IMG PHYSICAL THERAPY

805 N. Richmond St., Suite 103 Fleetwood, PA 19522

IMGPT.COM 610-944-8140
Chris Gordos, DPT Center Manager
Eric Parrish, MPT Staff Therapist
Hand / Wrist Stretching and Strengthening
Home Exercise Sheet
Rehabilitation ofthehand / wristmay take anextended period oftime. Aloss ofstrength, range of
motion, anduseis common after aninjury orsurgery. Your strength, range ofmotion, anduseofthe
hand / wrist can beregained. It may become frustrating at times, butyou can besuccessful withhard
work, patience, andlistening to your body.
When you are exercising on your own athome there are some things to remember....
O Any specific exercise thatcauses pain is hindering the healing process
for your injury and should be modified or discontinued.
O Swelling after exercise indicates that the exercise is too difficult orit isnot
being done correctly. You need to change your program to eliminate the
problem. Be sure toice thatarea of swelling and use compression wrap as
necessary.

o Re-injuries during the rehabilitation process will slow your progress. If you
get recurring pain either lower the resistance; lower the number of sets or
repetitions; or reduce the range of motion toavoid the area of pain.
O You should experience muscle soreness, dull ache, fatigue, and stretching sensations, but the
exercises shouldnot increase the pain or swelling.

O When in doubt about how much weight touse for exercises, guess low. It is
safer and easier toadd weight than tohurt yourself with too much weight.
O Consult your Physician or Physical Therapist if any problems arise or ifyou
have any questions regarding an exercise. Itisbetter tomake sure thatyou are
doing an exercise correctly than tocause further injury by doing an exercise
incorrectly.

These exercises areto be done 1time per day OR3 to 5 days per week.
Perform 2 sets of15 repetitionsforstrengthening exercises.
Stretching isperformed 3-15 times holding 10-30 seconds each time.
Ice for 15minutes after exercising.
Do not ice before exercising.
RoutineFor: Program Elbow Jan 14,2011
Created By: Eric Parrish / Chris Gordos

HAND -13 Wrist Flexor Stretch HAND -14 Wrist Extensor Stretch

Keeping elbow straight, grasp injured hand andslowly bend Keeping elbowstraight, grasp injuredhand and slowly bend
wrist back until stretch is felt. Hold 30 seconds. Relax. wrist forward until stretch is felt. Hold 30 seconds. Relax.

Repeat_2z5_times per set. Do. sets per session. Repeat 3-5 times per set. Do 1 sets per session.
Do 1-2 sessions per day. Do 1-2 sessions per day.

HAND - 40 PROM: Wrist Radial / Ulnar Deviation HAND - 20 Forearm Pronation Stretch

With injured hand in

handshake position, grasp
and slowly turn to palm
down position untilstretch
is felt. Hold 30 seconds.
Relax.

Grasp injured hand with other hand and gently stretch hand
andwristfromsideto sideas far as possible. Holdeach
position 30seconds. Relax. Repeat 3-5 timesper set.
Repeat 3-5 times per set. Do _1 sets per session. Do 1 sets per session.
Do 1-2 sessions per day. Do 1-2 sessions per day.

HAND -19 Forearm Supination Stretch HAND - 8 AROM: Finger Flexion / Extension

Actively bendfingers of
Withinjuredhand in injured hand. Start with
handshakeposition, grasp knuckles furthest from
andslowly turnto palmup palm, and slowly make a
until stretch is felt. Hold 30 fist. Hold 10 seconds.
seconds. Relax. Then straighten
Relax. fingers as far as possible.

Repeat 3-5 times perset. Repeat 10 times perset.

Do 1 sets per session.
Do 1 setsper session.
Do 1-2 sessions per day.
Do 1-2 sessions per day.
Page 1 of4
Copyright 1999-2009, VHI
Routine For: Program Elbow Jan 14,2011
Created By: Eric Parrish / Chris Gordos

HAND - 38 PROM: Elbow Flexion / Extension HAND - 63 Wrist Flexion: Resisted

Grasp injured arm at

wrist and gently bend
elbow as far as possible.
Then straighten arm as With injured palm up,
far as possible. Hold poundweightin hand, bend
each position 30 wrist up. Return slowly.
seconds.

Repeat 3-5 times

per set.
Do 1 sets
per session. Repeat 15 times per set.
Do 1-2 sessions Do 2 sets per session.
per day. Do 1 sessions per day.

HAND - 64 Wrist Extension: Resisted HAND - 65 Wrist Ulnar Deviation: Resisted

With injured palm down, pound weight in hand, bend With injured thumb down and pound weight inhand,
wristup. Returnslowly. bend wristup. Return slowly.
Repeat 15 times per set. Do __2 sets per session. Repeat 15 times per set. Do 2 sets per session.
Do 1 sessions per day. Do 1 sessions per day.

