It’s been hectic again, I travel so much! I was in Western North Carolina teaching at the World Massage Festival and the entire time I was there I was unable to get online. It seems the entire school’s internet service was out so everyone was stuck…bummer! In any case, I’m only finally getting caught up with email, etc., and I apologize for the delay in both this blog and in my forum answers (if you posted something there).
A woman posted a message on the Hand/Wrist Forum that I think is really important, so I’m going to copy it here and then post the message that I gave her.
The answer I’m giving her is about treating a locked wrist after the cast is removed, but the theory is exactly the same regardless of which joint was broken. If muscles are tight, that joint isn’t moving until they are released.
Here’s the message:
I broke my wrist..the radius, in two places. The over the elbow cast was replaced after 3 weeks, the shorter one taken off at 6 weeks. Had significant tightness/loss of motion in elbow/better now but still slight pain/tightness. My hand after getting cast off 7 days still quite swollen. Cannot flatten my palm, can not move my palm up at all and only slightly down. I have been massaging my hand, still icing it, trying to move it gently. I see a tiny bit of improvement. I am getting scared, it is my dominant hand. The resident that discharged me gave me nothing to guide me, just said, start using it. It is extremely weak, as well. I bought your book and was getting ready to work on problems that cause my right pinky and ring fingers to be numb and then I broke my wrist. I have had that for 2 years. So, I am wondering if that problem is impeding healing. I don’t want to damage my hand. The resident said to come back in 6 weeks and if not better..THEN physical therapy. That does not seem right to me.
I agree with you that you shouldn’t be leaving it for six weeks, but I also believe that you are definitely on the right track by thinking about releasing the tight muscles so they will stop putting pressure on your wrist joint.
When you break a bone the muscle that inserts into that bone will snap back and suddenly become short, putting a strain on the insertion point at the joint. when the bone was then set, I would be surprised to hear that anyone released the tension in the muscle fibers, so it was/is still pulling on the insertion point. Think about pulling your hair hard and then trying to move your head in the opposite direction. That is exactly what happens when the muscles are pulling tightly on the joint and you try to move it in the opposite direction.
Just from what you are describing I would say your flexor (underside of your forearm) and extensor (top side of your forearm) are both tight. Another analogy is to think of having a stick and then pulling hard on attached ropes that go in both directions. As you are pulling you are unable to move the stick either way because you are pulling in both directions. Same thing with the flexors (move your palm down so you can press your hand into a table top) and extensors (move your hand up so your fingers are pointing at the ceiling). You may like to do an internet search to look at both sets of muscles, or you can go to http://www.carpaltunneltreatment.org and then look at the section called Anatomy Lessons.
You don’t need to do any exercises, that will only make the muscles even shorter, you do need to find the spasms, apply direct pressure, and then after all the spasms are released you can begin to stretch.
I just came back from breaking both of the bones of my ankle (my foot wasn’t attached to anything) and I worked on the muscles the entire time I was in the hard cast (reaching as far into the cast as possible), and then when I was out of the hard cast and could reach my leg by unbuckling the boot, I worked on every muscle from my knee to my toes. It was painful, it was very focused and slow, but within two weeks of being out of the hard cast I had full range-of-motion in my ankle (even though I was still non-weight bearing for another two months). The doctors were shocked, but when I tried to show them what I had done the doctor said “that’s not my field, I don’t deal with muscles, just bones.” I couldn’t believe it!
YOU are your own best therapist in this situation. You need to work on all of the muscles from the front of your shoulder all the way down to your thumb muscle in your hand (the rest of your fingers are moved by your flexors and extensors). Massaging your hand is like pulling your hair as hard as you can and then massaging your scalp to stop the headache. Your hand movement comes from your forearm and that’s the only place that will work when you are trying to make a difference.
I suggest you read the entire website thoroughly so you can understand what is happening, and if you didn’t read the Home Page of https://julstromethod.com, it will definitely be worthwhile for you to do so. Also read the sections titled “Muscles and Pain” and “What’s Happening Exactly.” You can release the spasms, I’m sure of it. By the time you go to the PT (who is going to give you exercises) you’ll have full movement of your hand and wrist again and be ready to do the strengthening exercises to finish off the situation.
