Summer has finally arrived! The sun is shining, so we’re all itching to get outside and be active – to play sports, hike mountains, and ride bikes!
Unfortunately, sports can lead to hard falls, and we occasionally fall off our bikes.
Falling onto an outstretched hand can lead to a Colles’ fracture in your wrist. When talking about bones, “broken” and “fractured” mean the same thing.
A “Colles’ fracture” is a type of broken wrist, and I’m going to guide you through the process of a Colles’ fracture from diagnosis to treatment.
These are the exact tips and tricks we use every day in the clinic! So you’re going to get some real insider knowledge!
I’ve broken this blog down into sections for you:
- How Do I Know If I Have A Colles’ Fracture?
- What to Expect
- Best Beginner Exercises
- Best Intermediate Exercises
- Best Advances Exercises
Let’s get the boring stuff out of the way first, and take a look at what’s going on inside your wrist right now:
There’s a lot more to wrists than most people realize. The “wrist” is made up of 8 different smaller bones (called carpal bones).
We also have 2 forearm bones (called your radius and ulna) that connect to various parts of these 8 wrist bones. If you have a broken wrist, it’s most likely you actually fractured a forearm bone (usually your radius).
If the break is close to the carpal bones, it will simply get called a “wrist fracture” or “broken wrist”, as that makes sense to most people.
A Colles’ fracture is a type of radius bone fracture, close to the carpal bones.
While this picture only shows the bones, it is important to remember that our wrists also have muscles/tendons, nerves, arteries, and veins running through them, as well as A LOT of ligaments (don’t believe me? Google: “ligaments of the wrist”).
How Do I Know If I Have A Colles’ Fracture? Wrist Sprain vs. Wrist Strain vs. Wrist Fracture
A broken wrist refers to a bone injury, but how do we know if it’s a bone injury or something different?
It’s simpler than you may think.
Your three general injuries are fractures/breaks, strains, and sprains.
A fracture/break means you injured a bone. Whether it be cracked, chipped, or broken into 2 or more pieces. This is where the Colles’ fracture falls.
A strain means you injured a muscle. Muscles are what let us move and control our body movements. Because we can control them, they are considered active structures.
- TIP: The ends of muscles turn into the tendons that attach to your bones. So if you injure a tendon, it is typically called tendonitis.
A sprain means you injured a ligament. We are unable to directly control our ligaments, so they are considered passive structures.
- Your ligaments are what actually hold your bones together.
So, how do you know if you have a Colles’ fracture? Great question.
First, a Colles’ fracture almost always has an associated “event” or “trauma” – like a fall onto your hand/wrist, or car accident. Whereas muscle or tendon injuries usually come from overloading the wrist (i.e. after a lot of lifting, or gripping).
That said, wrist sprains (ligament injuries) also usually have an associated “event”, most commonly when a sudden or gradual awkward movement/twisting of the wrist occurs. Differentiating a Colles’ fracture from a “sprained wrist” can be challenging at times. – but we’ve got you covered.
Check it out:
As seen in the above table, a Colles’ fracture has a “classic sign” called the dinner fork deformity, as the radius breaks and displaces toward the back of the hand:
A Quick Description of a Colles’ Fracture:
A Colles’ fracture is a type of wrist fracture in a group called distal radius fractures.
Do you really need to know that? – No. But think of the trivia knowledge you have now!
Distal Radius Fracture
Distal means “away from the centre of your body”, so in this case, closer to your hand.
Your radius is the forearm bone that connects to your carpal (wrist) bones, on the thumb side of you hand.
Therefore, a “distal radius fracture” is a broken forearm bone close to your wrist crease, on the thumb side.
A Colles’ fracture is a type of distal radius fracture.
As we already know, this usually happens by falling onto an outstretched hand, but specifically with your hand extended backwards.
This fracture causes the broken piece of the radius bone to move higher up on the back of the wrist. Thus resulting in the dinner fork deformity above.
What to Expect
First of all, the one surefire way to know if you have a Colles’ fracture is to get an xray. Then, the doctor will determine if you simply need a cast, or if you may need surgery.
If you don’t require surgery, your bones will be “set” back into place, and your arm will be put in a cast.
How long you spend in that cast is actually quite a large variable of 2-12 weeks.
Why a huge variable?
- Age – children typically require less time in a cast
- Complications or risk of complications may mean you’re in the cast longer
- Whether or not you had surgery
- Whether or not the bone is healing back together properly (when it’s not healing well it’s usually called malunion or non-union) – if the bone is slow to heal back together, then the cast will be on for longer.
Note: sometimes you will go in one cast for 1-2 weeks (when the swelling is at its highest), then you’ll get a new, longer-lasting cast once some swelling has subsided.
When your bone heals, the surgeon/specialist will take off the cast, and you will start physiotherapy.
Depending on your goals, what you want to be able to do with your hand (what you do for work, what sports you play, whether or not there were complications with your fracture/surgery etc), physiotherapy will usually last 1-6 months after your cast comes off.
When you will be able to return to work and sports is highly individualized. No surprise there, given a 2-12 week and a 1-6 month variance levels.
But enough! Here’s what you really want to know:
There are lots and lots of options for exercises after your cast comes off. The best thing to do is to have a physiotherapist assess your individual situation so that the most individualized plan of care can be created. For the sake of this blog, I will outline 2 beginner exercises, 2 intermediate exercises, and 2 advanced exercises. These are in no way inclusive, and are certainly not for everyone. They are intended to be used for information purposes only, and not as strict medical advice.
Best Beginner Exercises for Healing Your Colles’ Fracture
- Get a squishy stress ball and hold it in your hand
- Squeeze it (without pain) and hold for 5-10 seconds. Repeat 10 times. Do 3-5 times per day.
Wrist flexion and extension range of motion
- Support your forearm, and bend your wrist up and down as far as you can (pain-free).
- You can use your other hand to help it go further. Repeat 10 times in each direction. Rest. Do 10 more in each direction. Repeat 3 times per day.
Intermediate Colles’ Fracture Rehabilitation Exercises
Wrist flexion and extension with dumbbell
- As above, but hold a dumbbell in your hand. Repeat 2 sets of 10 reps. 2 times per day.
Wrist pronation and supination with hammer
- Hold a hammer in your hand with your elbow bent to 90 degrees.
- Rotate the hammer in each direction. Start with 10 times each way. Do 2 sets. Repeat 2 times a day. The closer your hand is to the head of the hammer, the easier it will be.
Advances Colles’ Fracture Rehabilitation Exercises
- Start from your hands and knees if you have to, and try to progress to full push ups (from your toes). Progress to 2 sets of 10 reps. Complete 1-2x/day.
- Stand on a step in front of a pull up bar. Grab onto the bars so your palms are facing you.
- Pull yourself up, squeezing your shoulder blades together, until your chin is above the bar. Slowly lower yourself back down and repeat.
- Try to progress to 2 sets of 10 reps. Complete 1-2x/day
By reading this blog, you now understand the anatomy of the wrist, how to know if you have a Colles’ fracture, and what you should do about it if you do! At Strive Physiotherapy & Performance, we are committed to providing an in-depth, one-on-one assessment to ensure we can work together to find the best plan of action for each individual client. Did you sustain a Colles’ fracture? Call us at 519-895-2020, or use our online booking tool on www.strivept.ca
to book an appointment with one of our knowledgeable physiotherapists, and they will be sure to help you understand your injury.
Physiotherapist at Strive Physiotherapy & Performance