Hand therapy · Singapore

Cubital Tunnel Recovery Program

Written by Mavis Tham, Shamaine Soh and Yuna Zhuang, Principal Hand Occupational Therapists at Phoenix Rehab.Clinically reviewed by Nigel Chua, Principal Hand Occupational Therapist & Director, AHPC A1300362Z.Last reviewed 3 October 2026.

Numbness in the small finger is the warning. Hollowing between the thumb and index finger is the damage.

Cubital tunnel is the ulnar nerve being compressed at the elbow. Most people notice it as pins and needles in the ring and small fingers, worse when the elbow is bent, worse at night. It is treated conservatively in many cases and surgically in others, and this program covers both. Hand and wrist cases are managed by our hand therapy team.

No referral needed. Every first visit is one 45-minute Assessment & Treatment, $230, nett, no GST. Bring your operation note or scan report.

Where are you right now?

Four situations we see

• Numbness and tingling, no surgery discussed yet. Splinting at night, elbow positioning and nerve glides are the conservative program, and they work best before there is weakness.
• Surgery is booked. Release or transposition. What you want before the date is a clear picture of what the first six weeks will ask of you.
• You have had it released and the numbness has not changed. Nerve recovery is slow and partial improvement over months is normal, but the grip and pinch work does not wait for the sensation.
• You have noticed the hand looks different. A hollow between the thumb and index finger, or the small finger sitting away from the others. That changes what matters and how quickly.

What does not come back

Muscle that has already wasted, and sensation after long compression

The ulnar nerve does two jobs. It carries sensation from the ring and small fingers, and it drives most of the small muscles inside the hand, which are the ones that spread the fingers, pinch a key, and stop the hand clawing. When the nerve is compressed for long enough, those intrinsic muscles lose their supply and shrink. The clearest sign is a hollow in the web between thumb and index finger, next to a normal looking other hand.

Once those muscles have wasted, releasing the nerve stops the loss but does not reliably bring the bulk back, and the clawing that comes with it can be permanent. Sensation behaves the same way. After prolonged compression, recovery is often partial. The nerve fibers regrow slowly, measured in months, and how far they get depends on how long they were compressed.

If you have numbness that wakes you at night, or you have noticed wasting, the right next step is a doctor, not a therapist. Your GP can refer you for nerve conduction studies, and that test is what tells you and your surgeon how compressed the nerve actually is. Bring that result to therapy, wherever you have therapy.

Usually expected, and what is not

Is this normal after a release or transposition?

Nerve surgery recovers differently from tendon or bone surgery, and some of what feels wrong is expected.

Usually expected

• Numbness unchanged in the first weeks. The nerve does not switch back on the day the pressure comes off.
• Tingling, buzzing or electric feelings as sensation returns, often over months rather than weeks.
• An area of numb skin around the scar itself that stays numb.
• A stiff and aching elbow in the first fortnight, particularly after a transposition.

Contact your surgeon or doctor

• New or increasing weakness after surgery, when it had been stable.
• The elbow locking, or an inability to straighten it that is getting worse rather than better.
• Redness spreading from the wound, discharge, or fever.
• Severe pain that is not settling with what you were prescribed.

If you have sudden severe pain with a hand or arm that is cold, white or losing sensation, or you are unwell with fever and a hot swollen wound, that is an emergency department today, not a therapy appointment.

If it is not going to plan

Three months on and the pinch is still weak

This is the common one, and it is usually not the nerve on its own. The elbow has been protected, the shoulder has taken over, the small muscles have not been asked to do anything specific, and grip has been measured only by how it feels.

Grip and pinch are measurable in kilograms, side to side, and so is the ability to hold the fingers apart against resistance. Until someone has measured them, weak is an impression rather than a finding.

The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what tissue does under graded work cannot be read in one visit. $690, nett, no GST.

The shape of it

What happens, week by week

After a cubital tunnel release the elbow usually moves within days. After a transposition it is often protected first. The nerve recovers on a much longer clock than the wound. The weeks below are the common shape; your surgeon’s protocol takes precedence.

• Weeks 0 to 2Stage 1 · Calm & ProtectWound protected, swelling managed, and the elbow moved as your surgeon allows. After a transposition a splint or sling may be used for part of this time. Leaning on the elbow and sleeping with it fully bent are avoided.
• Weeks 2 to 6Stage 2 · Move & MobilizeElbow and wrist range regained, gentle nerve gliding within what the nerve tolerates, and scar work.
• Weeks 6 to 12Stage 3 · Rebuild & StrengthenGrip, pinch and the small muscles of the hand strengthened and measured.
• Week 12 onwardsStage 4 · Return & PerformWork and sport positions loaded. Sensation and muscle reviewed at intervals, because nerve recovery can continue for months.

The weeks are typical ranges, not a promise. You move up a stage when you meet its criteria, and your surgeon’s protocol takes precedence over anything on this page.

The program

The four stages, and what moves you up

• Stage 1, Calm & Protect. Night splinting or elbow positioning to keep the nerve off tension, scar and swelling management after surgery, and removing the daytime positions that are loading it.
  Move up when: the wound has healed and your surgeon has cleared full elbow movement.
• Stage 2, Move & Mobilize. Elbow and wrist range, nerve gliding within the range the nerve tolerates, and scar mobilization. Criteria to move up are about range and nerve tolerance, not about the numbness having gone.
  Move up when: elbow bend and straighten are within about 10 degrees of the other side, and nerve gliding does not leave more tingling the next day.
• Stage 3, Rebuild & Strengthen. Grip, pinch and intrinsic work, measured. This is where the numbers start to move even when the sensation is still recovering.
  Move up when: grip, key pinch and finger spread are measured and rising, and work-position loading does not bring the tingling back the next day.
• Stage 4, Return & Perform. Load, endurance and the positions your work or sport actually holds the elbow in. Measured against the other side.
  Graduate when: grip and pinch meet what your tasks need, and sensation has been mapped and recorded at two reviews, so you and your surgeon know where it stands even if it is still recovering.

