Carpal Tunnel Surgery: Strengthening Exercises

Question: I had carpal tunnel surgery and am doing exercises given as advised. Are there any specific hand / wrist / grip strengthening exercises I could look at in the long term?

The exercises that are prescribed by your physiotherapist or othopedic surgeon would depend on your number of weeks post-surgery, but not all surgeons follow the same timeline. However, t you need to be very careful with active movements of wrist flexion beyond neutral and finger flexion with the wrist flexed. I will be suggesting a few exercises that you can do in the coming weeks but then again, it is much better to consult with your surgeon first.

During the first weeks, you can do these:

1. Nerve-gliding and tendon-gliding exercises
2. Gentle range of motion of the fingers and thumb toward all planes, as well as thumb opposition with the wrist stabilized in slight wrist extension
3. Gentle range of motion of active wrist extension, passive wrist flexion (without the splint), inward and outward motions of the wrist (with the wrist supported in slight extension), forearm pronation and supination and all motions of the shoulder and elbow to prevent your muscles from becoming tight.

By around 6 weeks, you can start including some of the treatments here:

1. Scar tissue mobilization
2. Isometric strengthening 4 weeks after surgery of the wrist and finger muscles.
3. You can add some grip and pinch exercises by 6 weeks.
4. Dexterity exercises like picking up small objects using different prehension patterns:
5. Pad-to-pad – like when holding a paper in between the fingers
6. Tip-to-tip – like when holding a pen
7. Tip-to-pad – like when holding a key

Should you feel any pain when doing any of these exercises, I suggest you stop immediately. The fix your elbow package has exercises that can help but avoid the movements that you are advised not to perform.