Follow-up after a fracture: cast, rehabilitation and course

The aim of treatment is for the fracture to heal without malalignment and with as few lasting problems as possible [1]. Fractures in good position usually need only a cast. Displaced fractures are first set back in place, and unstable fractures, fractures into the joint and comminuted fractures are often operated on [1].

The cast gives rest and protection so that the fracture can heal [3]. Swelling is reduced with cold and by keeping the arm or leg elevated, especially during the first two days [3]. In stable fractures of the upper part of the upper arm a sling is often used only for a short period, and rehabilitation can start after a couple of days [2].

After a long time in a cast the skin is often paler and drier, and the arm or leg may be thinner and weaker because the muscles have not been used. The joints can be sore and stiff and need time before mobility is normal again [3].

After a wrist fracture NHI describes that stiffness and reduced strength last 6 to 12 months in most people after the injury [1].

In wrist fractures the arm should be exercised early after the cast is removed. Everyday activities, play, sport and handicrafts are regarded as good exercises, and the load is increased gradually [1]. Everyone treated for a forearm fracture should be given instruction in exercises. For stable fractures physiotherapy does not give a better result than exercising on your own, while a physiotherapist or occupational therapist may be relevant for complicated fractures. If function and pain do not improve some weeks after cast removal, referral to rehabilitation may be necessary [1].

In fractures of the upper part of the upper arm NHI writes that guided physiotherapy and regular home exercises are decisive for the final result. Long-term shoulder stiffness is a possible complication, which underlines the need for rehabilitation [2]. Normal shoulder function is not achieved in everyone, and the result depends on regular exercises over several months [2].

After surgery, home exercises and physiotherapy can start as early as possible, with limitations depending on how the fracture was operated [2]. What the right load is in your situation is decided by the person who treated the fracture.

It varies with the type of fracture. With a cast on a wrist fracture in good position the cast is usually removed after about four weeks, and for stable fractures that have been set the cast can stay on for five to six weeks [1]. For fractures of the upper part of the upper arm NHI gives 8 to 12 weeks as common for stable fractures in good position and 6 to 12 months for malaligned and unstable fractures [2].

Most people recover fully after good treatment of wrist fractures, but long-term functional impairment is possible [1].

A cast that is too tight can cause damage over time. Contact a doctor or emergency care promptly in case of severe or increasing pain, numbness or tingling, cold, pale or bluish skin, or if you cannot move fingers or toes under the cast [1][4]. The same applies to increasing swelling, a cast that becomes wet or damaged, and blood, fluid or a bad smell from the cast [3]. In severe symptoms you should call 113 [4].

If pain and mobility do not improve some weeks after the cast has been removed, you should contact a doctor [1].

After the doctor has treated the fracture itself, a physiotherapist can follow up mobility, strength and gradual loading in consultation with what has been agreed with the treating doctor. You can read more about physiotherapy. When there is uncertainty about soft tissue injury, diagnostic ultrasound can be used as a supplement.

When can I start exercising after a fracture?

It depends on the fracture. In stable fractures of the upper part of the upper arm rehabilitation can start after a couple of days [2]. In wrist fractures the arm should be exercised early after the cast has been removed [1]. Follow the instructions of the person who treated the fracture.

Why is my arm or leg weak after a cast?

When the muscles have not been used, the limb often becomes thinner and weaker, and the joints can be sore and stiff. It takes time before mobility is normal again [3].

Do I need physiotherapy after a fracture?

Not always. In stable wrist fractures physiotherapy does not give a better result than exercising on your own [1], while guided physiotherapy is described as decisive in fractures of the upper part of the upper arm [2]. Ask the person who treated the fracture.

How long does stiffness last after a wrist fracture?

In most people stiffness and reduced strength in the wrist last 6 to 12 months after the injury [1].

The article on muscle strains and gradual return to activity describes a different course with gradual build-up. You can find more articles in the overview of articles.

This article was written by Dr.Dropin Fysikalske and is based on the sources listed below. It gives general information and does not replace an examination by a healthcare professional.

The websites were accessed and read on 22 October 2026.

1. Håndleddsbrudd (Wrist fracture). NHI.no. Last updated 3 April 2025. Link

2. Overarmsbrudd, øvre del (Fracture of the upper part of the upper arm). NHI.no. Last updated 16 December 2024. Link

3. Hansen TB. Gipsbehandling (Cast treatment). Patienthåndbogen, sundhed.dk. Professional update 24 July 2023. Link

4. Gipsbehandling, mulige komplikasjoner (Cast treatment, possible complications). NHI.no. Last updated 16 September 2025. Link