Physical Therapy and Exercises after Carpal Tunnel Surgery

Shahid Iquebal   by Shahid Iquebal, M.Pharm.    Last updated on October 3, 2019,

exercises after carpal tunnel surgery

What are the post carpal tunnel surgery exercises? What are the exercises you need to do after having a carpal tunnel surgery?

The carpal tunnel is a narrow pathway through which the median nerve travels on the side of your palm. During a carpal tunnel syndrome, this nerve is compressed within the tunnel by overuse of your wrist and fingers or by trauma to your hand resulting in pain, numbness, tingling and weakness.

Surgery may be required to relieve pressure on the nerve if these symptoms become severe. Physical therapy and exercises are needed after the surgery to improve nerve healing and increase the lost range of motion and strength. Consult and follow your doctor or physical therapist's specific instructions about which exercises are beneficial for you.

These recovery exercises basically help you in improving your range of motion, nerve gliding, strengthening and desensitization.

Range of motion exercise after carpal tunnel surgery

Range-of-motion exercises rehabilitate and improve movement of your fingers and wrist after the carpal tunnel surgery. Example of these types of exercises includes tendon-gliding exercises, thumb exercises and wrist range of motion exercise. There are nine tendons which travel through your carpal tunnel and they connect muscles in the arm to the fingers that they move.

Generally tendon-gliding exercises include following in sequential manner:

  • making a hook fist
  • bending your small knuckles in your fingers
  • flat fist
  • bending your large and middle knuckles
  • and a full fist which includes bending all your finger joints together

Thumb exercise is performed by bending your thumb into your palm followed by touching it to the tips of each finger and lifting it up and out to the side. Wrist exercises are also recommended to help in reducing the stiffness after the surgery.

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Nerve gliding exercise after carpal tunnel surgery

Carpal tunnel inflammation may cause your median nerve to get stuck in the surrounding tissues. Movement of the nerve in these cases is improved by nerve gliding exercises. The median nerve can be glided through a series of hand and finger positions in a nerve gliding exercise.

Starting with your fingers in a fist and wrist straight, your fingers are first straightened, then there is a backward bent of your wrist, thumb is moved out to the side, forearm is rotated into a palm-up position and finally using your opposite hand, a gentle stretch is applied to the thumb.

Strengthening exercise post carpal tunnel surgery

Strengthening exercises after a carpal tunnel operation mainly target three small muscles that are responsible for bending your thumb into your palm, oppose it against other fingers and move it out to the side.

These muscles are controlled by the median nerve and nerve compression may result in weakening of these muscles. Grip-strengthening exercises are also included to improve your grip strength. These exercises are started usually after 3-4 weeks after the surgery and can be performed by using balls and various rubber bands, and various exercise equipment.

Desensitization exercise

After getting the carpal tunnel surgery, you may experience uneasiness and trouble at the location of your surgery and in the fingers whose sensation is supplied by the median nerve like the palm-side of your thumb, index and middle fingers, and half of your ring finger. These areas of your hand are exposed to different textures until they are no longer irritating to the touch through desensitization exercise.

Items such as a pencil eraser, towel, cotton ball, popcorn kernels, beans and dry rice may be used for desensitization. Usually, these items are gently rubbed on the sensitive areas of the skin multiple times a day for up to 15 minutes until sensation returns to normal.

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Physiotherapy / Occupational Therapy/ Recovery exercise after carpal tunnel surgery

Depending on the condition of the patient after the carpel tunnel surgery, occupational/hand therapy usually begins approximately one week after the surgery and continues 2-3 times per week for a period of four to six weeks.

At first, your therapy will involve soft tissue massage and methods to relieve the swelling. At this stage of therapy, you are still having your stitches on, so you’ll be required to do only those exercises that mainly focus on improving your range of motion by bending your fingers, opening and closing the hand, stretching, and moving your wrist.

In the later stage of your recovery therapy, your exercises will focus more on stabilizing your joints and strengthening your hand muscles. You may be asked to squeeze and stretch therapeutic putty and do wrist curls with small weights to strengthen your hand. These exercises will stimulate the healing process, boost your strength to perform daily activities, and prepare you for your return to work.

Your therapists might also show you some other techniques to help avoid future problems with your hand. 

Shahid Iquebal

Shahid is a pharmacologist with masters in pharmaceutical sciences and pharmacology. In the past, he worked for Maxinov Healthcare Research Division and R.P Biotech. At DiseaseFix, he is a content guide and writer. He is also associated as a researcher with Integrated Resources Pvt Ltd. currently. Shahid’s areas of interests include cellular and molecular pharmacology, pre-clinical screening, and systemic and clinical Pharmacology.

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