Seated radial deviation lifts your hand toward the thumb side of the wrist, against gravity. You sit at a table with your forearm resting on it, thumb pointing up and the hand free past the edge, then raise the hand toward the ceiling from the wrist and lower it again. There is no weight in the hand, so physios often use it in the early weeks of getting a stiff wrist going again, such as just after a cast comes off, and add a dumbbell later.

How to do the seated radial deviation

Sit at a table and rest your forearm on it, with a rolled towel under the forearm just behind the wrist, as in the video. Shuffle forward until the wrist sits at the table edge and the hand hangs free beyond it.
Turn the hand so your thumb points up at the ceiling and your little finger faces the floor. Let the fingers stay relaxed and straight.
Keeping the forearm flat and still on the towel, lift the hand up from the wrist, thumb first. The wrist only tilts a short way in this direction, so stop while it still feels easy.
Lower the hand slowly past level, as far as is comfortable, so the fingers point down toward the floor as in the video. Keep the thumb relaxed alongside the hand rather than tucked into your palm.
Lift again and keep going at an even pace. The video shows the left hand; work whichever side your program lists.

What you should feel

Light work along the thumb side of the forearm as the hand rises, and an easy stretch along the thumb side of the wrist as it lowers. Expect a small movement rather than a big one.

Common mistakes

Rolling the forearm until the palm faces the table, which turns this into a different wrist exercise.
Raising the elbow or forearm off the towel to get the hand higher.
Letting the hand fall on the way down instead of lowering it under control.
Clenching a fist, which stiffens the wrist and cuts the movement short.
Tucking the thumb into the palm as the hand lowers, which strains the tendons on the thumb side of the wrist.

How often

Many programs start with 2 or 3 sets of 10 to 15 slow lifts, done 1 to 3 times a day. Your physio will adjust this.

Stop and check with your physio if

Sharp pain at the base of the thumb or along the thumb side of the wrist as the hand lifts.
Tingling or numbness in your thumb or fingers while you work. If it stays after you stop, or keeps getting worse, get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
Since the fracture or cast, the hand is getting more painful rather than less, the skin becomes very sensitive to light touch, or the hand changes color, temperature, swelling or sweating compared with the other one, or looks shiny. See your doctor or physio as soon as you can, within a few days at most, as this can be complex regional pain syndrome (CRPS) and early treatment may help.

From the clinic

The towel lifts the wrist clear of the table edge, so the hand can dip below level and come back up without knocking the table. Lifting the hand straight up against gravity is harder than sliding it sideways across a flat table. That sliding version is wrist radial and ulnar deviation, and for a very stiff or weak wrist it is often the place to start. Once this one feels easy, wrist radial deviation with a dumbbell adds a light weight, and isometric radial deviation works the same muscles with the wrist held still.

Tilting the hand toward the thumb pulls on the tendons that run along the thumb side of the wrist. If those tendons are already sore, as in de Quervain's tenosynovitis, ask your physio how far to lift before you start. After a broken wrist, hand or forearm, or surgery on any of them such as a tendon repair, start only when your doctor, surgeon, physio or hand therapist says the bone or repair is ready for this, and follow their plan for how much to do. The wrist fracture rehab program shows how wrist exercises are usually staged after a break.

Written and checked by the PocketPhysio editorial team. Last updated 2026-09-28.

This page is general education, not a diagnosis or a personal treatment plan. If you have pain, an injury or a health condition, see a physiotherapist or doctor before starting new exercises.

Seated radial deviation