EPL REPAIR (Zone 2+)
Therapy guide
- OPA at 10 days post op
- POP wrist and thumb extended. Fingers free.
- Physio begins at 1st clinic appt
- Volar splint, forearm based with thumb and wrist in full extended position
Exercises: 0 –3 weeks
- Keeping splint on, full flexion/extension of all unaffected digits
- With splint off, thumb in full extension, flex and extend IPJ x10
- Hand flat on table, bring thumb into side of IF x10
- Scar massage – once wound healed. 5 minutes every hour
- Keep an eye on the splint. Make sure fit is OK, adjust as necessary.
Exercises: 3 - 5 weeks
- Commence ‘place and hold’ exercises. X5
- Bend thumb to ½ of full flexion. Repeat x10
- Advise patient not to rush rehab. Reiterate tendon healing times, especially as the hand will be feeling a lot better now. Advise that tendon could still rupture or stretch if over-used.
Exercises: 5 - 6 weeks
- Continue all other exercises
- Aim for full fist by 6 weeks (i.e. full ROM at thumb) – this is a gradual process
- Start some strengthening work – again graded
Exercises: 6 - 7 weeks
- Wean off splint. To wear at night and ‘at risk’ times for next 10 days
- Full fist with overpressure. Sustained holds
- Can start light activities
- Not to lift anything heavier than a kettle
Exercises: 7 weeks +
8 weeks: Can consider driving (if has a good grip) but remember it is their responsibility to safely do so.
10 weeks: Can return to heavy work
12 weeks: Can return to full contact sport