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Maxey: Rehabilitation for the Postsurgical Orthopedic
Chapter 12: Carpal Tunnel Release
Suggested Home Maintenance for the Postsurgical Patient
Days 1 to 10
GOALS FOR THE PERIOD: Decrease pain, manage edema, improve AROM of UE, initiate self-management and patient education
1. Protect incision
2. Elevate the hand above the heart
3. Ice frequently
4. AROM exercises for shoulder, elbow, forearm, and thumb
5. Tendon-gliding exercises
Days 11 to 21
GOALS FOR THE PERIOD: Decrease pain, manage edema, improve AROM of UE, initiate self-management and patient education
1. Moist heat
2. Retrograde massage when incision has closed
3. Scar massage when incision has closed
4. Continue tendon-gliding exercises
5. Nerve-gliding exercises
6. Continue AROM exercises for shoulder, elbow, forearm, and thumb
7. Add AROM exercises for wrist extension, radial and ulnar deviation (avoid wrist flexion as necessary)
8. Isometric exercises for wrist extension and flexion
9. Use scar conformer or silicone gel sheeting at night
10. Use splint as needed to control symptoms
11. Ice as necessary
Days 22 to 42
GOALS FOR THE PERIOD: Decrease pain, manage edema, improve AROM of UE, initiate self-management and patient education
1. Continue all previous exercises and modalities as indicated
2. Add wrist flexion AROM
3. Add putty gripping and pinching exercises with light resistive putty
4. Add grip isometric exercises by squeezing a towel roll
5. Add PREs for wrist extension and flexion with [pic] to 1 lb
6. Add PREs for shoulder girdle and elbow with 1 to 2 lb
7. Add forearm strengthening using a hammer
8. Continue to use scar conformer at night
9. Practice ergonomic principles
Days 43 to 90
GOALS FOR THE PERIOD: Complete self-management of symptoms and home maintenance program, return to full-time work activities
1. Aerobic warm-up exercise using a bicycle or treadmill
2. Continue previous exercises as indicated, progressing intensity and duration as indicated
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