What can Hand Therapy do for you post surgery?

A number of complications can arise post-surgery, many of which can easily be treated. If you are experiencing pain or discomfort from your surgery there may be some simple strategies that will help ease your symptoms.

Surgical Reconstruction

After any injury, surgery or condition, stiffness can occur and strength can plummet due to disuse of the muscles, prolonged periods of being held still in a cast, persistent swelling that blocks movement and patients ‘protecting’ their arm resulting in non-use of the joint. Joints are prone to getting stiff very quickly and we use a variety of techniques to ensure we get the hand and wrist moving first and then work on regaining strength.

We often see patient’s months post surgery with stiffness and limited ROM who believe their surgery wasn’t successful due to their ongoing symptoms. Some patients required the extra education on the process of healing structures and given the right exercises and confidence they begin using their hand in daily activities to achieve optimal results post a surgery.

Depending on the injury or surgery completed exercises can be active, active-assisted, or passive and may consist of TAM (total active motion), TPM (total passive motion), joint blocking, tendon glides, intrinsic and extrinsic and proprioception exercises. There is a balance between creating movement in the injured limb to prevent tissues sticking together, while also resting the injured part to allow structures to heal well. At Lime we are able to see patients post fracture and fixations, dislocations, arthroplasty, joint replacement, ligament repairs, skin grafts and many more.

Wound Management

At Lime we are able to complete dressing changes for clients with wounds healing by primary intention. The most common wounds we see are post-surgical wounds of the hand e.g. lacerations, dupuytren’s release, tendon repairs, ORIFs. We often need to debulk dressings to allow for ROM and to fabricate splints to adequately fit the client. Goals of wound care in the clinic are to promote healing and prevent/manage infection, remove nonviable tissue by debridement, establish and maintain a clean, moist, protected wound bed and maintain skin surrounding wounds. If any signs of infection are seen clients are directed back to their GP for management. We aim to provide optimal wound healing for all our clients in order to achieve the best results post operatively, begin scar management and aid in early functional use of the upper limb.

Oedema Management

Fluid build up in a patients hand or arm causing oedema can greatly impact on the healing process of wounds, restrict movement and cause pain post surgery. We often see patients who have experienced persistent oedema post surgery and are unsure how to manage their swollen limbs. We are able to identify the underlying causes and recognise the different types of oedema, clinically assess and determine the appropriate treatment techniques for different oedema presentations. Using simple compression bandaging for upper limb management like Coban wrapping or compression garments, along with education on massage techniques, identifying skin integrity issues and maintaining skin hydration can all improve functional outcomes post surgery.

Scar Management

At Lime we offer scar management services, not just for scars to the upper limb but whole body, Scars that occur as a result of injury, burns or surgery can become thick, raised and inflamed quickly. On occasions scars adhere to the tissue underneath the skin and prevent movement causing contractures, pain and disability. The final stage of wound healing, remodelling phase, occurs anywhere from 3 weeks to 2 years from injury. Scar adhesions begin to form and mature as new collagen is produced and it is at this stage of healing, scar management should begin and is most effective. Early referrals will enable implementation of correct and consistent methods to minimise scar tissue. We deliver treatment techniques to improve scars, decrease functional impairment and prevent the spread of scar tissue. We use researched and evidence based treatments to improve the look and feel of scars such as compression, silicon gel, massage, splinting and desensitisation techniques. Therapists routinely note the colour, size, shape and texture of healing scar tissue, often taking photos to see the progression of healing.