C.J. Allen Upper Extremity & Hand Therapy treats patients throughout Holbrook from our Hauppauge clinic. Every therapist here works exclusively on the hand, wrist, elbow and shoulder, and a large share of what we see are fractures and the stiffness that follows them.
Recovering From a Wrist or Hand Fracture
A distal radius fracture — a broken wrist, usually from a fall onto an outstretched hand — is one of the most common injuries we treat. The bone typically heals on schedule. The problem is what happens around it: six weeks in a cast leaves the wrist stiff, the fingers swollen, and the forearm unable to rotate. That is what therapy addresses, and starting promptly after the cast comes off makes a substantial difference to the eventual range of motion.
Why Stiffness Is the Real Enemy
Immobilization is necessary for healing but costly for motion. Joints held still develop tightness in the capsule and surrounding tissue within weeks, and once that is established it takes far longer to reverse than it did to develop. This is why we begin working on the uninvolved joints — fingers, elbow, shoulder — even while a fracture is still protected.
Conditions We Treat
- Wrist, hand and finger fractures, casted or surgically fixed.
- Post-surgical rehabilitation of every kind.
- Tendon injuries and repairs.
- Carpal tunnel syndrome and nerve compression.
- Trigger finger.
- Thumb and hand arthritis.
- Sprains, ligament injuries and dislocations.
- Tennis and golfer's elbow.
Understanding Hand Arthritis
Arthritis in the hand takes two main forms and they behave differently. Osteoarthritis is wear of the cartilage that cushions a joint. In the hand it settles most often at the base of the thumb, and at the joints nearest the fingertips. It tends to build gradually, ache after use, and stiffen after rest. Rheumatoid arthritis is an autoimmune condition in which the body attacks its own joint lining. It typically appears symmetrically — the same joints on both hands — with swelling, warmth and prolonged morning stiffness.
The distinction matters because the management differs. Rheumatoid arthritis needs medical treatment directed at the disease itself, alongside therapy. Osteoarthritis is managed mechanically: change the loads through the joint and you change the symptoms.
How Hand Therapy Helps
Therapy cannot reverse arthritic change. What it can reliably do is reduce pain and keep the hand working, and for most people that is the outcome that actually matters.
- A custom orthosis that rests and supports the painful joint — for thumb-base arthritis in particular, a well-made splint often makes the difference between managing a jar lid and not.
- Manual therapy and joint mobilisation to ease stiffness and maintain the motion you have.
- Grip and pinch strengthening, dosed carefully — too much aggravates an arthritic joint, too little lets the hand weaken further.
- Joint protection technique for cooking, cleaning, typing and gardening: how to spread load across larger joints instead of concentrating it on small ones.
- Adaptive tools that reduce strain — jar openers, built-up handles, key turners. Unglamorous, and often the single most useful thing we do.
- Heat, cold and pain-management strategies you can apply at home rather than only in clinic.
What Your First Visit Looks Like
The first appointment is mostly assessment. We take a history — what happened, what you have been told, what you are struggling to do — then measure range of motion, grip and pinch strength, swelling and sensation, so there are baseline numbers to track against rather than impressions.
We look at the whole upper limb, not just the painful part. Wrist pain frequently traces back to the elbow or shoulder, and treating only where it hurts is how people end up back six months later.
You will usually start treatment the same visit and leave with something to do at home. If a splint is needed, we can often fabricate and fit it during that appointment rather than ordering something in.
Swelling Management
Persistent swelling after a fracture is not merely cosmetic — it physically limits how far a joint can bend and makes movement painful, which leads to less movement and more stiffness. Compression, elevation, specific manual techniques and appropriately dosed motion break that cycle. Addressed early it resolves readily; left for months it becomes considerably harder.
Custom Splinting
Orthoses are fabricated on site and molded to your hand. After a fracture, a removable custom splint often replaces a cast for the final weeks — protecting the healing bone while permitting the controlled motion that prevents joints from locking up.
Regaining Strength
Strength returns last, after motion and swelling are addressed, and it is where people tend to lose patience. Grip strength after a wrist fracture commonly takes three to six months to normalize. We progress loading deliberately and measure it, so progress is visible even in weeks where it does not feel like much is happening.
Your Home Program
Most of the recovery happens between visits. We give you a short, specific program, confirm your technique in the clinic, and advance it as you improve rather than handing over a generic sheet at discharge.
Three exercises you will actually do beat twelve you will not. We would rather build the programme around your day — something you can do while the kettle boils, or during a break at work — than hand you a routine that needs half an hour and a quiet room you do not have.
Exercises We Commonly Prescribe
Every plan is different and yours should come from your therapist. But these are the movements we teach most often, so you know roughly what to expect.
Finger bends
Why: keeps the finger joints moving through their available range, which is what prevents the stiffness that follows immobilisation.
How: start with the hand open and flat. Curl one finger slowly toward the palm, hold a few seconds, release. Work through each finger in turn.
Thumb touches
Why: restores opposition — the thumb's ability to meet the fingers, which is what makes pinching and gripping possible at all.
How: touch the thumb tip to the tip of each finger in turn, forming an O each time. Hold briefly, repeat.
Tendon glides
Why: keeps the flexor tendons sliding freely inside their sheaths rather than adhering to the surrounding tissue. This is one of the most important movements after any hand surgery or immobilisation.
How: move through the positions in sequence — fingers straight, hook fist, full fist, tabletop, straight fist — pausing briefly at each.
Grip strengthening
Why: rebuilds the hand and forearm strength lost during immobilisation. Grip declines quickly and does not return on its own.
How: squeeze a soft ball or therapy putty, hold a few seconds, release. Ten to fifteen repetitions is a typical starting point, though we will set yours.
Wrist rotations
Why: improves wrist mobility and circulation, and helps reduce the swelling that limits motion.
How: elbow bent and tucked at your side, circle the wrist slowly one way, then the other.
One important caution. Do not start these on your own after surgery or a fracture. The right exercise at the wrong stage of healing can undo weeks of progress — and after a tendon repair it can rupture the repair outright. Wait until your therapist clears each movement specifically.
How Long Will It Take?
Fracture rehabilitation commonly runs eight to sixteen visits over two to four months, depending on the injury and how long the wrist was immobilized. You will get a realistic estimate at your evaluation, revised openly if things change.
Do I Need a Referral?
Bring your prescription, surgeon’s protocol, or referral to your first visit and we’ll build your treatment plan from there. If you’re not sure whether you need a referral, give us a call and we’ll sort it out with you.
One Therapist, Full Sessions
You work with the same Certified Hand Therapist for your entire appointment, every visit. After a fracture, progress is often a few degrees of motion in a week, and consistent eyes on it are what distinguish normal slow progress from a plateau that needs the plan changed.
Getting Here From Holbrook
Our Hauppauge office is northwest via Veterans Memorial Highway (Route 454), typically ten to fifteen minutes from most of Holbrook. Parking is at the building and the office is fully accessible — which matters if you are arriving in a cast or sling.
Scheduling and Insurance
Call (631) 761-6996 or request an appointment online. Most insurance accepted — our team will assist with insurance verification and help coordinate your care.