Wishing you well,
Julie
twobad11
Dr. Donnelly,
I am a senior Warrant officer in the Army. I just had a long 8 week period in a cast for a wrist fracture/Dislocation surgery. Was wondering if my Doc is telling me everything I need to know. Is it usual to have a very stiff wrist after cast removal? I have been working my muscles…. but it does not seem to affect the mobility. If you coud help me understannd what exercises in the forearm i should be doing, it is appreciated. I cant move my hand more than a couple centimeters either up or down. Howeer, been trying to keep my sexy at the gym. thanks
Chief
Julie Donnelly
Hi Chief,
I totally understand the stiffness when the cast is removed. The problem is that your muscles snapped back into spasms when you had the initial break, and then the bone was fixed but the muscles weren’t released. As you were in the cast the muscles just got tighter and tighter. The analogy I use is, if you pulled your hair hard on the right, and also pulled it hard on the left, you wouldn’t be able to turn your head in any direction, but all you need to do is let go of your hair.
It’s the same with muscles. When they snapped back into the spasms, it was the muscles on the top of your forearm (the extensors; lifts your flat hand up off a table toward the ceiling) and your flexors on the under side of your forearm (brings your hand down). Because they are both tight you can’t move up or down. Plus there is a muscle called brachioradialis that brings your hand to the side (thumb moving sideways). With the muscles pulling in all three directions you can’t move. You need more than just a massage (doesn’t get to the deepest fibers, even if it’s called a deep tissue massage).
Have you looked at http://www.CarpalTunnelTreatment.org? You can self-treat the muscles properly and successfully. The treatments are very deep, and focused on specific spasms, but it’s not hard to do. Don’t get discouraged, I know you can make it 100% better by releasing the tension in these muscles.
Wishing you well,
Julie
kathy morris
i fell in work on my elbow causes a break to my radius and to cracks going up in to my joint of my left hand the pain still as bad as the day i done it even after taking the cast off , im haveing phyios but my wrist lockes the hand shakes and the pain so bad never hand this till i started phyios why is it happening
Julie Donnelly
Hi Kathy. When a bone breaks the muscles attaching to the bone will snap to their shortest length, and then stay that way until they are treated to eliminate the spasms that formed in the fibers. The odds are you are doing exercises that are further shortening the muscles of your lower arm. This is putting an additional strain on the insertion point where the tendons attach to the bones of your hand. I suggest you release the spasms in the muscles of your flexors and extensors (lower arm muscles). You may want to consider getting the Julstro System (see http://www.julstro.com/wrist-and-hand-pain/) which fully explains the muscles that insert into your wrist, as well as all of the muscles that will cause hand/wrist pain and numbness. The Julstro System teaches you how to treat each of these muscles properly. You can also go to a trigger point massage therapist, although it will take several sessions before the muscles release fully and stay in their normal length.
The odds are excellent that the pain will be eliminated after the tight muscles are released.
Ciano
Hello,
My mate just said after he got his cast removed, he just forced his hand to close by his will. He said it hurt but now he can move his hand freely. As someone who broke his hand once too, i can’t even fathom the idea of what he did, is the thing he did scientifically possible? It sounds way too painful and weird to me.
Sincerly,
Ciano Huang
Julie Donnelly
Hi Ciano,
Yes, it is possible, even probable. It would have been MUCH easier if he had released the spasms in his forearm muscles before trying to force his hand shut. When you “untie” the spasms (knots) the muscles move easier, and without straining the fibers. That is exactly what I teach in all of my products…how to release the spasms and then stretch the muscles.
Wishing you well,
Julie
Ciano
Hello again,
Does the method of forcing your hand to move have any cons? Like pain for a long time? If i ever break a bone again, i’m considering using the forceful method too.
Sincerly,
Ciano Huang
Julie Donnelly
Hi Ciano. The negative can be that the muscle fibers will tear if they are so tight and then forced to stretch without first releasing the spasms. It’s quite easy to release the spasms and flush out the muscle fibers so there isn’t any reason to take the chance of tearing the fibers.
I had a serious ankle break, it was so bad that my foot was only held on by my muscles and tendons, the end of the long bones, where they meet the ankle joint, were all broken in half. I did exactly what I’m suggesting to you. I worked deeply on all of the muscles that cross over the ankle joint and it took the strain off the joint. When the cast was removed I worked even deeper because I could now go along the entire length of the muscle. AFTER releasing all the spasms and the contraction in the muscles, I would then forcefully stretch and move my ankle.
In one week I had full range of motion in my ankle, although I couldn’t put put my foot on the floor to try to walk for three months while the bone was healing.
I know that what I’m suggesting works, so I suggest you don’t just stretch while the muscle fibers are in knots and putting a strain on the tendons and the joint.
