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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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