Therapy advice including care of casts after hand or arm injuries or operations

Swelling

Swelling is very common in the first few weeks following an injury or operation. You can reduce this more quickly by frequently moving your fingers to improve blood flow, and by raising your hand above your elbow resting on pillows.

Washing

Do not get the cast wet as it may break or damage your skin. Casts are sometimes called ‘plasters’ or ‘pots’. Watertight plastic sleeves are available to buy online or in pharmacies. Even if you use one of these, do not let your arm rest in bath water. Showering is better if possible. Alternatively, you can strip wash at a sink. If the cast does get wet, please contact the hospital immediately.

Getting dressed

Wear loose clothing to make getting dressed easier. When putting a top on, put the arm with the cast in first. When taking a top off, take the arm without the cast out first. You may need to adapt clothing to make armholes larger, as is shown in the image below.

Using the toilet

Loose clothing without buttons will help you use the toilet independently, but ask for help if you need it. It is best to use the uninjured hand to assist with personal hygiene and to avoid contaminating the cast with bacteria. Hand sanitizer and antibacterial wipes can be used to clean fingers so the cast does not get wet.

Eating

You may need to adapt how you hold your cutlery as this may be more difficult whilst your cast is in place. Ask someone to cut up food for you if necessary.

Moving yourself and carrying things

It takes about 6 weeks for a fracture to heal. During this time, do not put push down with the affected hand when getting up from a chair or bed, or pick up any heavy items.

Slings

You may need to wear a sling to keep your hand elevated, but when you are in bed or resting you should remove the sling and rest your arm on a pillow. Keep changing the position of your arm regularly to avoid pressure areas forming. Keep moving your unaffected joints to avoid stiffness.

School

You can return to school once your pain and swelling has improved. You or a parent or carer should contact the school once your cast is put on to ensure that any changes are put in place before you go back.

Top tips for school

• If you need to, ask a member of staff or a friend to carry things for you between lessons.
• Ask to start and finish lessons 5 to 10 minutes before the rest of the class if you need this time to change classrooms.
• Do not do any PE or games whilst the cast is on. Once the cast is taken off check when it is safe to start again with your therapist.
• If the hand you write with is affected, school may be able to provide you with a tablet.

Removal of the cast

Once the cast has been taken off, you should be able to return to normal activities within 6 to 12 weeks. Most people have some pain and stiffness because the wrist and hand has not moved normally for some weeks. This will gradually improve over time with exercise, which is important, and with normal daily activities. Therefore, routine referrals to therapy are not usually required. Do not do any contact sports such as football, rugby, hockey or netball for a further 12 weeks, unless advised otherwise by your therapist.