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Hand & Wrist Rehab Protocol


This section applies to all patients. 

  • No NSAIDS such as Advil, Motrin, ibuprofen, Naprosyn, and Aleve x 2 weeks.

  • Pain: Tylenol for mild pain and if needed use mild narcotic provided.

  • Bracing: If recommended, use brace during sleep the first 2 nights if able. Sleep is more important so if you cannot sleep and use the brace, feel free to remove it.

  • Driving restrictions: No driving until you can safely shift and steer the vehicle.

  • Work restrictions: Depends on duration of lifting restrictions.

  • Exercise restrictions: 2 weeks relative rest then 4 weeks progressive PT.

The following may not apply to all patients. Your provider will complete this section, depending on your needs.

☐ Use wrist/thumb spica brace for _____ days

☐ You can do gentle wrist/hand/finger range of motion exercises after 2 days

☐ f/u for OT / PT in 5-7 days

Activities: In general, with strength and activities, keep pain level below 4/10.

First 2 Weeks:

  • Strengthening/Motion: Isometrics are good for muscles and pain control. Very gentle flexion/extension exercises are good. PT will help with range of motion.

  • Walking: No restrictions.

  • Cycling: May do gentle ride on stationary bike for 10-15 minutes, then 30 minutes after week 1.

  • Swimming: No swimming for the first 2 weeks.

  • Throwing/rock climbing/tennis: None of these the first 2 weeks.

Weeks 2-4:

  • Strengthening/Motion: Start gentle low load concentric/eccentric exercises with PT. Work on progressive strengthening while keeping pain below 4/10.

  • Cycling: No restrictions except would stay on exercise bike for 2 weeks.

  • Swimming: May begin gentle swimming (<=50% of usual distance and intensity) at 2 weeks. Keep pain below 4/10.

  • Throwing/rock climbing: No throwing or rock climbing until after 4 weeks. Do strengthening in anticipation of these activities if desired.

Weeks 4-6:

  • Strengthening/Motion: Progress to moderate loading and progressive strengthening of the wrist flexor/extensor muscles.

  • Cycling: May do road biking and trail biking; avoid mtn biking until 6 weeks.

  • Swimming: May increase distance and time to 75% of normal. Use buoy for rest.

  • Throwing/rock climbing/tennis: Can begin gentle climbing and return to throwing/tennis program at 4 weeks.