Hand therapy exercises can help improve strength and dexterity in the hands and fingers. They are especially helpful for improving fine motor skills after a neurological event like stroke or brain injury.
Furthermore, hand strengthening exercises like these can also help prevent conditions like arthritis from getting worse. If you want to add some therapeutic hand exercises to your home exercise program, read on.
This hand therapy exercise guide contains exercises for all ability levels. It’s organized from simple to complex exercises. Use the links below to jump to any section:
- Stretching Exercises
- Easy At-Home Hand Therapy Exercises
- Physical Therapy Hand Exercises
- Strengthening Hand Therapy Ball Exercises
- Hand Therapy Putty Exercises
- Advanced Hand Therapy Exercises
Stretching Exercises for Extremely Stiff or Paralyzed Hands
Every therapeutic home exercise program should start with a warm up, and your hands are no different.
For those with paralyzed hands from neurological injury like stroke, you should start with passive exercise. This means using your unaffected hand to help your affected hand complete the exercises. Not only will this will help prevent muscle stiffness after stroke (spasticity), but it can also help introduce movement into your affected hand.
For those who do have some hand mobility, you can practice these hand therapy exercises actively (meaning no assistance from your unaffected hand) as a good warm-up activity.
1. Wrist Extension and Flexion
For this gentle hand dexterity exercise, start with your forearm on a table. Let your hand hang off the side of the table with your palm down. Then, move your hand up and down, bending at your wrist. When you’re done, repeat with your palm facing up.
2. Thumb Extension and Flexion
For another gentle exercise, start with your palm open, as if you were signaling the number 5. Then, practice moving your thumb over to your little finger, signaling the number 4. Continue to move your thumb back and forth between these 2 positions.
3. Inner Arm Stretch
Place your hands in your lap and interlace your fingers. Then stretch your affected arm palm-side up. You should feel this stretch all the way up your inner arm. Hold this stretch for 20 seconds and release. Then, repeat on the other side.
4. Wrist Stretch
With your fingers still interlaced, gently bend your affected wrist backward and get a nice stretch there. Hold this stretch for 20 seconds and release. Repeat on the other side.
Individuals recovering from a stroke or brain injury may find these four exercises challenging enough. You can stop here and repeat these 4 exercises with high repetition.
Repetition and movement are important because that’s how you rewire the brain (via neuroplasticity) and improve hand function.
Those looking for additional challenges can continue to the next hand therapy exercises.
Easy At-Home Hand Therapy Exercises
For those with some hand movement, you can use common household items as part of your home exercise program. The following tasks are simple yet therapeutic ways to strengthen your fine motor skills.
5. Stacking Coins
Grab a handful of loose change and practice stacking coins on top of each other. This will help improve coordination and fine motor skills.
Try to stack the coins by size. Put the largest ones at the bottom.
6. Pinching Clothespins with Each Finger
To gently improve finger strength, take a clothespin and practice pinching it with different fingers. Start with your thumb and index finger, then move onto your thumb and middle finger, ring finger, then pinky. Using your thumb, index finger and middle finger is a functional ‘tripod grip’.
7. Playing Board Games
If you want to make things more fun and interesting, play board games like checkers or chess which require you to practice your fine motor skills as you move your pieces and activates your brain for scanning, decision making and sequencing tasks.
8. Putting Together a Puzzle
Puzzles double as a fun activity since it also helps improve hand and finger coordination.
9. Playing a Virtual Piano App
Getting back to playing instruments is a great occupational therapy hand exercise because it is afunctional activity. An alternative if you don’t have an instrument. To work download a virtual piano- or guitar-playing app and practice on your phone.
When you resume an activity you have done prior to your stroke, the brain remembers the movement pattern and naturally activates the normal muscle motion.
Physical Therapy Hand Exercises
Now it’s time to meet Barbara, our favorite occupational therapy assistant. You will find no shortage of hand therapy exercises to add to your home exercise program. Try her expert hand therapy exercises in the video below, or by following the written instruction after:
10. Palm Up and Down
Place your hand palm-up on a table. Then use your non-affected hand to flip your hand palm-down. This helps improve hand and wrist mobility. Repeat 10 times.
11. Wrist Bend Movement
Gently bend your wrist up and down while supporting your arm on the table with the hand hanging past the edge of the table. This improves flexibility in the wrist which is needed for increased hand movement and range of motion. Repeat 10 movements.
12. Wrist Side Movement
Place your affected hand palm-down on the table and use your other hand to bend your wrist side-to-side.
13. Rolling Movement
Place a water bottle or soup can in your affected hand with your palm-side up on a table. Practice curling your fingers to grasp the bottle or can, then relax. This works on strength and range of motion. Repeat 10 times.
14. Wrist Curl
Take the same water bottle and hold it in your affected hand. Then, practice bending your wrist up and down, keeping your elbow stabilized on the table. This will feel like a bicep curl, but for your wrist. This is an excellent strength-building exercise.
15. Grip And Release
Take a pen and place it on a table. Practice gripping the pen with your affected hand and move it across the table. Release, and repeat by bringing the pen back to the other side of the table.
16. Pen Spin
Take the same pen and practice spinning it with your thumb and index finger. This is helpful for isolating finger movements for fine motor skills.
17. Coin Drop
Place 8 coins neatly in a row in your hand. Then, practice placing them down one at a time, using your thumb and index finger while keeping the other coins in your hand with your other fingers.
