A ganglion cyst is a type of harmless, fluid-filled tumor that usually occurs in the wrist. The most common place for a ganglion cyst to form is on the back side of the wrist (called dorsal ganglions), but they can also form on the inner side, where the thumb attaches to the wrist (called volar ganglions). Less common places for this type of cyst to occur are in the finger joints, on the foot and on the outer parts of the knee or ankle. If you have a ganglion cyst on your wrist, your doctor might suggest watchful waiting, wrist immobilization or a minimally invasive procedure that drains the fluid from the cyst. If your cyst does not go away or it's causing you a lot of pain, you might have surgery called a ganglion resection. After your surgery, you are likely to need physical therapy. Here's what you might expect during these physical therapy sessions.
After surgery in the wrist, you will need to begin using the joint again soon to prevent atrophy of the muscles and stiffening of the joint. In most cases, you will be instructed to perform range-of-motion exercises. These exercises will have you flexing and rotating your wrist as you move it in various directions.
Sometimes a patient cannot move his or her own wrist to perform these exercises. In that case, your physical therapist can move the wrist for you. This is called passive range-of-motion and it will help build up your strength to the point that you can do it yourself as well as keep your joint moving freely.
Your therapist will probably give you exercises to do that use the aid of various weights. Many of these can be done at home, and your healthcare provider will give you instructions for doing so if that is appropriate for you. Do not attempt to perform exercises on a joint that has had recent surgery without the advice of your physical therapist or doctor.
Finger extensions can be done simply by extending and spreading the fingers or with the use of a rubber band that provides resistance. You might be given a ball to squeeze or putty to manipulate with the hand that had the surgery. As you heal, you might be asked to pick small beads out of soft clay or putty; this can help to re-strengthen tiny finger muscles that may have been weakened either by the cyst or by the surgery itself.
Another component of your physical therapy will be massage. Your therapist may apply warmth, then use oil or lotion to lubricate your wrist as he or she massages the muscles. Massage after ganglion resection can help reduce scar tissue and reduce swelling. The physical therapist will also show you how to perform the same type of massage at home to enhance healing.
Unfortunately, ganglion cysts have a high recurrence rate; dorsal ganglions tend to recur about 20 percent of the time, and volar ganglions, about double that. When you are seeing your physical therapist, he or she can check to see if the cyst seems to be coming back. After your physical therapy services have ended, however, you'll need to watch for recurrence and let your hand and wrist doctor know if it occurs. Massaging the area can help you feel for new cyst development.
Depending on the exact location of your ganglion cyst and what type of work you do, you might need to wear a brace for up to six weeks. Keeping up with your physical therapy appointments is vital to experiencing thorough healing and to avoid losing muscle strength or range of motion.