Advanced Wrist and Hand Tendon Repair Rehabilitation

Program Overview This guide outlines an advanced, 14-week rehabilitation plan following wrist and hand tendon repair. It combines supervised therapeutic exercise, manual therapy, splinting, ultrasound, functional training, and proprioceptive work. The plan is delivered three times per week in 60-minute sessions and uses an ankle brace, back brace, balance pad, and resistance band as supporting equipment. Each phase builds gradually on the last, so your clinician will adjust the pace to match your healing and comfort.

Who This Program Is For and Its Goal This program is for people recovering from surgical repair of wrist and hand tendons who are ready for an advanced, structured progression under clinician supervision. The goal is to safely restore wrist and hand motion, strength, coordination, and everyday function while protecting the healing tendon. It is not a substitute for individualized medical care. Your treating clinician decides whether this level is right and adjusts it as you improve.

Before You Start Review this plan with your surgeon and physical therapist before beginning, especially if you have any concerns about your wound or splint. Make sure your splint fits well and your equipment is set up safely. Begin only when your clinician has confirmed your phase and cleared you for the specific activities. Always warm up before activity, and never push into sharp pain or swelling.

Safety Notes and When to Stop Do not start or continue exercises during acute inflammation or severe pain; these are reasons to pause and check in with your clinician. Keep your spine in a neutral position and stop any movement that causes sharp pain, new swelling, numbness, or tingling. Seek urgent care for fever, spreading redness, wound drainage, or sudden loss of movement. Otherwise, contact your clinician if pain increases or does not settle with rest.

Weekly Structure Plan on three sessions per week, about 60 minutes each, across 14 weeks. Sessions include warm-up, guided exercise, manual therapy, splinting checks, and functional practice. Your clinician moves you through phases in plain terms: early protection, then early protected motion, then progressive strengthening and functional use. Phases overlap and progress based on meeting criteria, so expect gentle changes rather than sudden leaps.

How the 14-Week Plan Is Organized The 14-week plan is organized into phases that advance as you meet clinician-set criteria. Early weeks focus on protection, splinting, and gentle motion. Middle weeks add protected motion, scar care, and light resistance. Later weeks progress to strengthening, simulated daily and work tasks, and wrist weight-bearing on the balance pad. The ankle brace and back brace are used for safe positioning during supported activities, while the resistance band provides graded resistance.

What a Typical Session Looks Like Each session follows a warm-up, main work, and cool-down pattern. Warm-up may include gentle shoulder and elbow movement while maintaining a neutral spine. Main work combines your prescribed exercises, manual therapy, splint checks, and functional or proprioceptive tasks using the balance pad and resistance band. Cool-down includes gentle stretching and settling, plus review of your home program and symptom response.

Warm-Up, Main Work, and Cool-Down Warm up for a few minutes with easy shoulder, elbow, and non-involved hand movement, keeping your spine neutral and using the back brace if advised for support. Main work uses the resistance band for graded strengthening and the balance pad for wrist weight-bearing and control, all within your phase limits. Finish with gentle cool-down stretches and elevation. Your clinician tailors each piece to your tendon repair and tolerance.

Tracking Progress Track your progress with the outcome measures your clinician selects: the Michigan Hand Outcomes Questionnaire, grip strength with a dynamometer, wrist range of motion by goniometry, the DASH score, the Patient-Specific Functional Scale for wrist-hand tasks, and the Carpal Tunnel Questionnaire. These show how function, strength, motion, and symptoms change over time. Share your home exercise and symptom notes at each visit so the plan stays accurate.

How Progression Criteria Are Used Your clinician uses the phase criteria, such as motion targets, wound healing, pain levels, and safe tendon gliding, to decide when to advance. You do not move ahead on a calendar alone; comfort, swelling, and function matter too. Outcome measures add an objective picture, so improvements in grip, motion, and daily tasks guide the next steps. If progress stalls or symptoms flare, the plan may slow down.

Recovery and Self-Care Support recovery with rest between sessions, elevation and compression as advised for swelling, and careful splint wear. Keep skin around scars clean and follow your scar massage instructions when cleared. Stay active with approved shoulder and elbow movement to maintain upper limb function. Report changes in swelling, sensation, or pain early so your clinician can adjust your program.

Pain Management and Red Flags Use only medications prescribed by your clinician, and keep pain at rest low as advised. Do not exercise through severe pain or acute inflammation. Rest, elevation, and compression can help swelling. Seek urgent care for fever, spreading redness, wound drainage, or sudden loss of movement or sensation. Contact your clinician for increasing pain, new numbness, or swelling that does not settle.