Physiotherapy, Occupational therapy and Exercise


PLEASE NOTE; The text on this page contains extracts from the information handout for patients with a BPI  who have had surgery at the  Royal National Orthopaedic Hospital Stanmore U.K. Other institutions, particularly those outside the U.K. may have different procedures and protocols according to the type of surgery and their own general preferences. Please refer to the hospital and the surgeon who performed your surgery for advice and information about procedures for taking care of the surgical wound, sling and/or splint. The information on this page is meant as a guide only, and is not to be used in place of any information provided by your own surgeon, hospital and support team.  

You may have had nerve grafts or other nerve surgery that requires the arm to be immobilised for a period of time, usually a few weeks. To allow the nerve repair to occur, the arm will be held tightly to your side in a "Hunter Sling." The arm must NOT BE REMOVED FROM THE SLING for ANY reason. If the sling should become loose or break, allowing your arm to move, then replace and secure the sling for the full 6 weeks or for however long your doctor tells you.
During this time, bathing and showering will be difficult. You MUST NOT REMOVE THE SLING, therefore, avoid getting it wet. It will be difficult to wash the affected arm, but if you wish, you can wash the armpit by carefully sliding a face cloth through.

You will have clips in place which will be removed after 2 weeks. If you are local to the hospital where your surgery was performed, you will return there., otherwise your local practice nurse or GP will be able to remove them.
It is important to keep the wound clean and dry. Should you become worried about it, contact your GP surgery for a check up.

The following hand and finger exercises are safe to do while the affected arm is in a sling following exploratory (primary) surgery, provided you don't have any other injuries in these areas. Please refer to your physician if in doubt. 

While your arm is immobilised in the sling, You must not move the shoulder or elbow but it is important to keep the wrist and hand moving to stop them stiffening up. Use your other hand to assist the movements. As with all exercise, take care not to over do it.  All these movements should be repeated a number of times. Check with your physiotherapist for the number of repeats suitable for you.
Wrist in mid position. Fingers curled under as in diagram. Lift the back of your hand up with your other hand. Hold for approx. 30 secs.

Hold fingers and wrist straight. Bend wrist towards the little finger, then towards the thumb. Use your other hand to assist the movement.

Fingers; Support below the finger joint to be exercised. Bend your finger at the knuckle assisting the movement with your other hand. Then bend the middle joint. Repeat for each finger..

As above; Bend your finger tip using your other hand to assist. Repeat for each finger.

Bend your fingers 90 degrees to the palm, then straighten using your other hand.

Support below the thumb joint to be exercised. Bend the bottom joint of your thumb assisting the movement with your other hand.

Hold your thumb below the joint to be exercised. Bend and straighten the upper joint.

Bring your thimb to the base of your little finger, then bring your thumb back.

Bring your thumb away from the index finger then back again.
The purpose of this web site is to educate people about Brachial Plexus Injuries and help people who have these injuries with rehabilitation and other issues. The home exercise diagrams and accompanying text are intended to provide a resource for patients who have already been instructed on the exercises by a qualified health care professional.
The information presented is not intended for the purpose of self-diagnosis or self-prescription of any treatments or exercises discussed on this site. You should never rely on this information to determine a diagnosis or course of treatment.  Please visit or call your physician or other qualified allied health care provider prior to performing any of the therapeutic exercises listed on this site. If you have any health care questions or concerns, please consult your physician promptly. You should never disregard the advice of your physician or other qualified health care provider because of any information you read on this site.
The operators of this web site do not practice medicine or dispense medical services through this web site.

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