De Quervain Tenosynovitis Rehabilitative ExercisesDe Quervains Tenosynovitis Exercises

Stretching & Warm Up

It’s always important to start your rehabilitation exercises by slowly warming up the injured or aggravated joints. Use the following stretches and warm ups to promote blood flow, increase tissue malleability and prepare your joint for more advanced progressions. Always remember to relax and pay attention to your body, as it will give you the best instruction on how to adjust effort and volume. It’s time to feel good, because your recovery starts now!

Thumb Stretch

Movement Instructions:

  1. Hold your hand in front of your body so that your thumb is facing the ceiling
  2. Keeping the same hand position, place your thumb inside your palm.
  3. Slowly close your remaining 4 fingers around your thumb, making a fist.
  4. Keeping the fist, allow the top of your fist to bend forward and down towards the ground. The motion should resemble pouring a drink.  This should be performed slowly and gently, no pain should be felt, just a gentle stretch.
Sets Repetitions How it should feel

Notes:
4 5 seconds A comfortable pulling sensation on the back of the thumb near the base
2 30 seconds

Thumb Abduction

Movement Instructions:

  1. Hold your hand in front of your body so that your hand lay flat and parallel to the floor.
  2. Holding your hand flat, allow your thumb to start parallel to your index finger.
  3. Slowly slide your thumb away from the hand and towards the ground. The thumb should result perpendicular to the index finger
  4. To finish the movement, slowly contract the thumb back into place alongside the index finger.
  5. Repeat the movement as required
Sets Repetitions How it should feel

Notes:
4 20 seconds A smooth contraction on the thick base of the thumb

Thumb Extension

Movement Instructions:

  1. Place your hand flat on a clear surface and allow your fingers and thumbs to come together
  2. Begin the movement by sliding your thumb away from your index finger and towards your body.
  3. To finish the movement, slowly contract the thumb back into place alongside the index finger.
  4. Repeat the movement as required.
Sets Repetitions How it should feel

Notes:This movement resembles the thumb abduction. To observe how this involved muscles are different, watch the small “pocket” that forms on the inside of the wrist in
4 20 seconds A smooth contraction on the side of the wrist

Preliminary Resistance Exercises

When you feel the Tenosynovitis has improved to the point where there is consistent range of motion and no pain, you may be ready to begin resistance exercises. The purpose of using preliminary resistance exercises is to strengthen affected muscles and generate improved movement patterns to prevent re-injury. You have come a long way to get to this point, keep up the good work!

Thumb Extension

Movement Instructions:

  1. Similar to the warm up exercise, place your hand flat on a stable surface and rest your hand in an opened position as if you are preparing to trap a rolling ball.
  2. Wrap an elastic band around the index finger and thumb. This will be used to provide resistance.
  3. Begin the movement by spreading your thumb away from your index finger as far as possible. The thumb should result perpendicular to the index finger in maximal contraction.
  4. To finish the movement, slowly guide the thumb back into place alongside the index finger.
  5. Repeat the movement as required.
Sets Repetitions How it should feel

Notes:This movement resembles the thumb abduction. To observe how the involved muscles are different, watch the small “pocket” that forms on the inside of the wrist.
2-3 15-20 A smooth contraction on the side of the wrist

Thumb Abduction

Movement Instructions:

  1. Similar to the warm up exercise, hold your hand in front of your body so that your hand lay flat and parallel to the floor. Allow your thumb to start parallel to your index finger.
  2. Wrap an elastic band around the index finger and thumb. This will be used to provide resistance.
  3. Slowly slide your thumb away from the hand and towards your body. The thumb should result perpendicular to the index finger
  4. To finish the movement, slowly contract the thumb back into place alongside the index finger.
  5. Repeat the movement as required.
Sets Repetitions How it should feel

Notes:
2-3 15-20 A forceful contraction on the thick base of the thumb with noticeable fatigue upon finished set.

Neurological Exercises

It is of upmost importance that you perform these neurological rehabilitative exercises with extreme caution! The neurological system within our body is very sensitive and should be treated with care. That being said, exercises can be done to reduce sensitivity of deep muscle impingements.  We recommend an evaluation with your physiotherapist before attempting any of these movements and they should always be performed slowly, being careful not to reproduce the symptoms, or aggravate the condition.

Radial Neural Mobility Exercise

Movement Instructions:

  1. Stand up straight with your hands facing forwards at your side.
  2. Turn the wrist that is affected so that the back of the hand is faced forward. Make a fist
  3. Very slowly lower your shoulder and tilt your head to the opposite side of your affected wrist.
  4. Explore a gentle stretch by slowly extending the entire arm straight back behind your torso.
  5. Very gently return your arm to the starting position and take a deep relaxing breath.
Sets Repetitions How it should feel

Notes:
3 15 seconds A very gentle and sensitive pulling sensation along the back of the wrist, arm or shoulder.

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About

Brad Saltz is a successful graduate of the University of Sydney’s Masters of Physiotherapy program, after earning a Kinesiology and Health Sciences Honours degree at York University. He is currently fully accredited and registered in good standing in Canada and Australia, and practices Acupuncture under licence from the AFCI. Brad specializes in the treatment of sports injuries, overuse injuries and motor vehicle accident injuries.

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