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


The Hand to Elbow Clinic
29a James Street West
Bath BA1 2BT

Tel 01225 316895
Fax 01225 484949
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