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Physical Therapy

Disease and injury of the hand as well as the resulting surgical treatment can often lead to pain and immobilization that causes functional limitations.
The duration of immobilization should be minimized to only the amount of time considered essential so that movement is not unnecessarily restricted.
Physical and occupational therapy are used to support the continued treatment of the patients.
As soon as it is clear that a patient cannot obtain normal function of the hand on his own accord, the prescription of physical and occupational therapy is absolutely necessary!
In the case of many diseases, injuries or surgeries of the hand, it is anticipated that physical and occupational therapy will be required. Since the goal is to achieve the least possible limitation of function, the prescription is issued early on.
Physical and occupational therapy have also shown their worth in preparation before hand surgery. For example, surgery involving the freeing of flexor tendons can only be successfully carried out when preoperative physical and occupational therapy is able to achieve full mobility of the hand or finger in question.

In general, the prescription of physical and occupational therapy should follow these guidelines:
  • Acute Phase: Therapy should occur daily in order to ensure healing or functional normalization as quickly as possible.
  • Chronic Phase: Therapy is continued one or twice a week in order to maintain the functional level reached through therapy during the acute phase. The patient must play a more active role in this phase by independently completing the learned exercises.
The following physical therapy techniques are often utilized in cases of hand surgery:
  • Stimulation of circulation (movement exercises, stimulation with warm and cold, edema prophylaxis and therapy, lymph drainage)
  • Relaxation of muscles (mobilization, stretching massage)
  • Stimulation and encouragement of muscle contractions (stimulation with ice, stretching, exercises with various materials)
  • Joint mobilization (passive full-range movement, active movement, special join techniques such as: manual therapy, Maitland's therapy static and dynamic splints)
  • Strengthening of muscles with intact enervation (resistance exercises)
  • Promotion of skin elasticity and the gliding of tendons (skin care, stretching, active bending with resistance, mobilizing massage, ultrasound)
  • Encouragement and stimulation of superficial sensibility ("touch" and "recognition" of various materials, massage)
  • Prescription of a home training program (at least 10 minutes every hour!)
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