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, Founder and Clinical Director, Registered Occupational Therapist, AHPC A1300362Z.Last reviewed 2 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 fibres 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 program
The four stages, and what moves you up
- Stage 1, Calm and 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.
- Stage 2, Move and 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.
- Stage 3, Rebuild and Strengthen. Grip, pinch and intrinsic work, measured. This is where the numbers start to move even when the sensation is still recovering.
- Stage 4, Return and Perform. Load, endurance and the positions your work or sport actually holds the elbow in. Measured against the other side.
Logistics
When can I…
Your surgeon decides, based on healing and what your job demands. These are typical points, not permissions.
What our patients say
Google reviews from our clinics in Singapore.
| Activity | Typical point | What has to be true first |
|---|---|---|
| Desk work | From the start | Elbow positions changed: no leaning on the elbow, and no long spells with it bent. After surgery, 1 to 2 weeks. |
| Driving | 1 to 2 weeks after surgery | Comfortable, out of any sling, and a grip on the wheel you trust. |
| Lifting, gym | 6 weeks after surgery | Your surgeon clears load, and grip is tested against the other hand. |
| Racquet sport, climbing | 6 to 12 weeks | Stage 4 criteria met. Without surgery, once the night symptoms have settled. |
| Medical certificate | Your doctor issues it | Hand therapists do not issue MCs. We can write a report on your functional limits for your doctor or employer. |
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.
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.
Where we are
Clinics across Singapore
SERANGOON
265 Serangoon Central Drive #04-269
S550265 · Lift C only
NE12CC13 Serangoon MRT
WhatsApp 8892 4121TANJONG PAGAR
10 Anson Road #02-77A
International Plaza, S079903
EW15 Tanjong Pagar MRT
WhatsApp 8227 7074JURONG EAST
2 Venture Drive #02-02
Vision Exchange, S608526
NS1EW24 Jurong East MRT
Opening 20 October 2026
WhatsApp 8242 7340