After having undergone a carpal tunnel operation it is essential to carry out exercises with the wrist; however it is important to proceed gradually and to start using the joint again calmly. Work week after week not to tire your wrist too much and cause damage.
Steps
Part 1 of 3: During the First Week after the Surgery
Step 1. Follow the rehabilitation program recommended by your doctor
This means allowing the soft muscles to heal, avoiding joint stiffness and allowing the nerves and tendons to regenerate. You may need to see your orthopedist or physical therapist regularly to make sure everything is going according to plan.
Step 2. Keep your wrist raised as much as possible
This is a very important detail during the first 4 days after the operation to minimize swelling; you can use a shoulder strap while standing or moving to keep your wrist in an elevated position.
When you sit or lie down, use a pillow so that your hand and wrist are above the level of your chest; this foresight limits swelling and consequently pain
Step 3. Move your fingers
Make them sway slowly and gently, stretching them out as much as possible; then bend your knuckles trying to touch the base of the palm with your fingertips. Repeat this movement 50 times an hour: it helps weakened tendons to regain strength.
Alternate these finger exercises until you find that you can do them with relative ease and without pain
Step 4. Perform finger adductions and abductions
These simple exercises "educate" the fingers to move using the flexor tendons and at the same time reduce edema. Here's how to proceed:
- Open your hand keeping your fingers straight; spread them apart as much as possible and then join them tightening.
- Repeat 10 times.
Step 5. Use your hand in simple everyday activities
Although exercise is very good, normal actions are also a good "workout" for the wrist; however, avoid straining your hand for long periods in tasks that put a lot of stress on the joint, such as typing on a laptop.
You shouldn't go back to work for at least two weeks after the operation to allow muscles and tendons to heal. if you force your hand to type on the computer, the pain returns and weak tendons become irritated
Step 6. Apply ice to help relieve pain and swelling
Put on a cold compress cyclically, especially during the first 4 days; low temperatures keep edema at bay by reducing the caliber of blood vessels.
Wrap the ice pack or ice pack in a towel so as not to place it directly on the skin, as prolonged contact with ice causes skin damage; apply it for 15-20 minutes at a time
Part 2 of 3: During the Second Week after the Surgery
Step 1. Go to the doctor to remove the postoperative dressing
You'll likely have a sturdy patch applied to cover the stitches, and you'll need to make a commitment to change it every time it gets dirty. When replacing, take a few minutes to clean the skin surrounding the wound and the skin on the wrist.
Although it is now possible to shower and wet the wrist, avoid soaking the wound by swimming in the pool and placing the joint in a bowl of water
Step 2. Put on the brace
The orthopedist will advise you to purchase a specific brace and use it during the second week after the operation, both day and night. The function of this device is to protect the joint and hold it in a certain position.
You should only take it off when you shower and perform the exercises described in the next steps
Step 3. Integrate the movement routine with push-ups of the thumb
Keep doing the exercises listed in the first section of the article, which shouldn't be very challenging at this point; add thumb pushups by opening your hand and extending this finger. Turn the palm up, bend the thumb trying to touch the little finger and then return the thumb to the starting position.
Repeat the movement about 10 times
Step 4. Extend your thumb
This exercise is performed by opening the palm, straightening all the fingers and turning the back of the hand down; take your thumb with your other hand and gently pull it back.
Count to 5 and release the tension; repeat the exercise 10 times
Step 5. Exercise the extensor muscle of the forearm
Extend your arm out in front of you taking care to keep your elbow straight and palm down. Use your other hand to push your fingers down until you feel a gentle stretch; in this way, you stretch the muscle fibers of the arm and the back of the wrist.
Hold the position for 5 seconds and repeat the process 5 times throughout the day
Step 6. Do the forearm flexor exercise
Extend the affected arm in front of you keeping the elbow straight and the palm facing up. Grab your fingers with the other hand and gently push them down until you feel the stretch; pull them towards your forearm, hold the position for 5 seconds and release. Repeat the movement 5 times.
Move on to the next stage of the exercise by turning the palm down and using the other hand to hold the fingers; push them towards your forearm until you feel the stretch, count to 5 and repeat the whole procedure 5 times
Step 7. Do wrist rotations
The exercise is performed with the support of the table, chair or other hand. Extend your arm in front of you and close your hand into a fist; rest your forearm on the table letting your hand hang over the edge and turn your palm to the floor.
- Move your hand up and down by bending your wrist, taking care to proceed with great delicacy; repeat the sequence 10 times and rotate the arm so that the palm is facing down. Move your hand up and down 10 more times.
- To support the elbow you can use your other hand instead of the table.
Part 3 of 3: During the Third Week after the Surgery
Step 1. Undergo stitch removal
Go to the doctor's office to remove the suture; after 3-4 days from this procedure you can wet your wrist; however, do not do this before this time, as you need to allow the small holes time to heal and close.
- Use a lotion or cream on the scars left by the stitches to allow the scar tissue to heal. avoid scented products, as they may irritate the area.
- Massage your skin for 5 minutes, twice a day.
Step 2. Gradually reduce the use of the brace
You no longer have to use it at night, but only during the day; soon you will be able to wear it only when you are exercising.
If you decide to return to work, continue to use the brace for approximately 6 weeks after returning to work
Step 3. Do exercises to strengthen the muscles, such as wrist curls and those that stimulate the extensor of the forearm
Close your hand into a fist to increase pressure on your wrist and straighten your forearm as you perform the movements described in the previous section of the article; by doing so, the exercise becomes more intense and rewarding.
You can intensify the curls recommended in the other section by using light weights, such as a bottle of water or a tennis ball; this extra weight makes the exercise more strenuous by opposing greater resistance to the joint movement
Step 4. Try the ulnar decompression exercise
It is performed in a sitting position, with the back straight and looking forward; tilts the head towards the opposite side with respect to the operated wrist, raises the arm involved in the treatment outwards up to shoulder height. Use your thumb and fingers in the "OK" gesture.
Lift your arm and then bend it towards your head as you lift your elbow, so that the circle defined by the thumb and forefinger is close to the eye; the other three fingers should be close to the ear. Apply pressure to your face with your wrist fully extended, count to 5 and repeat 10 times
Step 5. Engage in grip exercises
You can do them at this stage of recovery to gain some strength in the forearm and wrist muscles; you can do them using a chair and add weights to increase the intensity and difficulty.
- Lie prone on the ground in front of the chair so that, with your arms fully extended, you can grab the two closest legs; keep a firm grip with your elbows straight and close to the floor.
- The first movement consists in trying to lift the chair for 10 seconds without letting it touch the floor; the second is identical, but you have to hold out for 30-40 seconds. Allow yourself a few seconds of recovery between each lift to engage all the muscles of the forearm.
- The third exercise is performed by lifting the chair for 2 seconds, lowering it quickly without letting it touch the ground and lifting it again for another 2 seconds, constantly repeating the sequence. The reason you have to hold the chair up for 2 seconds is that the upward movement does not have to be as fast as the downward movement.
- The last movement is performed with twists that require greater stability and muscle strength; lift the chair for 20-30 seconds by rocking it slightly and rapidly to the right and left.
Advice
- When taking a shower, wrap a plastic bag around your wrist so that the water does not wet the dressing.
- To prevent the bag from peeling off, keep a gentle stream of water, to prevent an intense spray from hitting your arm or hand directly and tearing the plastic.
