ÌÀÍ·Ìõapp

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When patients come to us for hand therapy after surgery ¡ª whether they¡¯re recovering from a carpal tunnel release to relieve pressure in the wrist, a tendon repair, or surgery to address fractures or broken bones ¡ª one lingering outcome is nearly universal: a scar.

Hand therapy after surgery is critical for helping restore function and mobility, and having scar management as part of your treatment plan is a simple, but powerful, way to ensure a smoother recovery. In fact, with proper care, techniques and a little consistency, you can improve scar mobility, comfort and appearance.

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While scars are a natural part of the healing process, scars that are not properly cared for can lead to functional limitations ¡ª inhibiting your ability to make a full recovery after surgery.

For example, you may experience tightness or pulling while moving your hand; reduced range of motion; hypersensitivity, numbness or tingling; and/or thickened, raised or dark scars.

After surgery, scar tissue also can adhere to tendons, muscles or nerves ¡ª further limiting mobility and causing discomfort. Scar tissue can be especially disruptive in the hand, where intricate structures must work closely together for the hand to function correctly.

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In hand therapy, a certified hand therapist or occupational therapist can address your scars to promote healing and recovery. Techniques and solutions might include:

Scar Massage: Once your incision is fully closed and healed, usually around two to three weeks post-surgery, your therapist may recommend gentle scar massage. Scar massage helps to improve blood flow, break up adhesions and soften the scar.

Outside of therapy, apply lotion (such as vitamin E, cocoa butter or a silicone-based lotion) up to three times a day for two to three months, or even as long as a year for larger or older scars. Massage the scar in firm, circular motions with lotion for about two to three minutes.

Desensitization: If your scar is feeling sensitive or numb ¡ª  or if it starts to tingle ¡ª  gently rub or tap the scar area to desensitize it, so that it becomes more accustomed to touch. Gradually increase stimulation as tolerated, using materials such as a soft cloth, a rough towel or even rice in a bowl.

Stretching: Movement is key to restoring collagen in your hand and for keeping scar tissue from becoming restrictive (e.g., a tightening that can limit mobility). Your therapist likely will work with you on stretching exercises during hand therapy, and may give you stretching techniques and protocols to follow at home.

Silicone scar sheets: Silicone scar sheets are widely recommended and backed by research to reduce discoloration ¡ª thereby improving appearance of the scar ¡ª and to reduce scar thickness. Scar thickness can impact mobility and cause discomfort, especially if the scar is adhering to underlying structures like tendons and nerves.

Apply silicone sheeting over the scar for several hours a day or overnight for the first two to three months after surgery (or longer, if needed), and then use silicone gel during the day for invisible, ongoing treatment.

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While you are recovering from hand surgery, promote healthy healing of your scar by avoiding the following:

• Don¡¯t massage open or scabbed areas.
• Don¡¯t pick or peel scabs, as this can increase scarring.
• Avoid prolonged sun exposure on fresh scars. Ultraviolet rays can permanently darken healing tissue.

In just a few minutes each day, you can improve your scar¡¯s appearance and ¡ª more importantly ¡ª preserve the motion and function of your hand. Talk to your occupational or certified hand therapist to create a scar care plan tailored to your specific surgery and healing stage.

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McKenzie Hollander, OTD, OTR/L, is an occupational therapist at Shirley Ryan ÌÀÍ·Ìõapp. She specializes in the treatment of musculoskeletal and orthopedic cases, and particularly those involving the upper extremities. She recently graduated from Marquette University with a doctorate in occupational therapy and gained hands-on experience in orthopedic settings during her clinical rotations.

Additionally, McKenzie completed a doctoral capstone project focused on hand therapy, further strengthening her expertise in this specialized area. With a dedication to improving patient outcomes and a deep understanding of musculoskeletal rehabilitation, McKenzie continues to contribute to the multidisciplinary care of patients recovering from upper-extremity injuries.