Physical Therapy Exercises After Carpal Tunnel Surgery

The carpal tunnel is a narrow pathway on the palm side of the wrist, through which the median nerve travels. This nerve can be compressed within the tunnel by overuse of your wrist and fingers or by trauma to your hand. Nerve compression can lead to pain, numbness, tingling and weakness. If these symptoms become severe, surgery may be required to relieve pressure on the nerve. Exercises are performed after surgery to improve nerve healing and increase range of motion and strength. Follow your doctor or physical therapist's specific instructions about which exercises are best for you.

Range of Motion

Range-of-motion exercises restore movement of your fingers and wrist after carpal tunnel surgery. Tendon-gliding exercises are examples of these types of exercises. Nine tendons travel through the carpal tunnel as they connect muscles in the arm to the fingers that they move. Typical tendon-gliding exercises include making a hook fist -- bending your small knuckles in your fingers; flat fist -- bending your large and middle knuckles; and full fist -- bending all your finger joints together. Thumb exercises include bending your thumb into your palm, touching it to the tips of each finger and lifting it up and out to the side. Wrist range-of-motion exercises may also be performed to help reduce stiffness after surgery.

Nerve Gliding

Inflammation in the carpal tunnel may cause your median nerve to get stuck in the surrounding tissues. Nerve-gliding exercises improve movement of the nerve 2. The median nerve is glided through a series of hand and finger positions.

Desensitization

After carpal tunnel surgery, you may experience discomfort at the location of your surgery and in the fingers whose sensation comes from the median nerve -- the palm-side of your thumb, index and middle fingers, and half of your ring finger. Desensitization exercises expose these areas of your hand to different textures until they are no longer irritating to the touch. Items such as:

• a towel
  
• cotton ball
  
• pencil eraser
  
• popcorn kernels
  
• beans
  
• dry rice may be used for desensitization

Typically these items are gently rubbed on the sensitive skin several times each day for up to 15 minutes until sensation returns to normal.

Strengthening

Strengthening exercises after carpal tunnel release target 3 small muscles that bend your thumb into your palm, oppose it against other fingers and move it out to the side. These muscles are powered by the median nerve and may become weak from nerve compression. Grip-strengthening exercises are also included. These exercises typically start 3 to 4 weeks after surgery and can be performed with exercise putty, rubber bands or other hand-specific exercise equipment.