Rehabilitation After Minor Hand Surgical Procedures

By Lorenzo G. Walker, M.D.

CONTROL OF SWELLING: Hands avoid swelling by movement and gripping.  During the postoperative period, these activities are limited first by your bandages, and then by pain and scar sensitivity.  While movement of the hand is still less than normal, rely on elevation (above your heart) and ice to diminish swelling.  as you begin to mobilize the hand, this will become less of a problem.

UPPER EXTREMITY NERVE STRETCHES: Each exercise 10 reps, 5 times a day.

HAND RANGE OF MOTION EXERCISES:

Hand - 17 Active Range of Motion Wrist Flexion/Extension

Actively bend wrist forward then backward as far as you can.  Repeat 10 times.  Do 3 sessions per day.

Hand - 13 Wrist Flexor Stretch

Keep elbow straight, grasp involved hand and slowly bend wrist until a stretch is felt.

Hold 5 seconds.  Relax.  Repeat 10 times.  Do 3 sessions per day.

Hand 18 - Active Range of Motion Forearm Pronation/Supination

Start with arm in hand-shaking position and slowly rotate palm down until a stretch is felt.  Hold 5 seconds.  Relax.  Then rotate palm up until a stretch is felt.  Repeat 10 times.  Do 3 sessions per day.

Hand 14 - Wrist Extensor Stretch

Keep elbow straight, grasp involved hand and slowly bend wrist down until a stretch is felt.  Hold 5 seconds.  Relax.  Repeat 10 times.  Do 3 sessions per day.

Hand 42 - Wrist Radial/Ulnar Deviation: Active Range of Motion against Gravity

With thumb facing you, gently bend wrist toward then away from you.  Keep elbow bent and supported.  Repeat 10 Repitions/set.  Do ____ sets/session.  Do 3 sessions per day.

Hand 15 - Wrist Flexor Stretch

With palms comfortably resting on table, slowly move body over hands until a gentle stretch is felt in forearms.  Hold 5 seconds.  Relax.  Repeat 10 times.  Do 3 sessions per day.

Hand 8 - Active Range of Motion Finger Flexion/Extension

Actively bend fingers of involved hand.  Start with knuckles furthest from hand and slowly make a fist.  Hold 5 seconds.  Relax.  Then straighten fingers out again as far as you can.  Repeat 10 times.  Do 3 sessions per day.

Hand 10 - Active Range of Motion Thumb Abduction/Adduction

Actively bend thumb out away from palm as far as you can.  Hold 5 seconds.  Then pull thumb back to touch fingers.  Try not to bend fingers toward thumb.  Repeat 10 times.  Do 3 sessions per day.

Hand 9 - Active Range of Motion Thumb Flexion/Extension

Actively bend thumb across palm as far as you can.  Hold 5 seconds.  relax.  Then pull thumb back into "hitch hiking" position.  Repeat 10 times per session.  Do 3 sessions per day.

Hand 44 - Paper Crumpling Exercise

Begin with palm down on a piece of paper.  Maintaining contact to surface with heel of hand, crumple paper into a ball.  Repeat 10 Repetitions/Set.  Do ___ sets/session.  Do 3 sessions per day.

FINGER TENDON EXERCISES: Hold other fingers straight while bending one finger down.  Repeat with each finger.  When bending the little finger, allow the ring finger to bend along with it.  Don't hold the bend for long, and perform only one repetition at a time at each finger to minimize discomfort,  Periodically stretch the fingers and wrist back if it is uncomfortable.  15 times each finger.

STRENGTHENING: Squeeze the Hand Exerciser Dr. Walker gave you as much as possible.  Early after the surgery, when your palm may be too sire, squeeze a wet pair of solks, a tennis ball, or any "Play-Dough" type material.  you can progress to light hand weights (1/2 - 5 lbs.) as tolerated.

GENERAL: Dr. Walker has prescribed a home program for you because most people who undergo the type of surgery you have had do not require formal visits with a hand therapist.  But remember, every patient is different!  If you feel you are not making adequate progress, notify the doctor; changes may be needed in your program.