Paediatric Orthopaedic Specialist
After elbow cast
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
For whom: After cast removal and confirmation of healing: start only authorised movements. Loading, resistance and sport need fracture-specific instructions; avoid forced passive manoeuvres. Gradual daily activities are sufficient in many uncomplicated cases.
Dose and frequency: Perform only the exercises selected during the visit. The listed dosages are examples to adapt: follow the dose, frequency, rest and progression prescribed for age, symptoms and phase. Do not automatically perform the whole list.
Equipment and supervision: A stable, clear surface, comfortable clothing and a secure support. Check resistance-band anchors. Adult supervision; avoid marbles and small objects if the child may put them in their mouth, using a towel instead.
Avoid: Forcing a painful or unauthorised movement; Increasing load, resistance or frequency without the agreed rest periods; Doing balance exercises without stable support or supervision.
1.Active assisted flexion and extension
Active elbow movement, when advised for this fracture
When permitted, actively bend and straighten the elbow within a comfortable range. The other hand may guide the arm only if assistance has been advised; do not push to gain the last degrees. Progress with tolerated daily use.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
2.Forearm pronation-supination
Recovers forearm rotation (turning palm up and down)
If rotation is permitted, keep the elbow near the side and slowly turn the palm up and down. Stay within a comfortable range; do not push the restricted direction or use a lever.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.3.Active forearm rotation
Pronation and supination without levers, within the authorised range
A variation of forearm rotation, not a second dose to add. If the treating clinician permits movement, keep the elbow near the side and actively turn the palm up and down within the prescribed range. Do not use objects as a lever or have an adult force the arm. Stop for pain or locking; assisted or passive movement only if prescribed and demonstrated for this fracture.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
4.Recovery of permitted flexion and extension
Active mobility; assistance only when prescribed and demonstrated
A variation of active elbow bending and straightening, not a second dose to add. If the treating clinician permits movement, actively bend and straighten the elbow within the prescribed range without forcing the last degrees. Neither the other hand nor an adult should push the arm; assisted or passive movement only if prescribed and demonstrated for this fracture. Stop for pain or locking.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
5.Progressive strengthening - flexors
Strengthening muscles that bend the elbow
Strengthening is not routinely needed after every fracture. Only if advised by the treating clinician after healing: bend the elbow without weight, then with prescribed light resistance, avoiding increasing pain or swelling.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
6.Daily functional activities
Use the arm in daily activities to recover function
Gradually resume eating, dressing, washing, drawing and quiet play with the arm, within the given limits. Throwing, sport, fall-risk activities and heavier loads require fracture-specific advice; cast removal is not automatic clearance.
Gradually resume everyday activities already permitted, without counting sets or repetitions. Follow fracture-specific limits for heavier loads, throwing and sport.
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- A red or hot joint, or inability to bear weight: seek prompt assessment; use emergency care if severe.
- Acute pain during mobilization exercises
- Persistent or increasing swelling
- Complete joint block
- Feeling of instability
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Paediatric Orthopaedics - ASST Gaetano Pini-CTO
Content version: 24 September 2026
ortopediaevolutiva.com • Printed: 18/10/2026
Full sheet and videoshttps://ortopediaevolutiva.com/en/parents-kids/exercises/post-cast/after-elbow-cast
Prepare the visit handout
Use the condition and phase indicated by your clinician. You can leave out individual exercises; instructions, illustrations and safety advice remain together.
Exclude exercises if needed
6 of 6 exercise cards included
The full web page remains available. Your selection is not saved or shared.
Before You Start
Who is this guide for?
After cast removal and confirmation of healing: start only authorised movements. Loading, resistance and sport need fracture-specific instructions; avoid forced passive manoeuvres. Gradual daily activities are sufficient in many uncomplicated cases.
What you need
A stable, clear surface, comfortable clothing and a secure support. Check resistance-band anchors. Adult supervision; avoid marbles and small objects if the child may put them in their mouth, using a towel instead.
Suggested frequency
Perform only the exercises selected during the visit. The listed dosages are examples to adapt: follow the dose, frequency, rest and progression prescribed for age, symptoms and phase. Do not automatically perform the whole list.
