How to care for thenar muscles after receiving stitches on the hand?

Care of Thenar Muscles After Hand Stitches

Continue progressive strengthening and range of motion exercises for at least 6-9 months post-surgery with no limitations on use or activity choice, focusing on exercises that improve joint mobility and muscle strength of the thenar eminence. 1

Immediate Post-Operative Phase (First Week)

• Apply cryotherapy during the first postoperative week to reduce pain and swelling, with benefits most pronounced in the first 3 postoperative days. 2
• Ensure patient education on safe ice application to avoid cold injury. 2
• Begin gentle active range of motion exercises of the thumb as soon as wound closure permits, avoiding excessive force that could disrupt the repair. 3

Early Rehabilitation Phase (Weeks 1-4)

• Start progressive strengthening exercises focusing on thenar muscles (abductor pollicis brevis, flexor pollicis brevis, opponens pollicis) incorporating both concentric and eccentric exercises, provided there is no increase in pain or effusion. 1
• Perform exercises aimed at improving thumb opposition, abduction, and flexion to restore thenar muscle function. 3
• Monitor for pain, effusion, or temperature increase as signs to slow progression. 2
• Perform exercises at least 3 times per week with each session lasting at least 30 minutes for optimal results. 1

Intermediate Phase (Weeks 4-12)

• Continue full range of motion exercises for the thumb, focusing on exercises that improve joint mobility and muscle strength of the thenar eminence. 3, 1
• Progress resistance gradually as tolerated, ensuring no reactive swelling or pain with each advancement. 2
• A minimally supervised home exercise program is appropriate for motivated patients at this stage. 1

Advanced Phase (3-6 Months)

• Continue strengthening and range of motion exercises for at least 6-9 months post-surgery with no limitations on use or activity choice. 1
• Return to normal daily activities to promote functional recovery. 1
• Adjust the exercise program as needed based on progress. 1

Critical Pitfalls to Avoid

• Do NOT advance ROM or resistance if reactive swelling, pain, or temperature increase occurs - this indicates tissue irritation requiring a reduction in activity level. 2
• Do not restrict functional use of the hand unnecessarily, as this can lead to stiffness and poor outcomes. 1
• Do not rely solely on time-based criteria for return to activities; use objective functional testing including grip strength and range of motion assessment. 2

Return to Full Activity Criteria

• No pain or swelling with activities involving thenar muscle use (pinch, grasp, opposition). 2
• Full thumb range of motion achieved, particularly opposition and abduction. 2
• Adequate thenar muscle strength demonstrated through functional testing. 2