If it's in the hand or wrist, it's what I do.

Post-operative hand & wrist surgery recovery

Rehabilitation following hand and wrist surgery is a specialist area in its own right. I work closely with surgeons as part of structured post-operative pathways, supporting recovery from the earliest stages through to full return to function.

This includes post-operative wound care and suture removal where appropriate, alongside the management of oedema, restoration of movement, muscle re-education and protection of the surgical repair as healing progresses.

From early mobilisation through to return to full function, the focus is always on achieving the best possible outcome while respecting the biology of healing and the demands of each individual patient.

Wrist and hand fractures

Fractures of the radius, ulna, carpal bones, metacarpals and phalanges all require carefully structured rehabilitation to restore movement, strength and function.

Whether managed conservatively or following surgery, rehabilitation plays a key role in determining outcome. The difference between a good recovery and a long-term restriction is often found in the quality, timing and progression of therapy.

Treatment may include bespoke splinting, phased mobilisation and progressive loading, tailored to the stage of healing and the individual demands of the patient.

Tendon injuries · flexor and extensor

Tendon injuries are among the most technically demanding conditions in hand therapy. Both flexor and extensor repairs require precise rehabilitation protocols where timing is critical. Mobilising too early can risk the repair. Delayed progression can lead to stiffness and adhesions.

My experience within a specialist hand surgery unit provided regular exposure to tendon repairs and their post-operative management. This has given me a clear understanding of the rationale behind each phase of rehabilitation and how to progress recovery safely and effectively.

Ligament injuries and instability

Ligament injuries of the wrist and hand including scapholunate ligament tears, TFCC tears, ulnar collateral ligament injuries such as gamekeeper's thumb or skier's thumb, and carpal instability require accurate assessment and a carefully structured rehabilitation programme.

The aim is to restore stability without unnecessarily compromising movement, ensuring the joint remains both supported and functional throughout recovery.

Treatment typically includes targeted splinting, proprioceptive training and progressively loaded exercises, tailored to the demands placed on the hand in daily life, work or sport.

Carpal tunnel syndrome

Carpal tunnel syndrome is caused by compression of the median nerve at the wrist and typically presents with tingling, numbness and nocturnal pain.

In mild to moderate cases, conservative management can be highly effective. This may include nerve gliding exercises, splinting and activity modification, all tailored to reduce nerve irritation while maintaining hand function.

Following carpal tunnel release surgery, structured rehabilitation is equally important and is often an under-recognised part of recovery. The focus is on restoring function, reducing residual symptoms and supporting a safe return to normal activities.

Trigger finger · stenosing tenosynovitis

When the flexor tendon catches or locks within its sheath, the result is the catching, clicking or locked finger of trigger finger. Conservative management with splinting and tendon gliding exercises is often effective. Where injection or surgical release has already taken place, structured post-procedure rehabilitation helps restore smooth tendon glide and prevent recurrence.

De Quervain's tenosynovitis

De Quervain's tenosynovitis is an inflammatory condition affecting the tendons at the base of the thumb, specifically the abductor pollicis longus and extensor pollicis brevis. It causes pain, swelling and weakness with thumb and wrist movement.

It is commonly seen in new parents, musicians and individuals with repetitive hand demands.

A combination of splinting, load management and progressive rehabilitation is highly effective in most cases when identified and managed appropriately.

CMC joint arthritis

Osteoarthritis of the carpometacarpal joint at the base of the thumb is one of the most common hand conditions I treat and one of the most functionally limiting.

Custom splinting can significantly reduce pain and improve function. This is often combined with joint protection advice, strengthening of the surrounding musculature and activity modification. In many cases, this allows patients to regain meaningful function without the need for surgery.

Where surgery is required, I have experience supporting rehabilitation following CMC joint replacement, working closely within post-operative pathways to guide recovery and optimise functional outcomes.

Dupuytren's contracture

Dupuytren's contracture is a progressive condition affecting the palmar fascia, which can gradually draw the fingers, most commonly the ring and little fingers, into flexion.

Where surgical fasciectomy or needle aponeurotomy is performed, post-operative hand therapy is essential to maintain correction, manage scar tissue and restore as much extension as possible.

Rehabilitation typically includes night splinting, scar management and active exercise programmes, all tailored to support function and reduce the risk of recurrence-related stiffness.

Repetitive strain and overuse injuries

Overuse injuries of the hand and wrist, whether related to keyboard work, manual trades or instrument practice, often present as diffuse pain, weakness or reduced fine motor control.

Management begins with identifying the load patterns contributing to symptoms. Treatment then focuses on reducing tissue irritability, addressing strength and control deficits and modifying activity to support recovery without complete rest where possible.

The aim is to restore sustainable function and enable a safe return to full activity with reduced risk of recurrence.

Musicians' and performing artists' injuries

Pianists, string players, guitarists, percussionists and other performing artists place unique and highly specific demands on their hands that are rarely encountered in general clinical practice.

I am registered with BAPAM and have experience working with musicians and performers, giving me an understanding of both the physical demands of their craft and the psychological pressure that can accompany injury.

Treatment is tailored around the individual instrument, repertoire and performance requirements, ensuring rehabilitation is aligned with the functional and artistic demands placed on the hands and wrists.

Flexor pulley injuries · climber's finger

Flexor pulley injuries occur when the structures that hold the flexor tendons close to the bone in the finger are overloaded, most commonly during rock climbing but also in other grip-intensive activities.

They typically present with pain at the base of the finger, swelling and reduced ability to fully load the finger without discomfort. In more significant injuries, there may be visible bowstringing of the tendon.

Management is guided by accurate grading of the injury and careful load control. Treatment often includes protective splinting, progressive loading strategies and a structured rehabilitation programme designed to restore strength while protecting the healing pulley system.

The aim is a safe return to full grip function and sport-specific loading without recurrence.