Common mistakes to avoid
- •Forcing a painful or unauthorised movement
- •Increasing load, resistance or frequency without the agreed rest periods
- •Doing balance exercises without stable support or supervision
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- A red or hot joint, or inability to bear weight: seek prompt assessment; use emergency care if severe.
- Acute pain during mobilization exercises
- Persistent or increasing swelling
- Complete joint block
- Feeling of instability
Detailed Exercises
- 1
Active assisted flexion and extension
Active elbow movement, when advised for this fracture
When permitted, actively bend and straighten the elbow within a comfortable range. The other hand may guide the arm only if assistance has been advised; do not push to gain the last degrees. Progress with tolerated daily use.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.Bend and straighten your elbow
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Brief demonstration of the approved movement; follow the individual dose and limits in the exercise sheet. The video does not replace the full programme.
- 2
Forearm pronation-supination
Recovers forearm rotation (turning palm up and down)
If rotation is permitted, keep the elbow near the side and slowly turn the palm up and down. Stay within a comfortable range; do not push the restricted direction or use a lever.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme. - 3
Active forearm rotation
Pronation and supination without levers, within the authorised range
A variation of forearm rotation, not a second dose to add. If the treating clinician permits movement, keep the elbow near the side and actively turn the palm up and down within the prescribed range. Do not use objects as a lever or have an adult force the arm. Stop for pain or locking; assisted or passive movement only if prescribed and demonstrated for this fracture.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme. - 4
Recovery of permitted flexion and extension
Active mobility; assistance only when prescribed and demonstrated
A variation of active elbow bending and straightening, not a second dose to add. If the treating clinician permits movement, actively bend and straighten the elbow within the prescribed range without forcing the last degrees. Neither the other hand nor an adult should push the arm; assisted or passive movement only if prescribed and demonstrated for this fracture. Stop for pain or locking.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme. - 5
Progressive strengthening - flexors
Strengthening muscles that bend the elbow
Strengthening is not routinely needed after every fracture. Only if advised by the treating clinician after healing: bend the elbow without weight, then with prescribed light resistance, avoiding increasing pain or swelling.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.Elbow curl with a light bottle
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Shows only an elbow curl with a light bottle, after confirmed healing and individual clearance for strengthening. Bottle weight is not measured; no automatic dose or progression.
- 6
Daily functional activities
Use the arm in daily activities to recover function
Gradually resume eating, dressing, washing, drawing and quiet play with the arm, within the given limits. Throwing, sport, fall-risk activities and heavier loads require fracture-specific advice; cast removal is not automatic clearance.
Gradually resume everyday activities already permitted, without counting sets or repetitions. Follow fracture-specific limits for heavier loads, throwing and sport.Drawing with a crayon
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Only after confirmed healing and individual clearance for movement and loading. Illustrates drawing only; the other activities in the exercise sheet are not demonstrated.
Washing hands and arms
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Only after confirmed healing and clearance from the treating clinician. Shows washing only, not the other daily activities on the sheet.
Stacking two blocks
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Only the quiet activity of stacking two blocks, within the limits already cleared. Other daily activities in the exercise sheet are not demonstrated.
Gentle soft-ball toss
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Shows only a soft-ball toss from the child to the doctor, after specific clearance. Catching by the child and the other activities are not demonstrated.
Using a spoon to eat
Press Play to load the video. Follow the instructions and precautions on this exercise sheet.
Only after confirmed healing and clearance from the treating clinician. Illustrates eating with a spoon; it is not a prescribed technique and does not cover all activities on the sheet.
Frequently Asked Questions
How long does it take to recover elbow mobility after a cast?
Recovery varies with the fracture, treatment and immobilisation and may continue for months. Many children need only gradual resumption of permitted daily activities and gentle active movement; physiotherapy is not automatically necessary. The treating clinician checks progress and selects any exercises.
Is it normal for the elbow to still be stiff after cast removal?
Some stiffness can occur after a cast and often improves with permitted normal use. Do not force the elbow; contact the treating clinician if pain, swelling or movement worsens.
Should I worry if my child cannot fully extend their elbow?
Temporary loss of extension is common, but progress and follow-up depend on the injury. Attend the planned review and contact the treating clinician earlier for increasing pain, swelling, locking or worsening movement rather than waiting 2–3 months. Do not push the elbow to gain the last degrees.