar deviation) and thumb (flexion, extension, abduction, opposition); pain with attempted end-range movements; tenderness over the anatomical snuffbox; weakness in grip and pinch; feeling of stiffness or "tightness."
Region / Body Part: Radial (thumb) side of the wrist, anatomical snuffbox, thumb base, wrist joint. Pain is typically localized to the wrist but can radiate slightly into the thumb or forearm.
Pain Type: Dull ache, stiffness (worse in the morning or after periods of inactivity), sharp pain with specific movements or pressure, tenderness to touch, occasional clicking/popping.
Severity / Stage Tags: Post-acute (after fracture healing confirmed), Chronic stiffness. Severity depends on initial fracture type, healing complications, and duration of immobilization.
Suggested Drill Focus: Pain/swelling management → gentle passive/active-assisted ROM → scar tissue mobilization → isometric strengthening → progressive resistance → grip/pinch strengthening → functional integration.
Red Flags: Sudden severe increase in pain, new or worsening neurological symptoms (numbness, tingling, weakness in hand), severe swelling/bruising, signs of infection, pain not improving with rest, significant deformity (rule out re-fracture or non-union) → urgent medical evaluation. **Always follow surgeon's/physician's specific post-fracture precautions.**

Warm-Up (5–7 mins)

Diaphragmatic Breathing (1-2 min): Deep belly breaths to reduce overall tension and calm the nervous system, promoting relaxation in the arm and shoulder.
Gentle Arm Circles (1 min): Small to large circles forward and backward, pain-free range only, to gently mobilize the shoulder and elbow.
Finger Flexion/Extension & Thumb Opposition (1 min): Gently open and close fingers, make a loose fist. Touch thumb to each fingertip, pain-free range only.
Light Grip Squeezes (1 min): Gently squeeze a soft ball or rolled towel for 5-10 seconds. 5-8 reps.
Thoracic Spine Mobilization (2 min): Gentle rotation and extension movements of the mid-back (e.g., seated twists, cat-cow on all fours) to improve posture and reduce compensatory strain.

Weeks 1–2 — Acute Pain Management & Gentle Protection (4–5×/week)

Goal: Reduce acute wrist pain and inflammation, protect the healing scaphoid fracture, and initiate gentle, pain-free mobility of the wrist, thumb, and fingers, strictly avoiding aggravating movements or positions.

#	Exercise	Instructions	Key Cues
1	Diaphragmatic Breathing & Relaxation	Lie on back, knees bent. Focus on deep belly breaths. Consciously relax shoulders, neck, and arms. 5-10 minutes daily.	Breathe into abdomen, not chest. Slow, controlled. Consciously release tension. Promotes overall relaxation.
2	R.I.C.E. Protocol (Rest, Ice, Compression, Elevation)	Rest: Avoid aggravating activities. Ice: Apply ice pack to wrist for 10-15 min, 2-3 times daily. Compression: Use a light elastic bandage/wrist support if comfortable. Elevation: Keep wrist above heart level. Ongoing.	Reduces inflammation and swelling. Avoid tight compression. Listen to your body.
3	Gentle Passive/Active-Assisted Wrist AROM (Pain-Free, Limited Range)	Use your non-affected hand to gently move the affected wrist through flexion, extension, radial, and ulnar deviation, only within a pain-free range. 10-15 reps × 2-3 sets.	Move slowly and smoothly. Do not push into pain or resistance. Let the assisting hand do most of the work. Gentle joint lubrication.
4	Gentle Thumb Flexion/Extension & Opposition	Gently move thumb across palm (flexion) and away from palm (extension). Touch thumb to each fingertip. Pain-free range only. 10-15 reps × 2-3 sets.	Maintain thumb dexterity. Keep wrist relatively still. Avoid pain.
5	Finger Flexion/Extension (Full Range)	Gently open and close fingers, making a full fist and then fully extending fingers. 10-15 reps × 2-3 sets.	Maintain full finger mobility. Keep wrist still. Avoid pain.
6	Isometric Wrist Contractions (Very Gentle, Neutral Position)	Forearm supported on a table, wrist in neutral. Gently press hand/wrist into resistance (other hand/table) for flexion, extension, radial, and ulnar deviation (5% effort). Hold 5-10s. 5-8 reps each × 1-2 sets.	Barely feel the muscle working. No movement. Stop if any pain. Focus on gentle muscle activation without movement.
7	Activity Modification & Protection	Identify and avoid activities that aggravate your wrist/thumb pain (e.g., heavy gripping, twisting, weight-bearing through wrist, push-ups). Consider a wrist brace or tape for support if needed. Ongoing.	Listen to your body. Rest is crucial for initial healing. Protect the wrist from further irritation.

Cooldown (5–7 mins)

Forearm Flexor Stretch (2 mins): Extend arm straight, palm up, fingers pointing to floor. Use other hand to gently pull fingers towards body. Hold 20-30s each side.
Forearm Extensor Stretch (2 mins): Extend arm straight, palm down, fingers pointing to floor. Use other hand to gently pull fingers towards body. Hold 20-30s each side.
Thumb Stretches (2 mins): Gently stretch thumb across palm and away from palm, within pain-free limits.
Ice Application (10-15 mins): Apply ice pack to the affected wrist area to reduce inflammation and pain, if comfortable.
Relaxation Breathing (2 mins): Deep, slow breathing to promote full muscle relaxation and recovery, focusing on calming the nervous system.

Written/Suggested by MMSx certified Professionals (MMSx Authority) — NEEBAL framework applied.

Disclaimer: This rehabilitation program is educational and follows evidence-based principles. **Individuals recovering from a scaphoid fracture should first be thoroughly assessed and cleared by their surgeon and/or physical therapist before initiating any exercise program.** Strict adherence to post-fracture precautions is paramount. Stop any exercise that causes increased pain, numbness, tingling, or other concerning symptoms. Progression should be very gradual and strictly symptom-limited. This is not medical advice. MMSx Authority, TrainersEye, and affiliates disclaim liability for injuries or adverse outcomes.