Preventing Hand Reinjuries

Recovering from a hand, wrist or elbow injury can be a long and multifaceted process that doesn't stop right after your surgery is over or your splint is taken off. To fully regain function and avoid aggravating the still-sensitive tissues and bones in the injured area, make rehabilitation your next step.

It can be tempting to get right back into sports or other, more routine activities after being sidelined. But once your hand, wrist or elbow has sustained an injury, the area is at a higher risk for getting hurt again, say sports medicine experts.

"It's important to reach full recovery in a manner that will best prevent you from having an injury again in the future," says Neal Chen, MD, hand specialist for Mass General Brigham Sports Medicine, and chief of the Hand & Arm Center at Massachusetts General Hospital.

Often, achieving that full recovery—and staying there—involves a program of rehabilitation and hand therapy.

"There are things we can do to limit the risk of hand injury in the future, which is a lot about education and trying to look at the problem globally," Dr. Chen says.

How Rehabilitation Reduces Reinjury Risk

Physical therapy can feel like a lot of work, but it's worth it. After days, weeks or even months of inactivity, your newly healed tissue isn't as strong as it was before your injury. Return to play too hard or too fast, and your hand, wrist or arm could easily end up right back to where it was, or even worse.

Even if you're careful, hitting the court or field on your own to test how healed you are sets the stage for unintentionally pushing yourself too far. A physical therapist can assess how your healing hand, wrist or arm is able to perform in a controlled environment that won't aggravate your hand, wrist or elbow injury.

After determining your baseline, the physical therapist will develop a plan for you to regain maximum function and mobility, allowing you to gradually return to play without overtaxing your injury. Plans typically involve strengthening and stretching exercises along with manual techniques aimed at reducing stiffness and tightness, improving your range of motion and strengthening your muscles to reduce instability. After your rehabilitation sessions, your Mass General Brigham physical therapist will likely also give you instructions for safely stretching or exercising at home.

"It's important to reach full recovery in a manner that will best prevent you from having an injury again in the future."

Easing Back Into the Game

Rehab programs are highly individualized. The details of your physical therapy plan and when you'll be able to return to play depend on several factors, including:

• The site and severity of your injury
• Age
• Fitness level
• Therapy goals

That said, there are steps every patient can take to get the most from rehab and reduce the risk for reinjury as much as possible as they ease back into normal activities. Here are some general strategies to keep in mind following surgery:

1) Do your physical therapy homework: It might sound obvious, but it's still worth emphasizing—if your physical therapist gives you exercises to do or instructions to follow at home, stick with them. If your therapist recommends applying heat or massage before exercising and ice afterwards to reduce inflammation and pain, don't skip out

2) Protect the injury: Continue to wear any wraps or splints exactly as prescribed. If something feels uncomfortable, let your physical therapist know instead of making changes on your own

3) Find other ways to stay active: Even if you can't play your sport, you don't have to sit on the couch. Just stick with activities that won't tax your injury. Walking, jogging or hiking typically get the green light, but check with your physical therapist first

4) Keep the lines of communication open: Lack of communication can be a recipe for reinjury. Make sure you clearly understand the details of your injury and rehabilitation plan, and confirm that everyone else on your team—including your doctor, physical therapist, sports and conditioning specialist, and coaches—is on the same page about it, too

5) Be patient: Expect to spend about twice as much time in rehab as you did being totally inactive

"It can seem like a long trip to get from a stiff painful hand to the end point," Dr. Chen says.

Remember that sticking with your program will ultimately give you the best results—so you can get back to doing what you love.