Hand therapy putty: what it is and which resistance to choose

Hand therapy putty is a soft, mouldable dough, usually silicone based, that you squeeze, pinch, roll and pull apart to rebuild strength in the fingers, hand and forearm. This guide is for anyone buying their first pot: people recovering from a hand injury or surgery, readers with stiff arthritic hands, desk workers whose forearms ache by Thursday, and climbers after finger strength. It covers what the putty actually does, how the resistance grades work, and which level to start on.

TL;DR

• Therapy putty is a graded resistance tool for the hand, sold in firmness levels that run from very soft up to firm and, with some brands, beyond.
• Colour is a label, not a standard. Suppliers use different colour systems and different words for the same firmness, so buy on the firmness name rather than the shade.
• flexa.fit putty runs across five levels: pink is extra extra soft, yellow extra soft, red soft, green medium, blue firm.
• Post-surgery or post-injury, start on whatever your hand therapist prescribed. With no prescription, start a level below where you think you should be and move up.
• Grip strength tracks with general health. In the PURE study of 139,691 adults, every 5 kg drop in grip strength came with a 16% higher risk of dying from any cause.
• Expect hand function to improve before the numbers on a dynamometer do. The evidence on grip gains in arthritic hands is a lot more modest than most product pages suggest.
• The pack of five works out at £3.00 a pot against £5.89 for a single, so it is the cheaper route if you plan to progress at all.

What hand therapy putty is, and who actually uses it

Putty sits somewhere between a stress ball and a dumbbell. It gives way under load, which means the hand has to keep working through the whole range of a squeeze instead of hitting a hard stop. It can also be shaped, so one pot covers finger flexion, thumb work, pinch grip and finger spreading without any extra kit. The Royal Wolverhampton NHS Trust describes therapeutic putty as usually made from latex-free silicone and used to increase movement and strengthen the muscles of the hand and forearm, and its patient leaflet runs to thirteen separate exercises off a single pot.

Four groups buy it most often. People coming out of a cast, a tendon repair or a carpal tunnel release, who need to rebuild a hand that has been immobilised. People with arthritic or stiff hands, who want the joints moving without loading them hard. Desk workers with forearm and thumb strain from a keyboard, mouse or phone. And climbers, racket players and grapplers, who want the antagonist and pinch work that a hangboard never gives them.

It is deliberately unglamorous. A pot lives in a bag or a desk drawer and gets used in gaps, which is exactly why it survives in rehab programmes when fancier equipment does not.

What the research says about hand strength work

Grip strength is one of the more studied numbers in medicine, largely because it is cheap to measure. The PURE study followed 139,691 adults across 17 countries and found grip strength inversely associated with all-cause mortality, with a hazard ratio of 1.16 per 5 kg reduction in grip. In that dataset grip predicted all-cause and cardiovascular death better than systolic blood pressure did. That is an association rather than proof that squeezing putty extends your life, and the authors closed by calling for research into whether improving strength actually reduces mortality. It does explain why hand strength keeps turning up in clinical assessments.

On whether structured hand exercise actually helps, the strongest UK evidence is the SARAH trial. Researchers randomised 490 adults with rheumatoid arthritis of the hands across 17 NHS sites to usual care or usual care plus a tailored strengthening and stretching programme. At twelve months, hand function improved 7.9 points in the exercise group against 3.6 in usual care, a difference of 4.3 points, with no serious adverse events and a cost of £156 per person. That result is why NICE guideline NG100 tells clinicians to consider a tailored strengthening and stretching hand exercise programme for adults with rheumatoid arthritis who have pain and dysfunction of the hands or wrists.

Now the part most product pages leave out. A Cochrane review of seven trials covering 841 people found moderate quality evidence that hand exercise probably improves hand function slightly against usual care, but high quality evidence from one large trial showed little or no benefit on measured grip strength: a mean difference of 1.4 kg at three to eleven months, with a confidence interval that crosses zero. In arthritic hands the win shows up in what people can do rather than in what the dynamometer reads. Measure progress by opening jars and holding a kettle rather than by chasing a number.

Putty itself has been tested directly, though only in small studies. