10 Top After Carpal Tunnel Surgery Exercises

Carpal tunnel can be a frustrating medical condition. As a physical therapist, I see many patients with persistent carpal tunnel syndrome that has become so severe that it requires surgery. So, what do you do after surgery?

The good news is that after surgery you can finally start your recovery and get back to the activities that you love. This post will cover the best 10 after carpal tunnel surgery exercises to gain full function of the hand so that you can return to your everyday tasks!

Symptoms of Carpal Tunnel Syndrome

The common symptoms of carpal tunnel are:

• Numbness in the wrist, forearm and hand
• Tingling wrist, forearm and hand
• Pain
• Decreased grip strength

Carpal Tunnel Surgery

Before we can dive into the best exercises after carpal tunnel surgery, we must first understand carpal tunnel release surgery. If you are only interested in the exercises then feel free to skip over this paragraph.

Carpal tunnel occurs when there is compression of the median nerve.

In some mild cases, carpal tunnel can be treated with physical therapy exercises and wrist splints without surgery. However, if you are on this page, conservative measures likely did not work for you, and you will or already have undergone a surgical procedure for your carpal tunnel.  

Carpal tunnel release surgery is a form of wrist or hand surgery. It is when small incisions are made to the transverse carpal ligament in order to take some of the pressure off of the median nerve.

Do You Need Physical Therapy After Carpal Tunnel Surgery

Every patient is different, however, the general answer is yes, you will need physical therapy after carpal tunnel surgery.

Your surgeon will be able to guide you on the best way to rehab after carpal tunnel surgery, however, typically you will be recommended for either occupational therapy or physical therapy.

Both of these therapies will focus on a therapeutic exercise program including wrist exercises, hand stretches, mobility exercises, soft tissue massage, and scar tissue mobilization.

Carpal Tunnel Exercises

Carpal tunnel exercises are crucial to your recovery after surgery. A physical therapist will be able to lead you through effective exercises to improve your symptoms and return to your daily life activities. These carpel tunnel exercises are 1. Wrist Flexion 2. Wrist Extension 3. Wrist Flexor Stretch 4. Wrist Extensor Stretch 5. Tendon Glides Series A 6. Tendon Glides Series B 7. Median Glides 8. Finger Opposition 9. Thumb Opposition 10. Grip Strength.

Wrist Range of Motion Exercises

The initial stage of rehabilitation will consist of many range of motion exercises. These wrist range of motion exercises are 1. Wrist Flexion and 2. Wrist Extension.

1. Wrist Flexion

• Start with your forearm rested on a table in front of you with your palm up.
• Now bend your wrist towards you and then slowly return to starting position. Perform 10 times.
• This simple exercise helps to build strength in the wrist.
• Eventually, you can use a resistance band for added resistance, however during the early stages of rehabilitation this exercise should be performed without resistance.

2. Wrist Extension

• Start with your forearm resting on a table in front of you with your palm facing down.
• Now bend your wrist up towards the ceiling and then slowly back down to starting position. Perform 10 times.
• This hand movement is important in the recovery process.

Hand Stretches

Hand stretches can help to stretch the forearm extensors and forearm flexors and decrease overall stiffness. These include 3. Wrist Extensor Stretch and 4. Wrist Flexor Stretch.

3. Wrist Extensor Stretch

• Hold your arm out in front of you with your elbow straight.
• Now take your other hand and push your fingers and wrist down.
• Hold this stretch 20-30 seconds.

4. Wrist Flexor Stretch

• Hold your arm out in front of you with your elbow straight.
• Now take your other hand and pull your fingers back towards you.
• Hold this stretch for 20-30 seconds.
• This is a gentle stretch. It should not be painful.

Nerve Gliding Exercises After Carpal Tunnel Surgery

These nerve gliding exercises can help in decreasing nerve pain after carpal tunnel surgery. These include 5. Tendon Glides Series A 6. Tendon Glides Series B 7. Median Nerve Glides.

5. Tendon Glides Series A

This tendon glides has 3 steps:

• Start with your hand in front of you and hold your hand out like a stop sign with your fingers fully straight.

• Now bend the tips of your fingers to create a “hook” position.

• Now make a fist with your thumb outside of the fist. Hold each position for 3 seconds.

6. Tendon Glides Series B

• Start in the same “stop sign” position.
• Now bend the bottom of your knuckles while keeping your fingers straight.

• Now bend the middle knuckle by touching your fingers to your palm. Hold each position for 3 seconds.

7. Median Nerve Glides

The median nerve glide consists of 6 steps. 

• Make a fist with your hand with your thumb outside of the fist.

• Now straighten your fingers while holding your hand out like a stop sign with your fingers positioning towards the ceiling.

• Now keep the same position with your fingers but bend your wrist back towards you .

• Next, stay in the previous position while extending your thumb.

• Keep this same position and flip your hand so your palm is up.

• Lastly, remain in the same position and use your other hand to apply pressure downward on your thumb.

Hand Exercises

The best hand exercises for carpal tunnel are 8. Finger Bends 9. Thumb Opposition and 10. Grip Strength.

8. Finger Bends

• Start by bending the fingers of your affected hand one at time and then extend each one one at a time.
• As you get stronger you will be able to perform these finger bends into resistance such as theraputty or dynagrip. 

9. Thumb Opposition

• Start with your forearm supported and your palm up.
• Start by touching the tip of your index finger to the tip of your thumb.
• Now touch the tip of each finger to your thumb one at a time with your affected hand.

10. Grip Strength

• Hold theraputty or a dynagrip in the palm of your hand.
• Now squeeze and hold for 3 seconds and then release.

You can buy theraputty on Amazon. I recommend a pack of 4 with varying levels of resistance.

When To Start Exercise After Carpal Tunnel Surgery

Typically, you can start exercise immediately after carpal tunnel surgery, as soon as the day after surgery. Your surgeon will be able to provide you with the best medical advice and specific instructions on when to start exercise as everyone has a different healing process. 

When Can I Return To Work After Carpal Tunnel Surgery

Typically the full recovery time is 3 months for your wrist to return to normal function. The type of work you do will dictate when you can return to work, however, typically most people who do not have labor intensive jobs can return to work after 2 weeks. 

Regardless of your occupation, it is important to take breaks throughout the work day, especially if your job requires working on a laptop.

Restrictions After Carpal Tunnel Surgery

You will need to keep your stitches dry until they are removed. This is usually for 10-14 days. Don’t worry you can still wash your hands and shower as long as you cover your hand with a plastic glove or bag to protect the wound.

Your surgeon will be able to provide you with the best guidance on your specifica precautions.

The general precautions for after carpal tunnel surgery are that it is ok to perform light activities with your hand such as carrying a glass, however avoid carrying anything over 5 pounds, typing, housework and anything that involves vibration such as use of power tools. Most importantly do not do any heavy lifting.

Summary of After Carpal Tunnel Surgery Exercises

Now that you know the best after carpal tunnel surgery exercises it is a good idea to go out and try these physical therapy exercises with a licensed physical therapist. These exercises will improve carpal tunnel symptoms of pain, tingling and numbness and improve muscle weakness, range of motion and function.

If you are having elbow pain after carpal tunnel syndrome surgery you can find more exercises at 7 Best Physical Therapy Exercises Range Of Motion Exercises For Elbow.