Hand surgery, whether for carpal tunnel release, tendon repair, or fracture fixation, requires a highly specific recovery protocol. The question of whether you can exercise afterward depends entirely on the type of surgery performed and the individualized instructions given by your surgical team. The healing process involves a careful balance between protecting the repair and preventing stiffness, which necessitates a phased approach to resuming physical activity. Understanding the boundaries of safe movement at each stage is paramount to achieving a successful outcome and restoring full hand function.
The Critical Initial Rest Phase
The immediate post-operative period demands complete, non-negotiable rest for the surgical site, a phase that typically lasts for the first one to two weeks. This initial immobilization is necessary to protect the internal repair, whether it is a delicate tendon suture line or a set bone fracture, from being disrupted by uncontrolled movement or strain. Preventing motion is fundamental because the tensile strength of healing tissues, especially tendons, is at its lowest point during the first few weeks following the procedure.
Common restrictions during this time include avoiding lifting anything heavier than a cup of tea and refraining from pushing, pulling, or gripping actions. The focus shifts to managing swelling and protecting the incision. Keeping the hand elevated above the heart level is strongly recommended for the first three to seven days. While the operated wrist or fingers remain protected, the surgeon may encourage gentle, limited movement of the unaffected joints, like the shoulder or elbow, to prevent stiffness in those areas.
Resuming Non-Hand Specific Exercise
Once the initial protective phase ends and the surgeon permits activities beyond simple rest, the patient can often resume general conditioning that does not directly involve the operated hand. This transition allows individuals to maintain cardiovascular health and strength in the rest of their body while the hand continues its specialized healing process. Activities like walking, using a stationary bike, or operating an elliptical machine are generally safe because they minimize stress on the upper limbs.
When engaging in non-hand exercise, it is important to modify movements to eliminate gripping or weight-bearing on the affected side. For example, using straps to secure the forearm to a stationary bike’s handle can support the limb without requiring the fingers to grip. Throughout any exercise session, keeping the hand elevated when possible and monitoring the surgical site for any increase in swelling is a necessary precaution. Exercise helps promote circulation, which can aid in reducing generalized swelling, but the activity must not cause throbbing or pain in the hand itself.
Therapeutic Hand and Wrist Movement
The introduction of purposeful movement in the hand is a strictly controlled, therapeutic process, usually guided by a physical or occupational therapist. This prescribed rehabilitation is designed to combat joint stiffness and prevent the formation of restrictive scar tissue, known as adhesions, which can limit the smooth gliding of tendons. The timing for starting these movements is highly dependent on the type of surgery, with some tendon repairs requiring mobilization to begin as early as 48 to 72 hours post-operation.
Therapy distinguishes between passive range of motion and active range of motion. Passive movement is when the joint is moved by an external force, such as a therapist or the patient’s opposite hand, without the use of the muscles controlling the joint. This is often introduced first, particularly after tendon repair, to gently stretch the tissues without the force of muscle contraction that could strain the surgical repair.
Active range of motion follows, which involves the patient using their own muscles to move the fingers and wrist, gradually restoring strength and coordination. These specific exercises, such as tendon gliding movements, must be followed precisely as prescribed, as doing too much risks rupture, and doing too little risks permanent stiffness.
Recognizing Signs of Overexertion
Even when following the prescribed recovery plan, it is possible to push the healing tissues too far, and recognizing the warning signs of overexertion is a crucial part of self-monitoring. A sudden and noticeable increase in pain, especially if it becomes throbbing or is not relieved by rest and elevation, suggests that the activity level may be too high. The goal of therapeutic exercise is to restore movement, not to cause significant discomfort.
Excessive swelling that does not quickly subside after the activity or any new redness or warmth extending beyond the incision site can also signal a problem, such as localized inflammation or infection. Any unexpected drainage from the wound, a fever, or a change in the ability to move the fingers or hand should be treated as an immediate concern. If any of these signs appear, the patient must stop the current activity immediately and contact their surgeon or hand therapist for guidance.