Expert hand rehabilitation is as important as surgery itself. Dr Ma works closely with specialist hand therapists as an integral part of your recovery — before, during, and after treatment.
Surgery and hand therapy — one team, from the start
The integrated care model
Dr Ma works in close collaboration with a specialist hand therapist, triaging and planning patient care together from the very first consultation. Surgical and rehabilitation goals are aligned from the outset, ensuring the right pathway is chosen from the start.
Every patient is triaged and managed together — therapist and surgeon, ensuring the right pathway is chosen from the outset, not after the fact.
For many patients, the right answer is therapy alone, or therapy before surgery — and sequencing this correctly changes outcomes.
Management is integrated from the first appointment. Rather than defaulting to a surgical pathway, the approach explores what is most appropriate for each patient — whether that is therapy alone, therapy before surgery, or surgery with structured rehabilitation. Goals, lifestyle, and function all inform the decision.
"Good hand surgery and good hand therapy are inseparable. The best surgical outcome means little if rehabilitation is not started at the right time, in the right way."
Why hand therapy matters
The hand is a remarkably complex structure — 27 bones, dozens of tendons, multiple nerves and vessels, all working together in a very small space. After injury or surgery, the natural healing process can cause scarring, stiffness, swelling, and weakness that limit function if not carefully managed. Hand therapists are trained specifically to address these challenges.
What hand therapy addresses
Oedema (swelling) management after injury or surgery
Scar management — softening, desensitisation, and mobilisation of healing tissue
Splinting — custom fabrication to protect repairs, correct deformity, or position for healing
Range of motion exercises — controlled, progressive joint mobilisation
Strengthening — graded return of grip, pinch, and fine motor function
Nerve rehabilitation — sensory re-education and desensitisation after nerve injury or repair
Activity retraining — returning to work, sport, and daily activities safely
Pain management — hands-on techniques and education
Hand therapy before surgery
Pre-operative hand therapy is sometimes recommended to reduce stiffness, optimise joint mobility, trial conservative management, and help patients understand what to expect after surgery. In some cases, preparatory therapy can improve the surgical starting point and speed of recovery.
Hand therapy after surgery
Post-operative hand therapy begins at a carefully timed point following surgery — too early risks disrupting repairs; too late allows stiffness to set in. The timing and programme are tailored to each procedure and each patient. Dr Ma communicates directly with the treating therapist at every stage.
What to expect after surgery
Tendon repairs: Early controlled mobilisation within days, using a structured splinting protocol
Fracture fixation: Protected movement begins once stability is confirmed, progressing to strengthening
Nerve repairs: Long-term programme including sensory re-education as nerve recovers over months
Carpal tunnel / trigger finger: Post-operative therapy is not always required; your surgeon will advise based on how you recover
Wrist arthroscopy / TFCC: Graduated return to motion under therapist guidance
Dupuytren's fasciectomy: Extension splinting at night, therapy to maintain correction
Thumb / wrist arthroplasty: Progressive strengthening and activity retraining guided by your therapist
Splints and orthotics: Your hand therapist may fabricate a custom thermoplastic splint to protect your hand or wrist during healing. These are moulded precisely to your hand and are a critical part of many post-operative protocols.
Conservative management without surgery
Not all hand and wrist conditions require surgery. Many patients are managed effectively with hand therapy alone — including tendon and ligament injuries, repetitive strain conditions, arthritis management, mild carpal tunnel syndrome, and post-traumatic stiffness. Dr Ma will always discuss non-surgical options first where they are appropriate and likely to be effective.
Conditions often managed conservatively with therapy
Mild to moderate carpal tunnel syndrome
De Quervain's tenosynovitis
Trigger finger (mild cases)
Thumb CMC arthritis (early stage)
Mallet finger (closed, treated with splinting)
Volar plate injuries and PIP joint sprains
Partial tendon injuries not requiring repair
Wrist instability (selected cases)
If surgery isn't the right next step at your first visit, that doesn't mean nothing happens. Depending on your condition, this might mean a trial of splinting or activity modification with a follow-up review, a steroid injection to settle inflammation, a period of watchful monitoring with clear guidance on what would prompt an earlier review, or working alongside a hand therapist to track your progress between appointments. Many patients find it helpful to jot down brief notes between appointments — what's improved, what hasn't, and anything new — so the next review can build on a clear picture.
When to come back sooner
You don't need to wait for your scheduled review if symptoms are getting rapidly worse rather than better, you develop new numbness, weakness, or loss of function, pain is no longer manageable with what you've been given, or you're simply worried — even if you're not sure it's "serious enough". If at any point conservative management isn't working, surgical options remain fully available.
Dr Ma consults at Chatswood (Healthpac Medical Centre, Level 1/7 Help St) and Strathfield (Strathfield Private Hospital). Call (02) 8112 8569 or book online.
Frequently asked questions
In most cases, Dr Ma will provide a written referral to hand therapy as part of your post-operative or treatment plan. You can also self-refer to a hand therapist without a doctor's referral, though a referral ensures the therapist has the relevant clinical information to guide your programme.
The timing depends on the procedure. Some surgeries — such as tendon repairs — require therapy within the first few days. Others, such as carpal tunnel release, may not need formal therapy at all. Dr Ma will give you a clear plan at your post-operative appointment and will communicate directly with your therapist.
This varies considerably depending on your condition and procedure. A simple carpal tunnel release may require only one or two therapy visits. A complex tendon repair or nerve injury may involve therapy over several months. Your therapist will reassess at each visit and adjust the programme accordingly.
Medicare does not generally cover individual allied health consultations unless you have a GP-issued Chronic Disease Management (CDM) plan, which allows a limited number of allied health sessions per year. Most private health funds cover hand therapy under their extras cover — check your policy for details. Your therapist's reception can advise on claiming.
Yes — home exercise programmes are a key part of hand therapy. Your therapist will prescribe specific exercises tailored to your stage of recovery. Consistency with home exercises is one of the most important factors in achieving a good outcome. Your therapist will progress and update the programme at each appointment.