18. Finger Curl
Practice touching your thumb to each of your fingertips, starting with your index finger until you reach your little finger.
This is the same movement used in MusicGlove hand therapy, which has helped many patients improve hand function after stroke or TBI.
Hand Strengthening Exercises with a Therapy Ball
For some affordable and effective hand strengthening exercises, grab a set of hand therapy balls, which are a popular and affordable physical therapy tool. They usually come in different thicknesses so that you can keep yourself consistently challenged.
Resistance helps build strength in your hand by placing demand on your muscles, which helps grow the muscle fibers. Use a soft ball if you’d like to focus on hand coordination and dexterity, and use a firm ball if you’re focusing on hand strengthening exercises.
19. Power Grip
For a basic hand strengthening exercise, squeeze a therapy ball with your fingers and thumb. Focus on pressing the pads and tips of your fingers into the ball. Pick a ball with thickness that makes you feel challenged.
Pinch the ball with fingers and thumb extended. Press your fingers down into the top of the ball and your thumb upward on the bottom of the ball. As with all these hand strengthening exercises, this should make you feel challenged. If not, try to use a firmer ball.
21. Thumb Extension
Roll the ball up and down your palm by flexing (making your thumb bent) and extending (making your thumb straight). This will move the ball up and down your hand in a somewhat straight motion.
22. Table Roll
Roll the ball from the tip of your fingers to your palm. This hand therapy exercise focuses more on coordination than strength.
23. Finger Flexion
Hold the ball in your palm and press your fingers into the ball. This is different from the power grip above because you’re focusing on an inward movement instead of a global gripping movement. Imagine that you’re pressing your fingers straight into your palm.
24. Thumb Roll
Use your thumb to roll the ball in a circular motion on your palm. This is less about strength building and more about improving dexterity and fine motor skills.
25. Finger Squeeze
Squeeze the ball between any two fingers. This exercise is builds strength as well as providing a gentle stretch between the fingers.
26. Thumb Opposition
Roll the ball side to side on your palm using your thumb. This exercise is good for finger coordination and dexterity.
Hand Therapy Putty Exercises
If you’re looking for additional creative hand exercises, then hand therapy putty exercises are a good alternative and provides added challenging movements.
These exercises are similar to the exercise ball exercise, but the putty is more pliable and targets different intensity to the muscles.
27. Finger Scissors
Squeeze the putty between two fingers. This will help develop strength in the hand and fingers as well as provide stretch to the web space between the fingers.
28. Fingertip Pinch
Pinch the putty using your thumb and fingertips. This also develops strength and dexterity in the fingers and reaches the small muscles in the palm of your hand.
29. Power Grip
Squeeze all your fingers into the putty. This strengthening exercise targets the whole hand.
30. Flat Pinch
Pinch the putty down into your thumb with straightened fingers. Although it’s similar to the Fingertip Pinch, it isolates muscle movement and provides compression into the joint.
31. Finger Spread
Wrap the putty around two fingers and spread your fingers apart. This helps strengthen different hand muscles than the pinching movements.
32. Finger Extension
Wrap the putty around a hooked finger and then straighten your finger using the putty as resistance.
33. Finger Spread
Wrap the putty around your hand and then spread your fingers out to stretch the putty. This also targets a new set of muscles to improve strength and dexterity in the hand.
34. Full Grip
Squeeze down on the putty, pressing your fingers into your palm.
Advanced Hand Therapy Exercises
Once you’ve mastered the complex hand manipulation exercise, you’ll be ready to work on advanced hand therapy exercises. Add these to your home exercise program once you feel ready for a challenge.
35. Palm Down Wrist Flexion Exercise (Strengthening)
Rest your forearm on a table with your hand and wrist hanging off the edge. Keep your palm facing down. Then, lift the back of your hand up. (This is the opposite of the Wrist Curl movement.)
This movement is more difficult with the palm down instead of up. Try it first without any weight. Then, when you’re ready for a challenge, hold a water bottle or light dumbbell in your hand while you perform this hand strengthening exercise.
36. Rotation Exercise (Dexterity and Fine Motor Skills)
Take a pen, and try rotating it around your middle finger, using your thumb, index, and ring finger to help you manipulate the pen. Think about twirling the pen around your fingers.
37. Shifting Exercise (Dexterity and Fine Motor Skills)
Practice a sliding movement by holding the pen in a writing position (in between your thumb, index, and middle finger) and sliding the pen forward until you’re holding the end of the pen.
Then, side the pen back until you’re holding the tip once again. Think about inching your fingers along the pen.
38. In-Hand Translation Hand Exercise (Strength and Dexterity)
Gather 10 small objects (like uncooked beans) and practice picking them up with your fingers. But instead of immediately setting them down, try holding all of the objects in your palm while you continue to pick up more of them (‘in hand manipulation’). Then, once all the objects are in your hand, practice ‘translating’ them down one by one.
39. MusicGlove (Strength, Dexterity, and Fine Motor Skills)
Flint Rehab’s MusicGlove hand therapy is an interactive, music-based device that improve hand function after neurological injury like stroke or brain injury. It works by motivating patients to make hundreds of therapeutic hand movements while following along to an interactive game.
Not only is MusicGlove fun to use, but it’s also clinically proven to help stroke patients improve hand function within 2 weeks.