Measured at your first appointment and again at graduation: a hand function questionnaire, sensation in the ring and little fingers mapped with graded filaments, and grip and pinch strength in kilograms, on both hands.

Logistics

When can I…

Your surgeon decides, based on healing and what your job demands. These are typical points, not permissions.

Who you will see

The hand therapy team that runs this program

Hand, wrist and elbow cases are managed by the hand therapy team. You are matched to the therapist whose declared clinical interest fits what happened to you and the clinic that suits you, and you stay with the same therapist through the program. Every appointment is one to one with your therapist for the full 45 minutes. All are registered with the Allied Health Professions Council.

Mavis Tham

Principal Hand Occupational Therapist. Wrist fractures, TFCC and wrist ligament injuries, custom splinting.

Tanjong Pagar

Shamaine Soh

Principal Hand Occupational Therapist. Stiffness and scar tightness after hand or wrist surgery.

Orchard, Sundays

Yuna Zhuang

Principal Hand Occupational Therapist. Carpal and cubital tunnel, sports wrist and finger injuries, tennis elbow.

What our patients say

Google reviews from our clinics in Singapore.

  
 
 
 
  
 
Excellent5.0555 reviews
 
5.0
 
Excellent555 reviews
 
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 Micah 
 
53 days ago
 
 
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Amazing experience with Phoenix Rehab, was assisted by Mavis. She’s very kind and professional and did thorough check on my wrist. I feel very comfortable during the process.

I went in for thermoplastic splint, and everything went smoothly. She was able to address my needs on my left wrist sprain.

They were prompt with appointment process and inquiry. Also the clinic is very close to Tanjong Pagar MRT. I highly recommend!
  
 
 
 
 
 
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 Chiky Phan 
 
57 days ago
 
 
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Fist time doing ultrasound for my tennis elbow!! Let’s hope it gets better the next few weeks!! Thank Mavis Tham!!
  
 
 
 
 
 
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 XIN WANG 
 
74 days ago
 
 
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Great treatment from my therapist. My painful wrist felt a lot of relief after the session. I’m glad I can slowly get back to doing my usual activities without constant pain.
  
 
 
 
 
 
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 Abby Lee 
 
90 days ago
 
 
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Very helpful and friendly !
  
 
 
 
 
 
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 雪梅Cui 
 
128 days ago
 
 
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The masseur is very professional and provides excellent service ，yati is very good!
  
 
 
 
 
 
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 Tra Nguyen 
 
219 days ago
 
 
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I wasn’t able to close my fingers due to an injury. Nurul at Phoenix Rehab has helped me tremendously with my recovery process. I have been able to resume my daily activities and exercises after only a few sessions. Nurul has been very professional and positive throughout the entire process. Thank you so much for your help!
  
 
 
 
 
 
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 Juzer K 
 
257 days ago
 
 
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Huge shoutout to Yuna Zhang from Phoenix Rehab for helping in my recovery from golfer’s elbow 🙌

I walked in with persistent elbow pain that was affecting workouts and everyday tasks, and Yuna immediately made me feel confident I was in the right hands. She took the time to properly assess my condition, explain the root cause, and tailor a treatment plan to my specific needs instead of using a one-size-fits-all approach.

What I really appreciated was how personalised every session felt. The exercises she gave me were practical, easy to follow, and actually worked. Within a short time, the pain reduced significantly and my strength and mobility improved much faster than I expected.

On top of that, the pricing is very reasonable and affordable, which made committing to recovery much easier.

Professional, knowledgeable, and genuinely caring — highly recommend Yuna at Phoenix Rehab if you’re dealing with hand-related sports injuries 💪
  
 
 
 
 
 
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 Fazal Hanafi Chaudhry 
 
341 days ago
 
 
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I enjoy coming to Phoenix rehab as they offer a wide variety of services. I had a finger accident and was working with a very experienced hand therapist. Place is clean and comfortable.  Staff were friendly and appointment was on time
  
 
 
 
 
 
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 Stella Yam 
 
482 days ago
 
 
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Very good
  
 
 
 
 
 
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 Juliana 
 
484 days ago
 
 
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Have both physio n Tcm visits here, highly recommend!
  
 
 
 
 
 
 
 
 
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Orchard, Serangoon, Tampines

Nurul Nadzirah

Principal Hand Occupational Therapist. Finger and wrist fractures, De Quervain’s, wrist ligament injuries.

Orchard

Jasmine Ang

Principal Hand Occupational Therapist. TFCC and wrist ligament injuries, trigger finger, thumb and wrist pain after pregnancy.

Jurong East, from 25 October

The program belongs to Phoenix, not to one therapist. Your plan, your measurements and your surgeon’s protocol move with you if you change clinic.

What it costs

$230 per 45 minute appointment

One to one with your therapist for the whole 45 minutes. Nett, no GST. Same price for your first appointment and your last. After surgery the appointments are spread further apart, because nerve timelines set the pace rather than effort does. The Cubital Tunnel Recovery Program is 12 appointments, $2,760 in all. You pay for each appointment as you attend it. If you need more, your therapist shows you which stage criteria are still open, and each extra appointment is $230.

This program runs Stages 1 to 4 of the Phoenix Recovery Protocol, and sits under hand therapy after surgery alongside the rest of our recovery programs.

Get Assessed and Treated

Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.

Timeframes on this page are typical ranges, not promises. Where your surgeon has given you a protocol, that protocol takes precedence over anything written here.