Advanced Wrist and Hand Tendon Repair Rehabilitation

Advanced Wrist and Hand Tendon Repair Rehabilitation — Program Overview

This 23-week advanced program is designed for people recovering from wrist and hand tendon repair surgery who have been cleared by their surgeon to progress through a structured, supervised rehabilitation plan. Its goal is to gradually restore safe motion, strength, grip, and everyday hand function while protecting the healing tendon. You will work through four phases—protection, early motion, active motion with light strengthening, and moderate strengthening—using therapy putty, a balance board, and a back brace as tools within your sessions.

Before You Start

Talk with your surgeon and physical therapist before beginning, and only start once you have been cleared. This program is not appropriate if you have or are at risk of a blood clot, active infection, severe osteoporosis, or acute inflammation—your clinician will confirm this. Stop and call your clinician right away if pain keeps increasing, you notice swelling, redness, warmth, or wound opening, or you feel new numbness or tingling. Keep your spine in a neutral, comfortable position during all exercises as a precaution.

Weekly Structure

You will do three sessions per week, about 30 minutes each, for 23 weeks, moving through four phases in order: weeks 1 through roughly 3 focus on protection, weeks 4 through 6 on gentle assisted motion, weeks 7 through 10 on active motion and light strengthening, and weeks 11 through 23 on moderate strengthening and function. Your therapist decides when you advance based on how you meet each phase's goals, not just the calendar. Therapy putty, the balance board, and back brace are used as your therapist directs.

What a Typical Session Looks Like

Sessions follow a warm-up, main work, and cool-down pattern. A warm-up may include gentle shoulder and arm movement and light balance-board work to prepare your body. The main work focuses on your prescribed wrist and hand exercises—often using therapy putty for gentle resistance—alongside any modalities your therapist applies, such as ultrasound, electrical stimulation, laser, or contrast baths. Cool-down includes gentle stretching, elevation, and checking that your wrist and hand feel settled before you finish.

Tracking Progress

Your therapist uses the phase progression criteria—such as pain levels, measured wrist motion, grip and pinch strength, and scar mobility—to decide when you are ready to move to the next phase. These are guides, not strict cutoffs, and your clinician interprets them for you. Outcome measures including grip and pinch strength, goniometry for range of motion, the MHQ and DASH questionnaires, and sensory testing help track your recovery over time and adjust the plan.

Recovery and Self-Care

Keep pain manageable and stop any activity that steadily increases it. Rest, elevate your hand when swollen, and follow your therapist's guidance on modalities and contrast baths. Watch for red flags such as spreading redness, wound drainage, fever, sudden calf pain or swelling, or worsening numbness, and contact your clinician promptly. Follow all splint and positioning instructions and keep the wrist and spine supported and neutral during activity.