Wishing you well,
Julie
Abdul Kareem
i had a injury in my right hand radius dislocated and fractured falling from bike i had put cast for 6 weeks, after removing cast i cant move my right hand properly i doing my physio therapy but still i cant move my right hand properly if you have any solution suggest me what kind of exercise treatment i need to do
Julie Donnelly
Hi Abdul,
My experience in working with clients who can’t move after a cast is removed, even though they are doing physical therapy, is that the muscles are so tight that the only way to release the tension is to do very deep, focused and not-sliding therapy on each muscle that inserts into the joint.
I’ve been teaching people for years how to do this self-therapy, but it is very time-consuming and won’t be an overnight solution. The primary muscles for you to treat are your flexors and extensors (your lower arm muscles), but muscles in your upper arm, shoulder, and your thumb are also most likely involved.
You can either look for a massage therapist who is thoroughly trained in doing trigger point therapy, or you can consider either buying my book,
Treat Yourself to Pain-Free Living,” and do it yourself, or if you’d prefer we could do a Skype consultation and I’ll work with you to find all the places that need to be treated.
In any case, as long as your doctor has done x-rays and shown that your bones have healed properly and shouldn’t be causing any restrictions, the only thing left is either weak muscles or nerves not sending a “move” signal or tight muscles preventing your wrist from moving. My field of expertise is the tight muscles, so that’s the only one of these causes that I can help you resolve. The good news is I have seen so many people get relief that I believe you will return to normal as soon as you isolate the CAUSE of your problem.
Lil
Quick question – got my cast off for breaking my wrist and when I try to move it sideways in the direction to my thumb, can only move a little then it’s painful like my bone is still broken and if I try harder, it gives me very sharp pains and feels like my bone’s going to snap -so is that normal and that’s my muscle??
Julie Donnelly
Hi Lil,
When a bone breaks it causes the attached muscle to go into a spasm and shorten. The bone is set and heals, but the muscle is still short, so it’s putting pressure on the insertion point. It’s like pulling your hair and your scalp hurts, in the same manner, the muscle is pulling on the tendon and the bone hurts. I suggest you massage the muscle that is in spasm, with a goal of lengthening it toward your thumb. There are a lot of muscles in your forearm so I’d need to see where you’re feeling the pain to figure out which muscle needs to be treated. I suggest you consider getting the Julstro System for Hand/Wrist Pain as you’ll learn how to self-treat every muscle in your arm, plus a lot more. Once your muscles are released the pain and stiffness should be eliminated unless there is something wrong with the way the bone was set (unlikely, but it is possible).
Lil
Hi Julie! Thanks very much! That explains it! Much appreciated! Will keep massaging and exercising it… hope it gets strong again…
Thanks!
Lil
Julie Donnelly
You’re welcome Lil. Please feel free to come back and let me know how you are doing. Julie
Chris Harvey
As similar To those above I’ve just had a cast removed and and feeling the pain as the day I broke it. However I broke my scaphoid a while ago and had a lot less pain prior to the cast. I had a non Union bone graft and screw put in. After 7 weeks the dr said its not yet healed but removed cast anyway and the screw is “proud” so is catching on things in my hand and at times is painful. This just doesn’t seem right to me. 7 weeks moving my wrist and using a splint seems a bit risky in its condition.
Julie Donnelly
Hi Chris,
Somehow your message was sandwiched in between some answers to the other lady with the wrist pain, and I’m only just reading it tonight. It’s been six weeks since you wrote and I apologize for this delay. I hope you were able to read other messages and find some solutions. How are you doing now? I find it amazing that the cast was removed, has that screw situation been resolved.
Please send an email to CustomerService@Julstro.com and Sue, my Customer Service Manager will forward it to me so we can talk about this outside of the blog. These next two weeks I’m traveling and speaking at three different conventions and meetings. I’ll watch for your email and get back to you asap.
If you haven’t already gone there, please look at http://www.CarpalTunnelTreatment.org which is a page on the http://www.Julstro.com website. This page is dedicated to the hand and wrist and should have some information that will help you sort this out.
I’ll look forward to hearing from you.
Wishing you well,
Julie
Audrey
My scaphoid was fractured six weeks ago the doctor removed the cast , however my wrist is still swollen and my finger cannot bend ,.. What should i do?
Julie Donnelly
Hi Audrey,
It unfortunately common for a person to not have normal range-of-motion after having broken a bone, but fortunately it is simple to reverse the stiffness. I just responded to another comment that was very similar to what you are experiencing. I’m going to copy that response here so you can read it, and I’ll make additional comments where it fits:
First an explanation of the basics: a muscle originates on one bone, merges into a tendon, and the tendon crosses over the joint before it inserts into the bone on the opposite side of the joint. For example, your forearm muscles merge into tendons that cross over your wrist and insert into your hand and fingers. When a bone breaks, especially a joint, the muscle snaps back as the tension is released.
