After your surgery · Nicholas Genovese, M.D.
Home exercises after de Quervain release
Start when your surgeon or therapist says you are out of the splint. Mild discomfort is fine; sharp pain is not. Avoid heavy gripping, lifting and push-ups for 4–6 weeks, and avoid forceful pinching or repetitive thumb use.
Phase 1 — gentle motion (start when cleared)
- Assisted thumb lift away from the palm, and assisted thumb move away from the index finger: 5–10 times, 3 times a day.
- Active thumb out to the side and up away from the palm: 5–10 times, 3 times a day.
- Thumb to each fingertip, then across to the base of the little finger: 5–10 times, 3 times a day.
- Wrist bending forward and back through a comfortable range: 5–10 times, 3 times a day.
Phase 2 — gentle stretching (usually at 2–3 weeks, once Phase 1 is comfortable)
- Thumb across the palm toward the base of the little finger, wrist straight: hold 20–30 seconds, 3 times, 3 times a day.
- Wrist bent toward the little-finger side with the thumb resting beside the index finger: hold 20–30 seconds, 3 times. Do not tuck the thumb into a fist for this stretch until cleared.
- Assisted wrist bend forward and back with the other hand: hold 20 seconds each way, 3 times, 3 times a day.
Phase 3 — strengthening (usually at 5–6 weeks, only when Phase 2 is pain-free)
- Rubber band around the fingers and thumb; move the thumb out against the band: 5–10 times, twice a day.
- Light wrist lowering with a small can: slowly lower into bend and back, 5–10 times.
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.
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.