Tapping Exercises for Mild Radial Nerve Injury
Yes, patients with mild radial nerve injury can and should perform active finger motion exercises, including tapping exercises, as early mobilization prevents the functionally disabling complication of hand stiffness without adversely affecting nerve recovery. 1, 2
Immediate Exercise Protocol
Begin active finger motion exercises immediately following diagnosis of radial nerve injury. The American Academy of Orthopaedic Surgeons emphasizes that finger motion does not adversely affect adequately stabilized injuries and is critical for preventing stiffness, which is one of the most functionally disabling complications of upper extremity trauma. 1, 2, 3
Specific Exercise Guidelines
- Perform tapping exercises and full active range of motion of all fingers multiple times daily starting from day one of diagnosis. 1, 2
- Continue exercises even if splinting or orthotic support is required for wrist stabilization, as finger mobility must be maintained throughout any immobilization period. 1, 2
- Progress to wrist mobilization exercises at 1-3 weeks based on injury severity and clinical improvement. 2
Rationale for Early Mobilization
Hand stiffness results from pain, swelling, immobilization, or patient apprehension—all of which worsen with delayed mobilization. 1 Finger stiffness can be extremely difficult to treat after nerve injury healing, potentially requiring multiple therapy visits or additional surgical intervention if prevention is neglected. 4, 1
Active finger exercises are extremely cost-effective and prevent complications that would otherwise require extensive rehabilitation. 1
Home-Based Exercise Program
A home exercise program is equally effective as supervised physiotherapy for uncomplicated radial nerve injuries. 4, 2 Five randomized controlled trials comparing home exercise programs against supervised therapy showed no significant difference in outcomes for patients without complications such as complex regional pain syndrome or severe stiffness. 4
- Reserve supervised therapy only for patients developing complications such as persistent stiffness or complex regional pain syndrome. 2
- Instruct patients to move fingers regularly through complete range of motion to minimize stiffness risk. 3
Critical Pitfalls to Avoid
Never restrict finger motion during the recovery phase. Failure to encourage early finger exercises leads to severe stiffness requiring extensive therapy or surgery. 1, 2, 3 Even though the radial nerve controls wrist and finger extensors, maintaining mobility of all finger joints prevents secondary complications. 5
Do not delay exercises due to pain concerns. Implement multimodal analgesia (combining paracetamol with morphine if needed) to control pain rather than restricting beneficial movement. 1
Monitoring Requirements
Reevaluate any patient with unremitting pain during follow-up, as this may indicate complications or progression of nerve injury. 4, 2, 3 Most mild radial nerve injuries (second-degree nerve injuries) recover fully within 6 months with conservative management including early mobilization. 6
Recovery is faster if repetitive activities that exacerbate the injury can be decreased or ceased during the healing phase. 7 However, therapeutic exercises like tapping should continue as they promote rather than hinder recovery. 1, 2