After the Cast Comes Off: Regaining Movement After a Fracture

After six weeks in a cast, you expect to feel relieved when it comes off. Instead, the limb often looks thin, feels stiff, may be swollen and has dry, flaky skin. Many people are surprised by how weak and awkward it feels.

All of this is normal, and it improves with the right exercises.

Why it feels this way

• Muscle wasting: muscles shrink quickly when not used
• Joint stiffness: joints above and below the fracture stiffen when held still
• Swelling: fluid collects once the limb is hanging down and moving again
• Sensitivity: the skin may be extra sensitive after being covered
• Confidence: fear of re-breaking the bone is very common

The first few weeks

1. Follow your doctor's guidance about how much weight and force you can use. Bone continues strengthening for months after the cast is off.
2. Gentle movement: start moving the joints that were held still. Little and often, several times a day.
3. Manage swelling: elevate, use cold packs wrapped in cloth, and keep moving.
4. Skin care: wash gently and moisturise.

Example exercises

After a wrist fracture:

• Bend the wrist up and down, and side to side
• Turn the palm up and down with the elbow by your side
• Make a fist, then spread the fingers wide
• Squeeze a soft ball or rolled towel

After an ankle fracture:

• Ankle circles, pointing the foot up and down
• Write the alphabet with your toes
• Calf raises, holding on to a counter, once allowed to bear weight
• Balance practice, standing on one leg near a support

Building strength and function

As movement returns, your physiotherapist will add resistance with bands and weights, then practical tasks: carrying shopping, gripping, climbing stairs, squatting, and sport-specific skills.

How long does it take?

Many people regain most of their function within 6 to 12 weeks after the cast comes off, but full strength can take longer, especially after complex fractures or surgery.

When to get help

See a physiotherapist if stiffness or swelling isn't improving, you can't use the limb for daily tasks, or you're unsure what's safe. Seek medical advice promptly if you have severe pain that seems out of proportion, colour or temperature changes in the limb, or increasing swelling.