How to Rehab After a Carpal Tunnel Surgery in Rock Climbers

The best way to rehab after Carpal Tunnel Release is to ensure that your wound heals well and that you mobilize the scar, the muscles, and joints around the hand thoroughly. Then, when your hand moves freely, do strength training and gradually return to rock climbing after 6-12 weeks post-surgery.

Do you want to know what rehab after Carpal Tunnel Release looks like in your situation?

Then read on below.

Hey ho, let’s go.

1. What Happens During Carpal Tunnel Surgery?

During Carpal Tunnel Release Surgery either 1 of 2 forms of surgery is performed:

  • Open Technique: a cut is made on top of the carpal tunnel surgery (palmar side of the wrist) and the transverse carpal ligament is cut
  • Endoscopic Technique: a small how is made below the wrist where the surgeon puts a tube into your wrist. With a camera and small tools, the surgeon will be able to cut the transverse carpal ligament

2. How Will Your Symptoms Be After Carpal Tunnel Release?

It depends on the severity of your Carpal Tunnel Syndrome and what your symptoms will look like after surgery.

If you were “just” experiencing pain and little loss of function there’s a high chance most of your symptoms will be gone as soon as surgery is over. When the nerve doesn’t experience any entrapment anymore, there’s no reason to provoke pain.

However, if you were experiencing pain for months on end the nerve might take longer to recover.

The same is true if you were experiencing loss of function in the form of strength reduction or sensibility issues. This is a sign that the nerve is damaged and thus follows the recovery times of neurological tissues. These recover over 6-12 months, which means you can still experience CTS symptoms after surgery.

3. How to Quickly Recover from Carpal Tunnel Surgery as a Rock Climber?

The best way to recover fast after Carpal Tunnel Release is by entering surgery as fit and healthy as you can. This is called the “better in better out” principle. The better you enter surgery, the better you come out.

Furthermore, the following factors can help you to recover efficiently:

  • Drink a lot of water before and after surgery to help your body deal with the inflammation and waste products after surgery
  • Don’t smoke (quit entirely preferably) because it affects your blood circulation and thus reduces your healing capacity
  • Follow a solid rehab protocol. This will aid in loading the structures the right way at the right moment to enhance healing
  • Sleep well (as always!)
  • Eat well and enough. Talk to a nutritionist to find the right diet for you. As things go, what you eat and drink will become the building blocks of the tissues that need to recover

Now, let’s dive into what a solid rehab protocol looks like after Carpal Tunnel Release.

4. What to do in the First 2 Weeks after Carpal Tunnel Surgery?

During the first 2 weeks after surgery, you’ll likely be wearing a cast or brace of some sort to keep your wrist in the ideal position. This ensures you don’t irritate your median nerve unnecessarily and helps the wound to heal properly.

The wrist is a sensitive area with a lot of structures (bones, muscles, ligaments) and a thin layer of skin. Little changes can have big consequences. Definitely for us rock climbers.

The parts of your arm and hand you can move though, you should after surgery. This will enhance blood circulation in the area and ensure your joints don’t stiffen up.

Simply move your fingers, elbow, and shoulder deliberately. Move in all directions without adding any resistance. Do this multiple times per day.

5. How to Progress your Carpal Tunnel Rehab after Your Brace Comes off?

As soon as the brace comes off you can start moving your wrist. So do this! Move your wrist, fingers, and elbow in all directions. This is the same as what you did the previous weeks but now you can move more freely.

Another important exercise you can do is “sliders” of the median nerve. Because the median nerve was entrapped in the carpal tunnel it’s at least damaged a little. Sliding the nerve forward and backward will mobilize the nerve and aid the recovery of the nervous tissue.

I always explain sliders as “flossing of the nerves”. By moving the nerve front and back it’s freed from its entrapment.

See the video below on how to slide the median nerve. It’s an easy and effective exercise you base on the amount of pain you feel. You start sliding at the point you feel light provocation of the nerve. You sense this provocation by experiencing familiar symptoms from before your surgery or by a tingling sensation in your hand.

Once your operated wrist moves freely you can start doing strength training. This will aid in the development of the muscles around the hand and forearm. Besides that, it’ll also stimulate your nerve to heal better because you’re stimulating signal transmission.

Good exercises after Carpal Tunnel Release are:

  • Dumbbell Wrist Flexion
  • Dumbbell Wrist Extension
  • Triceps Extension
  • Biceps Curls
  • Bent of Rows
  • Pull-ups
  • (Very) Light Hang Board Exercises (if you did use them before surgery)

5.1 How to Treat the Scar of a Capral Tunnel Release the Right Way?

The best way to treat a scar after surgery is to first wait until the crust comes off and your skin is clean. Then, 3-4 times a day massage the scar with oil. This can be anything from olive oil to a cream that’s specially made for treating scars.

There should be no hard parts in your scar. It should move well, feel soft and not provoke any discomfort when moving your wrist.

6. How to Return to Rock Climbing after Carpal Tunnel Release?

The best way to return to rock climbing after carpal tunnel release is by slowly increasing your climbing volume, intensity, and training frequency. Before you jump back on the wall though, you should:

  • Be pain-free in your everyday life
  • Have full range of motion in your elbow, wrist, and hand
  • At least wait until 6 weeks after your surgery (for the wrist to heal)

You can read in my blog about “How to Return to Rock Climbing after a Break”. There I explain in detail how to gradually increase your climbing intensity.

Joël Broersma

Hey! I'm Joël, a rock climbing physiotherapist living & working in Switzerland. When I'm not at the crag climbing I like the run the trails around my home or go out for a paddle on the lake.

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