Carpal Tunnel Release (Endoscopic) Starter Exercise Guide

1. Hand & Wrist Elevation and Swelling Control

What it helps: Controls the swelling that is the main cause of stiffness after hand and wrist surgery. A swollen hand cannot make a full fist, and fingers left stiff in the first weeks are much harder to free later than the wrist itself is.

How often: every hour while awake sets of 10 slow fists, daily.

1. Rest the hand higher than your heart. Sitting, prop it on pillows or on the back of a sofa; standing, rest it on the opposite shoulder; lying down, support the whole forearm on cushions.
2. With the hand up, slowly make a loose fist and open it fully, spreading the fingers.
3. Repeat the slow fist-and-open several times, then let the hand rest in the raised position.
4. Come back to it regularly through the day rather than doing one long session.

Tip: Above the heart is the part that matters. A hand resting on your lap or in a sling at waist height is not elevated, and this is the commonest reason swelling does not settle.

2. Median Nerve Glides

What it helps: Keeps the median nerve gliding smoothly through the carpal tunnel — easing the irritation behind carpal tunnel tingling without over-stretching a sensitive nerve.

How often: 2–3 sets of 5–10, daily.

1. Start with a gentle fist, wrist neutral.
2. Open the fingers straight, then bend the wrist back so the palm faces forward and fingers point up.
3. Gently add a thumb stretch with the other hand if comfortable, then return. Move slowly through the sequence.

Tip: Gentle gliding — never a hard stretch, which can irritate a sensitive nerve.

3. Finger Range of Motion

What it helps: Keeps the finger joints moving through their full range — preserving the bend and straighten you need to grip, pinch, and use your hands for everything.

How often: 2–3 sets of 10, daily (several times).

1. Open the hand wide, fingers straight.
2. Make a full fist, then open again.
3. Bend each finger one at a time toward the palm, then straighten.

Tip: Smooth, comfortable motion through the whole range.

4. Tendon Gliding (Finger Glides)

What it helps: Keeps the finger tendons sliding freely through their sheaths and the carpal tunnel — preventing stiffness and catching, and keeping the hand smooth and supple.

How often: 2–3 sets of 5–10 of each, daily.

1. Start with fingers straight.
2. Bend just the top two knuckles into a "hook," then straighten.
3. Make a full fist, then straighten.
4. Bend the big knuckles only into a "tabletop," then straighten.
5. Make a "straight fist" (fingers curled but knuckles flat). Move slowly through each.

Tip: Move smoothly through the whole sequence.

5. Thumb Range of Motion

What it helps: Keeps the thumb's wide range — reaching, pinching, and opposing to the fingers — which is behind nearly every grip and pinch task the hand does.

How often: 2–3 sets of 8–10 each, daily.

1. Move the thumb out away from the palm, then back.
2. Touch the thumb tip to each fingertip in turn (opposition).
3. Make gentle circles with the thumb. Keep it comfortable.

Tip: Smooth, pain-free motion.

6. Elbow Range of Motion

What it helps: Keeps the elbow and forearm moving through their full range — preserving the bend, straighten, and rotation you use for everyday tasks.

How often: 2–3 sets of 10 each, daily.

1. Bend the elbow to bring your hand toward your shoulder, then slowly straighten it all the way.
2. With the elbow tucked at your side and bent 90°, turn your palm up, then down.
3. Move smoothly through comfortable range; don't force the ends.

Tip: Keep the upper arm still — the movement is at the elbow and forearm.

7. Walking Program

What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.

How often: throughout the day.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tip: Use your assistive device as directed.

8. Scar Massage & Desensitisation

What it helps: Keeps the scar soft and mobile rather than tethered to the tissue underneath, and settles the hypersensitivity that makes a healed scar uncomfortable to knock or lean on. It is also what most helps the deep soreness in the heels of the palm after a carpal tunnel release.

How often: 2–3 sets of 3–5 minutes, daily.

1. Wait until the wound is fully closed and any stitches are out — usually around two to three weeks. Check with your care team if unsure.
2. Put a little unscented moisturiser or plain cream on the scar.
3. Press firmly with a fingertip and move in small circles along and across the scar, firm enough to move the skin over the tissue beneath rather than sliding over the surface.
4. Then rub different textures over the area — a towel, a soft cloth, clothing — for a minute or two, building from soft to coarser as it becomes tolerable.

Tip: Firm enough to move the skin is the point. Light stroking feels pleasant and does very little.

Recovery reading

• Carpal Tunnel Surgery Recovery
• Trigger Finger Surgery Recovery
• Wrist Fracture (Distal Radius) Recovery
• Hand Therapy & Swelling After Surgery
• All Hand & Wrist recovery guides