Therapeutic exercise
Eccentric Wrist Radial Deviation with a Hammer
Dynamic eccentric loading of the first dorsal compartment using a hammer as an asymmetric weight. In the advanced phase of De Quervain's tenosynovitis, it simulates the movements of picking up and setting down objects — remodels the tendon in a functional pattern.
How to perform
- Starting position. Sit with the forearm supported on a table and the hand off the edge, palm facing the side.
- Step 2. Hold a hammer by the end of the handle (the head of the hammer far from the hand) with the thumb up.
- Step 3. Start with the wrist in ulnar deviation (the hammer head pointing toward the floor).
- Step 4. Raise the hammer head until the wrist is in radial deviation (the hammer head pointing toward the ceiling) — concentric phase, use the contralateral hand to assist if needed.
- Return. Lower the hammer slowly over 4–5 seconds to the ulnar-deviation position — this is the isolated eccentric phase, loading the tendons of the first compartment.
When not to perform
- De Quervain's tenosynovitis in an acute reactive phase
- Recent distal radius or scaphoid fracture
- Symptomatic rhizarthrosis
- Recent wrist surgery
- Lateral epicondylitis in an acute phase
- Pain that does not subside within 24 hours after the exercise
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Finkelstein Stretch
Specific stretch of the tendons of the abductor pollicis longus and extensor pollicis brevis in the first dorsal compartment. It is the Finkelstein maneuver applied as a therapeutic stretch — essential in the conservative treatment of De Quervain's tenosynovitis.
Thumb Extension with a Rubber Band
Isolated strengthening of the extensor pollicis brevis and abductor pollicis longus with a rubber band. In the recovery phase of De Quervain's tenosynovitis, controlled progressive loading promotes tendon remodeling and restores functional capacity.
Thumb Abduction with a Rubber Band
Isolated strengthening of the abductor pollicis longus in a pure palmar abduction plane (not combined with extension). Complements thumb extension — together they form the biomechanical pair of the first-dorsal-compartment muscles.