- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we are the most famous physical therapists
on the internet, Brad.
- In our opinion, of course, Bob.
- It's always our opinion
but today what we're gonna talk about, Brad,
three exercises you can do right
after carpal tunnel syndrome surgery.
- Right.
- Maybe not the day after.
- Right.
- Now, I gotta tell this story, Bob.
- Okay, tell them the story.
- We just had a patient come into the clinic
and she had carpal tunnel syndrome,
and she had surgery
and she went home and that was it.
- Sure.
- And she didn't have any therapy afterwards
which is not uncommon.
- Right.
- And oftentimes things work out well
but she had problems
with her coordination, her strength, everything,
her hands were just not working
like she expected them to
and there's very good reason for it.
They were tight,
there were scar tissue build up
and they were weak.
So, three of the best exercises to do.
- Right.
- Number one for coordination,
if you're feeling like you're not able to handle
paper and whatnot, like normally.
- Manipulate little coins.
- Exactly.
- Right.
- Simple exercise you just touch here,
touch here,
fingertip to fingertip on all four,
and then go back.
Here, in here and here.
- Real simple to do.
- Yep. Very simple.
Okay.
You can do that three times
going back and forth each way.
- Okay.
- Okay, and then wrist flexion stretch.
In other words, you're just gonna go like this
and pull back.
And that opens up the tunnel.
And what we're trying to do is get things to move,
get that scar tissue.
- Sure.
- To break up and get it all in a line
so it becomes more functional.
- So how long would you hold the stretch, Brad?
And how many times?
- It's a good question, Bob.
Depending on how it feels.
If it's pretty sensitive you're not gonna hold so long,
but after you do maybe three to five repetitions
about five seconds.
But if you tolerate five and it goes good,
you can go to 15
or even up to 30 seconds
near the end of when it's feeling good.
- So let pain be your guide.
You don't want to push this.
- Exactly.
- I mean, bump off the pain,
what we call bump up against it.
- Exactly. Don't don't use the old thing,
"no pain, no gain".
- Right, right.
- We don't need to do that.
You don't want to get it flared up.
- Exactly.
- And the last one is tendon glides.
- Cool.
This one's a little more tricky.
- Sure.
- So pay attention to this.
You're gonna start like this
and then you're just simply gonna go up
to this position right here.
- Kind of a claw. Huh?
- Yep.
Right up to there.
- I'll show it this way.
- There.
That's a good idea
and I'm gonna go this way.
We're a team, Bob.
- Do we want to go flat table too or not?
- Yeah.
That's the next one.
- Oh, that is?
- Okay. Yep.
So you're gonna do 10 of those
and then you're gonna do
out,
back
and then up and back
then back to here
and then the flat table,
bring it back to the fist
and then up and back.
And take your time with this one so you get it right.
Okay. It's kinda like saying, bye bye.
But we're not done yet.
And then I wanted to talk about the strengthening
because all of these exercises.
- Brad, I think we should do that a few more times.
- Few more times.
- Yeah. It just is a little complicated.
- Bob, they're gonna get bored with this.
- Okay, no.
- Okay. You're right, Bob.
We wanna make sure we get it right.
Back and extend a little bit here
and then out the table top.
Okay.
- Okay.
- They've had enough of it, Bob. Okay.
- My hands are getting tired.
- Yeah. It does. It works them.
And then if you need some strengthening,
the thing to do is go to the store
if you don't have a Nerf ball
or some kind of squeeze ball at home,
and so you can squeeze.
Okay? And you're gonna squeeze two to three minutes
and make sure if you're feeling pretty strong
get a more firm Nerf ball.
- Sure.
- Work it and work each finger a little bit,
you don't just grab the whole ball.
You can do that,
but it's nice to roll it.
- Start working on that grip.
- Yep. I like these with the fluid inside,
it kinda makes you feel good when that pops out, Bob.
Do you know what I'm talking about?
- Yeah. It gives you a good visual.
- Yeah. Okay.
So what can we say more about,
and we're having really good luck
with this patient that is doing this right now.
- Fantastic.
So this is something, especially
if you weren't given any therapy to do,
you could do it a couple of weeks after the surgery
or maybe a week later.
- Sure.
- And I'm sure your surgeon would approve of this.
- Right. Yeah.
- It's gotta be all healed.
- There is nothing radical here, so.
Alright.
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