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By Brittany Ferri October 17, 2020

Dupuytren’s contracture is a common disease that affects the fingers, especially the ring finger and little finger. While there are many natural approaches that are effective in managing symptoms of Dupuytren's, severe cases may need surgery to help someone regain function in the affected fingers. You may wonder just how debilitating surgery is and how much time it would take to recover. This can be especially concerning if you are an active person who consistently likes to exercise and be involved in various activities.

This mentality is great (and highly encouraged!), since motivation leads to quicker recovery times. However, it's still important to be safe and follow the aftercare instructions given by your surgeon. Most Dupuytren's surgeries involve the following basic rehabilitation protocol.

After Surgery

Post-surgery therapy sessions are a very important aspect of a complete recovery from nearly any surgery. Your doctor may recommend that you visit an occupational therapist or physical therapist (these professionals may also be called hand specialists if they have the letters "CHT" after their name).

You will be asked to attend therapy sessions for 5 to 6 weeks. Depending on the severity of your condition, your age, and the presence of other medical conditions, you may attend therapy for more or less time. Sessions will include heat treatments, massage, and exercises. The exercises are not typical exercises you might complete in the gym, rather they are concentrated on the hand and fingers to help you regain motion and flexibility.

The workouts are often quite simple and therapists will guide you in how to safely and correctly complete them. Therapists often give you additional exercises to complete at home without supervision, which further accelerates your recovery and progress toward meeting your goals. It is best to do them just how your therapist says, since this ensures you will get the best results.

Activity Limitations

Your fingers may be swollen for a few days after the operation and you may also need to take pain killers for the first week or so. It's important to take these medications not only so that you are in less pain, but also to help cut down on inflammation that will be present after any surgery.

You might have to wear a splint for several months after the surgery, especially at night, to keep your fingers straight and protect them. Following surgery, your daily activity should be limited and you should take caution to not exert your hand too much. If your job involves a lot of hand movement like typing, you will have to take time off for at least a couple of weeks. This is again dependent on the type of job you have, the type of surgery you had, and how fast you recover.

You should prioritize rest for the first few days after surgery and slowly return to your normal activities (as your doctor says it's okay). Taking small walks is a good way to get blood flowing and help with the healing process. This also does not require use of the hands, so it's a safe activity to begin right away. Donot exert your hands by lifting heavy objects, typing, scrubbing, cutting food, or holding equipment that vibrates (like jackhammers or hair clippers).

Refrain from any activities that involve repeated hand movements that can place undue pressure on the hands. Keep your hand dry unless allowed by the doctor to wash it, especially if you're wearing a splint. Otherwise, you might get the incision wet and place yourself at risk for developing an infection.

Post-operative care ispart of treatmentand essential to a patient’s recovery. Abide by the precautions you are given and focus on the hand exercises you are given by your therapist.

Complete your exercises

Here are some simple, but beneficial workouts for your hand that can help you regain flexibility and control different motions again. It is best to do these in conjunction with other therapist recommendations. You can do any of these exercises in sets of 10 to be completed 3-4 times each day.

Finger bends

Gently bend and straighten your fingers occasionally throughout the day to increase their flexibility and reduce swelling. Make a loose fist by curling your fingers inwards so that the first two joints are bent inward, but the knuckles are not. Open the fist, spread your fingers wide, and make another loose fist. Repeat as you are able to.

Finger spreads

Place your hands palm down on a smooth hard surface like a table. Spread out all your fingers as far as you can without causing pain. They should resemble a starfish. Close them back in again and repeat. You can also do this with your hand in the air, too. If needed, you can use two fingers from your other hand to stretch each finger further apart and feel a little stretch.

Windshield wiper

Assume the same position as above by placing your hands palm down on a smooth surface like a table. Spread out all your fingers as far as you comfortably can. One at a time, practice swiping each finger across the table multiple times.

Finger lifts

With your hand palm down on the table, lift each finger up one-by-one. Hold it there for five seconds before moving to the next finger and repeating the same step.

Thumb exercises

Touch the tip of your thumb to the tips of all the other fingers in succession. Also practice reaching your thumb across the palm and touching it to the base of your little finger.

Grip exercises

Gripping exercises are also great to help restore your ability to powerfully use your hands to grasp items. This exercise should be saved until your therapist or doctor specifically clears you for this type of movement. Once you can proceed, start by practicing with holding different objects. Begin with bigger ones that require less bending of the fingers and then move to smaller ones that need more precise control.

Straighten and hold

Use two fingers from one hand to straighten the affected fingers of the other hand. Arch these fingers back slightly until you feel a little tension. Keep them in that position for 10 seconds and ease up if you begin to feel discomfort that is not tolerable.

Another thing you can do is place your pointer finger just above the knuckle of the affected finger and push it back until you feel some tension. Then slowly move upwards, pressing the whole finger back. This will help strengthen the more delicate intrinsic muscles in your hand.

Rolling

For this exercise, you'll need a rounded or cylindrical object like a highlighter pen, marker, or a small rolling pin. Place it on a table or any flat surface and roll it back and forth by pressing the palm of your hand against it. It's recommended to do this for a few minutes, but you can do it as long as you'd like (if it's comfortable). This gives your hand a gentle massage and gets the blood flowing. You can also use your other hand to give your affected hand a full massage twice each day. 

Remember

With all of these exercises, make sure your movements are gentle and you don’t overstretch, since this can make the contracture worse and actually cause further damage to your hand. Avoid clenching your hand too tightly in a fist or holding objects that require a strong grip with the use of closed fingers. Be consistent with your workout and make sure to visit your therapists regularly.

Brittany Ferri
Brittany Ferri

Brittany is a registered and licensed occupational therapist who has 6 years of clinical experience treating conditions such as Dupuytren's, arthritis, carpal tunnel, and more. She is passionate about educating others about their health.


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