HAND - 66 WristRadial Deviation: Resisted HAND - 48 Forearm Pronation / Supination: Resisted

(Sitting)

With injured forearm supported, grasp object and gently

With injured thumb up, pound weight inhand, bend rotate palm up, then down, as far as possible without pain.
wristup. Returnslowly.
Repeat 15 times per set. Do 2 sets per session.
Repeat 15 times per set. Do 2 sets per session. Do 1 sessions per day.
Do 1 sessions per day.

Copyright 1999-2009, VHI Page 2 of4

Routine For: Program Elbow Jan 14,2011
Created By: Eric Parrish / Chris Gordos

HAND - 70 Wrist Elbow Flexion: Resisted - Palm Up HAND - 71 Elbow Extension: Resisted

Lie on back, pound

With injured arm straight,
weight in injued hand, arm
palmforward, holding
up, elbow bent and
pound weight, bend elbow.
supported. Straighten
Return slowly. elbow. Return slowly.
\ H i

Repeat 15 timesper set. i / Repeat 15 timesper set.

Do 2 sets per session. Do 2 sets per session.
Do 1 sessions per day. Do 1 sessions per day.

HAND - 35 Elbow Flexion: Resisted HAND - 36 Elbow Extension: Resisted

With tubing wrapped

around injued fist and
With tubing wrapped other end anchored,
aroundinjuedfist and other straighten elbow.
end secured under foot, curl
amiup as far as possible.

Repeat_L5__ times
per set.
Do 2 sets
Repeat __15_ times per set. per session.
Do 2 sets per session. Do 1 sessions
Do 1 sessions per day. per day.

SHOULDER - 44 Strengthening: Resisted Internal Rotation SHOULDER - 43 Strengthening: Resisted External Rotation

Hold tubingin injuedhand,

elbow at side and forearm Hold tubing in injuedhand,
out. Rotate forearm in elbow at side and forearm
across body. across body. Rotate
forearm out.

Repeat_J5_ times
per set.
Do 2 sets
per session. Repeat 15 times per set.
Do 1 sessions Do 2 sets per session.
per day. Do 1 sessions per day.

Copyright 1999-2009, VHI Page 3 of4

Routine For: Program Elbow Jan 14,2011
Created By: Eric Parrish / Chris Gordos

SHOULDER - 45 Strengthening: Resisted Extension SHOULDER-75 Strengthening:

Scaption - with ExternalRotation

Hold tubing in injued hand, Holding poundweight, raise injued

arm forward. Pull arm back, armdiagonally from hip to shoulder height, i
elbow straight. (NOT AS PICTURED) Keep elbow L/ \
straight, thumb up. ^
)

!/
Repeat 15 times per set. Ljf;fZ^r\ Repeat 15 times per set.
Do 2 sets per session. ^*\ \ Do 2 sets per session.
Do 1 sessionsper day. Do 1 sessionsper day.

SHOULDER- 84 ROM: Abduction (Standing) SHOULDER-83 ROM: Flexion (Standing)

Bringarmsstraight out in front

to shoulder height (NOT AS
PICTURED), without pain.
Keep thumbs facingup.
pounds.

Bring arms straight out from sides and raise arms only to
shoulder height (NOT AS PICTURED)without pain.
pounds Repeat 15 times per set.
Repeat 15 times per set. Do 2 sets per session. Do 2 sets per session.
Do 1 sessions per day. Do 1 sessions per day.

HAND-47 Towel Roll Squeeze

With injured forearm resting onsurface, gently squeeze

towel.
Repeat 15 times per set. Do 2 sets per session.
Do 1 sessions per day.

Copyright 1999-2009, VH1 Page 4 of4

 The Tray Exercise
-The purpose ofthis exercise is toglide the nerves to allow for improved motion while performing in safe range.

Correct Performance of the Exercise:'

1." Start by lifting your rib cage as high as possible (Can often be accomplished by taking in adeep breath)
2. Bend both Elbows to 90so thatyour palms are facing up. Imagine thatyou arecarrying a full tray.
3. Lift your shoulders straight up towards your ears. Must be done'in apain-free range.
4. Straighten your elbows, while keeping shoulders shrugged up.
5. If still pain/symptom free attempt to bend wrist so palm's are facing UP / DOWN.
6. Return arms to step #2, as if holding a tray .
7. Relax/lower your shoulders to a natural position.

Frequency: The exercise should be performed up to 30 times aday. In the beginning 10-15 at atime will be tough enough.
Remember that the exercises should not cause pain or increase your symptoms dramatically.

%s

TENDON GLIDING

STRAIGHT HOOK FIST

Slowlydraw your head

Sit in:astraight back chair
backwards, keeping your eyes
supported to the level of your
level.
shoulder blades. Your bottom
The movement is similar to
should be as far back in the
avoiding something being
chair aspossible. Relax against
pushed in your face.
the back ofthe chair.
Try to make me movement
smoothand draw your head STRAIGHT FIST
TABLE TOP
further back with each
repetition.
1. Start with your fingers and wrist
straight every time.
2. Make each type of fist 10 times.
Perform 30 _repetitions every DaV. Hold about 5 seconds.
3. Do these exercises 2 times evprv Haw