What should I expect during my recovery period?
Physiotherapy treatment at Next Step Physio can begin as soon as you are no longer required to wear your thumb brace, and once your surgeon has given approval for you to begin your rehabilitation. If some minimal support for your thumb continues to be required after wearing the rigid brace your physiotherapist may tape your thumb or prescribe a small soft flexible brace that you can wear as needed while you begin your rehabilitation.
Your initial few physiotherapy treatments will focus on relieving any lingering pain associated with the surgical process as well as the period of immobilization. Your physiotherapist may use modalities such as heat, ice, ultrasound, or electrical current to assist with decreasing any pain or swelling you have around the surgical site or anywhere into your hand or along your arm. Massage to these areas may also be done in order to improve circulation and assist with the pain.
The next part of treatment will focus on regaining the range of motion, strength, and dexterity in your thumb, wrist, hand, elbow, and even shoulder. Your physiotherapist at Next Step Physio will prescribe a series of range of motion and strengthening exercises that you will practice in the clinic and also learn to do as part of your home exercise program. Full motion of your thumb, including opposition, as well as motions enabling your thumb to extend fully away from your palm will be encouraged. The prescribed range of motion and strength exercises may include the use of rehabilitation equipment such as mini pulleys, putty, elastics or balls for strengthening and gripping resistance. In addition to strengthening your grip we will educate you on ways to grip and support items in order to do your tasks without putting too much stress on your new thumb joint.
If necessary, your physiotherapist will mobilize your thumb joint or any other joint in the area that is stiff and impeding normal movement of your hand and limb. This hands-on technique encourages the stiff joints to move gradually into their normal range of motion.
Minimizing or eliminating your pain as well as being able to move your hand and thumb so that you can complete your work tasks and daily activities is the goal of our therapy at Next Step Physio. Maximizing dexterity of your thumb and its fine motor abilities post surgically can greatly improve the functional use of your hand. For this reason, we will also incorporate specific activities into your rehabilitation program like picking up items from a table or twisting items into place using your surgical hand. Other exercises might include activities that are specific to the tasks you personally need to complete on a regular daily basis, such as typing or picking up papers or dishes. These functional activities encourage the joints and the muscles of the hand and arm to work in unison, which is critical to maximizing the use of your entire upper limb. Exercises where weight is put through your new joint, such as pressing the pad of your thumb into different surfaces, will also be added when the thumb is ready. These exercises encourage your surgical joint to tolerate weight in a controlled fashion. Finally, your physiotherapist will discuss ways that you can modify some of your regular activities in order to decrease the overall stress put on your thumb and to avoid problems with your thumb and hand in the future.
When you are well underway, regular visits to Next Step Physio will end. Your therapist will continue to be a resource, but you will be in charge of doing your exercises as part of an ongoing home program. In most cases you will need to attend regular therapy sessions for one to two months, but you should expect full recovery to take up to four months. Ongoing tissue remodeling will occur even up to 12 months post-surgery.
In the majority of cases the physiotherapy we provide at Next Step Physio after resection arthroplasty of the thumb occurs without any complications. If, however, during rehabilitation your pain continues longer than it should or therapy is not progressing as your physiotherapist would expect, we will ask you to follow-up with your surgeon to confirm that the joint is tolerating the rehabilitation well and to ensure that there are no hardware issues that may be impeding your recovery.
Next Step Physio provides services for physiotherapy in Edmonton.
Thumb arthritis may be surgically treated with a procedure called resection arthroplasty or sometimes called excision arthroplasty. The term excision means to take out. In this surgery, the surgeon takes out a small bone at the base of the thumb and fills in the space with a rolled up section of tendon. The soft tissue forms a false joint that keeps the thumb somewhat mobile and stops pain by preventing the joint surfaces from rubbing together.
Surgery can last up to 90 minutes. Surgery may be done using a general anesthetic, which puts you completely to sleep, or a local anesthetic, which numbs only the hand. With a local anesthetic you may be awake during the surgery, but you won't be able to see the surgery.
