Physical Rehabilitation Medicine/hand therapy


I recently had surgery to repair a extensor tendons to my right thumb. I was told by the surgeon i would have to go to physical therapy. I thought the insurance i was using was going to cover my therapy, i was wrong. I can not afford the out of pocket amount the therapist wants for me to attend, My surgery took place on 12/21/2012 and i did see the physical therapist on 01/21/2013 and outfitted my with a removable plastic split. i was due to actually start my therapy on 01/28/2013 but was toldcthat the insurance company will not cover the cost of P T. If you can help me my question is what exercises can i start with and what to progress to in order to gain as much normal use of my thumb as possible. I also noticed that when the therapist outfitted my with the removable split that my wrist was really stiff as well as my thumb. Is this normal? Thank you for your time and help, it is greatly appreciated.

You're approximately 5 weeks out of surgery so other than lifting you should be able to do light things.  I wouldn't pinch anything or do a lot of wrist motion either.  Still favor the arm until about 8 weeks.  Usually you can do just about anything unless you have a heavy job, etc.

The best exercise is to simply take your thumb over to your small finger.  But don't do it in conjunction with moving the wrist.  A good rule of thumb is "thumb with no wrist, wrist with no thumb".  Meaning "park" your thumb against your index finger and move the wrist up and down (flexion and extension).  Then hold the wrist still in a neutral position and then move the thumb over to the small finger.  Don't do both at once or it will put too much stress on the repaired tendon.  The good thing about the thumb is that it usually rehabilitates itself.  You use it so much that it tends to loosen up quite easily.

Favor it until the 8-12 week point.  Watch for "lag" or the inability to straighten the thumb up.  If you notice a lag occuring stop moving the thumb for a few weeks and see if it resolves.

I hope this helps.  Let me know if my advice doesn't make sense/doesn't work.  

Physical Rehabilitation Medicine

All Answers

Answers by Expert:

Ask Experts


Brian Neville, OTR/L, CWCE


I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!


10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

RSD article

Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

©2016 All rights reserved.