Think of an elastic band that is being stretched from one end of a stick to the other end of the stick. If the stick breaks the band snaps back and brings the two broken ends of the stick closer together. This is what is happening when a bone breaks. When it happens you can’t move your joint properly, and in some cases you can’t move it at all.
As the muscle snaps back it causes multiple spasms (knots in the muscle fibers) to develop. The spasms cause the muscle to shorten, but as the bone is being set the muscle is stretched back to full length. Unfortunately the spasms aren’t released, so the muscle is actually too short to go the distance from the one bone to the other. You don’t feel it while you’re under anesthesia, but as the anesthesia wears off you may feel pain at one or both of the bones. This is the muscle pulling, causing pain just like pulling your hair will cause pain at your scalp. To stop the pain in your scalp you need to let go of your hair, and in the same manner, to stop the pain on the bone you need to release the spasms/knots in the muscle. Your wrist is actually controlled by the muscles of your forearm. When they are tight because of spasms/knots, you are only going to move as far as the muscle will lengthen. Apparently the muscle that goes to that finger is completely contracted so it won’t lengthen enough to let you bend your finger.
With that said, the muscles of your forearm all need to be treated to release the spasms that developed when your wrist bone broke.
When the bone is set it is extremely unusual for anyone to release the muscles, but you can do it yourself. If you go to http://www.julstro.com and click on the wrist in the graphic on the Home Page, you’ll be able to read about a product I developed when I had severe carpal tunnel syndrome and couldn’t use my left hand. It was horrible, and it completely disappeared when I figured out how to treat each of the muscles.
Wishing you well,
Julie
Meridith Scherer
I found this post because I’m dealing with the same thing. Broken wrist from a car accident and after the cast was removed I can’t flip my hand palm up and my hand and wrist are extremely stiff with limited movement. I am starting PT on Wednesday but I feel I need a trigger point massage first. Is there anything I can or have my husband help me do? When I don’t elevate my arm it gets very swollen and circulation doesn’t seem great. Using my essential oils is helping but I feel like I need to stop the spasms and get rid of the tightness.
Julie Donnelly
Hi Meridith,
First an explanation of the basics: a muscle originates on one bone, merges into a tendon, and the tendon crosses over the joint before it inserts into the bone on the opposite side of the joint. For example, your forearm muscles merge into tendons that cross over your wrist and insert into your hand and fingers. When a bone breaks, especially a joint, the muscle snaps back as the tension is released.
Think of an elastic band that is being stretched from one end of a stick to the other end of the stick. If the stick breaks the band snaps back and brings the two broken ends of the stick closer together. This is what is happening when a bone breaks. When it happens you can’t move your joint properly, and in some cases you can’t move it at all.
As the muscle snaps back it causes multiple spasms (knots in the muscle fibers) to develop. The spasms cause the muscle to shorten, but as the bone is being set the muscle is stretched back to full length. Unfortunately the spasms aren’t released, so the muscle is actually too short to go the distance from the one bone to the other. You don’t feel it while you’re under anesthesia, but as the anesthesia wears off you may feel pain at one or both of the bones. This is the muscle pulling, causing pain just like pulling your hair will cause pain at your scalp. To stop the pain in your scalp you need to let go of your hair, and in the same manner, to stop the pain on the bone you need to release the spasms/knots in the muscle.
With that said, the muscles of your forearm all need to be treated to release the spasms that developed when your wrist bones broke.
When the bone is set it is extremely unusual for anyone to release the muscles, but you can do it yourself. If you go to http://www.julstro.com and click on the wrist in the graphic on the Home Page, you’ll be able to read about a product I developed when I had severe carpal tunnel syndrome and couldn’t use my left hand. It was horrible, and it completely disappeared when I figured out how to treat each of the muscles.
Wishing you well,
Julie
Aisha
My son’s broke both of his bone in his wrist, the ulna and the radius. His cast was removed after 7 weeks, but his wrist is still bent. Its not straight, the Dr. said it will straighten out in a couple of weeks. Is this true? I’m very worried.
Julie Donnelly
Hi Aisha,
I’m appalled that your message is almost a year old and I’m only just seeing it for the first time! It’s even worse because it’s your son who was having the problem. I’m so sorry! How is he doing now? The plus side of muscles is that they can always be released, even if they have been tight for many years. I want to work with you, how is he doing now? Please contact me directly and we’ll work on this together. You can reach me at customerservice@julstro.com.
Wishing you well,
Julie