Specialista in Ortopedia Pediatrica
After finger/toe cast or immobilization
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Active flexion and extension
Basic exercise to recover finger range of motion
For HAND FINGERS: fully open hand spreading all fingers, then close into fist pressing fingers toward palm. Focus on reaching maximum extension and flexion. For TOES: seated, actively move toes up and down, trying to curl them (as if grasping) then fully extend. Slow, controlled movements.
15-20 reps, 4-5 times daily
2.Individual mobilization of each finger
Specific work on each individual finger, especially the immobilized one
With other hand (or with parent's help), grasp each individual finger and GENTLY mobilize: flexion (bend) and extension (straighten) of each joint (MCP, PIP, DIP for hand). For foot, mobilize each toe individually. Focus more on finger that was immobilized. Slow movements, don't force beyond pain.
10 reps per joint, for each finger, 3 times daily
3.Thumb-to-finger opposition (for hand)
Recovers coordination and fine grip of hand
Touch thumb tip to each fingertip in sequence: thumb-index, thumb-middle, thumb-ring, thumb-pinky, then back. Move slowly and precisely. If a finger is stiff, focus on that specific touch. Variation: make circles with thumb and each finger.
10 complete cycles, 3-4 times daily
4.Putty/playdough exercises (for hand)
Gradual playful grip strengthening
Use playdough or modeling clay. SQUEEZE: press ball with all fingers. PINCH: pick small pieces with thumb and each finger. ROLL: make "snakes" rolling between palms. TEAR: pull pieces apart. Start with soft dough, progress to firmer. Fun activity ideal for children.
5-10 minutes of play, twice daily
5.Object pick-up (for hand and foot)
Functional exercise to recover coordination and strength
For HAND: pick up small objects (beans, buttons, coins) with pincer grip (thumb + one finger at a time). Put them in container. For FOOT: scatter marbles, pencils or fabric pieces on floor and pick up with toes. Simple fun exercise that improves function.
10-15 objects, 1-2 times daily
6.Finger and hand stretching
Stretches structures shortened by immobilization
For HAND: with other hand, gently pull each finger into extension, then flexion, holding 15-20 seconds. Then extend wrist with fingers straight. For FOOT: with hand, mobilize toes into flexion and extension, spread toes apart. Gentle stretching, never painful.
3 × 15-20 seconds each direction
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)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
Versione Web
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MioDottoreBefore You Start
Who is this guide for?
Children who had finger splint/cast removed. Focus on fine mobility and grip function.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ 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)
Detailed Exercises
- 1
Active flexion and extension
Basic exercise to recover finger range of motion
For HAND FINGERS: fully open hand spreading all fingers, then close into fist pressing fingers toward palm. Focus on reaching maximum extension and flexion. For TOES: seated, actively move toes up and down, trying to curl them (as if grasping) then fully extend. Slow, controlled movements.
15-20 reps, 4-5 times daily - 2
Individual mobilization of each finger
Specific work on each individual finger, especially the immobilized one
With other hand (or with parent's help), grasp each individual finger and GENTLY mobilize: flexion (bend) and extension (straighten) of each joint (MCP, PIP, DIP for hand). For foot, mobilize each toe individually. Focus more on finger that was immobilized. Slow movements, don't force beyond pain.
10 reps per joint, for each finger, 3 times daily - 3
Thumb-to-finger opposition (for hand)
Recovers coordination and fine grip of hand
Touch thumb tip to each fingertip in sequence: thumb-index, thumb-middle, thumb-ring, thumb-pinky, then back. Move slowly and precisely. If a finger is stiff, focus on that specific touch. Variation: make circles with thumb and each finger.
10 complete cycles, 3-4 times daily - 4
Putty/playdough exercises (for hand)
Gradual playful grip strengthening
Use playdough or modeling clay. SQUEEZE: press ball with all fingers. PINCH: pick small pieces with thumb and each finger. ROLL: make "snakes" rolling between palms. TEAR: pull pieces apart. Start with soft dough, progress to firmer. Fun activity ideal for children.
5-10 minutes of play, twice daily - 5
Object pick-up (for hand and foot)
Functional exercise to recover coordination and strength
For HAND: pick up small objects (beans, buttons, coins) with pincer grip (thumb + one finger at a time). Put them in container. For FOOT: scatter marbles, pencils or fabric pieces on floor and pick up with toes. Simple fun exercise that improves function.
10-15 objects, 1-2 times daily - 6
Finger and hand stretching
Stretches structures shortened by immobilization
For HAND: with other hand, gently pull each finger into extension, then flexion, holding 15-20 seconds. Then extend wrist with fingers straight. For FOOT: with hand, mobilize toes into flexion and extension, spread toes apart. Gentle stretching, never painful.
3 × 15-20 seconds each direction
Frequently Asked Questions
Why are fingers so stiff after the cast?
Immobilization causes shortening of capsule-ligament structures and loss of tendon gliding. It's normal for fingers to be stiff - the key is to start mobility exercises as soon as possible after cast removal.
How long does it take to recover finger mobility?
Most mobility returns within 4-8 weeks with consistent exercises. Some children recover faster. If stiffness persists after 2-3 months, a physiotherapy evaluation may be helpful.