After your surgery · Nicholas Genovese, M.D.
Home exercises after carpal tunnel and cubital tunnel surgery
Start these when your surgeon or therapist says it is safe. Move early but gently. Three to five short sessions a day work better than one long one. A mild stretch is fine; stop and call if symptoms steadily get worse. If you were told not to move the wrist or elbow yet, follow that first.
Carpal tunnel release
- First 2 weeks: finger and thumb motion; tendon gliding, 10 rounds, 3–5 times a day. Keep the wrist mostly straight; no forceful gripping, heavy lifting or push-ups.
- About 2–3 weeks, once the fingers move fully: wrist motion, 10 times each direction, 3 times a day; median nerve glides, 5–10 rounds, 1–3 times a day, backing off if tingling increases; scar massage and desensitization once the skin is closed.
- About 4–6 weeks: light grip and pinch strengthening with soft putty or a soft ball, increasing slowly.
Cubital tunnel release
- Weeks 2–6: elbow bending and straightening and forearm turning, 10–15 times, 3 times a day; gentle shoulder rolls and posture exercises; ulnar nerve glides, 5–10 times, 1–3 times a day as tolerated.
- Weeks 6–12: gradual grip, wrist and forearm strengthening; increase daily activities as comfort allows; avoid repeated full elbow bending early if it brings on symptoms.
Exercises
Tendon gliding
Move slowly through five positions, holding each for 3 seconds: straight hand, hook fist (knuckles straight, middle and tip joints bent), tabletop (knuckles bent, fingers straight), straight fist, full fist. 10 rounds, 3–5 times a day.
Median nerve glide
Move slowly through six positions, holding each 3–7 seconds: soft fist with the thumb outside; fingers straight with the thumb tucked; wrist bent back; thumb out to the side; palm turned up; a light stretch of the thumb with the other hand. 10–15 rounds a day. You should feel a gentle glide, not a shock. Back off if tingling increases.
Ulnar nerve glide ("OK glasses")
Make an "OK" sign with the thumb and index finger. Slowly bring it up to your face like putting on glasses, then lower it. 5–10 times, 1–3 times a day. Stop short of any electric feeling into the small finger.
Wrist motion
With your forearm resting on a table, gently bend the wrist down, back to straight, and up, then side to side. 10 times each direction, 3 times a day. Only when your surgeon says the wrist may move.
Scar massage
Start only after the stitches are out and the incision is fully closed, with no scabs or drainage (usually about 2–3 weeks). Use a fragrance-free moisturizer such as Aquaphor. Press firmly enough to move the skin and massage in small circles, then side to side and up and down. 2–3 minutes, 2–4 times a day for 6–8 weeks. Protect the scar from the sun for several months.
Desensitization
If the skin around the scar is very sensitive, rub it with a soft material (cotton ball, soft cloth) for 1–2 minutes, then slowly progress to rougher textures such as a towel or denim. Light tapping around the tender spot and moving the hand through a bowl of dry rice or beans also help. 3–6 short sessions a day. Mild discomfort is fine; stop if it causes sharp pain or a flare that lasts hours.
About these instructions
These instructions are general guidelines for patients of Nicholas Genovese, M.D. Your surgeon may change your plan based on your surgery and how you are healing. If anything here differs from what your surgeon or therapist told you, follow their instructions, and call the office before changing any activity, splint use or therapy.