Rehabilitation of a Cellist After Surgery for de Quervain’s Tenosynovitis and Intersection Syndrome

Abstract

This article describes the physical therapy intervention for a musician after surgery for de Quervain’s tenosynovitis and intersection syndrome, and briefly reviews these two tendon conditions. The patient, an 18-year-old female cellist, initially presented with symptoms of de Quervain’s tenosynovitis, including marked fibrosis of the first dorsal compartment, to the extent that surgical intervention was required. Seven months after decompression of the first dorsal tunnel, the second dorsal compartment was surgically released secondary to intersection syndrome. Physical therapy included the use of therapeutic exercise, joint mobilization, scar mobilization, soft tissue massage, stretching, and physical agents. Patient education regarding activity modification, management of cello playing, and posture while playing the cello and using a computer keyboard was vital to successful rehabilitation. The musician was able to return to playing the cello at her previous level of performance, practicing and performing an average of 3 to 4 h/day. Conservative treatment intervention during the 10 months preceding the current treatment may have been unsuccessful due to the absence of activity modification.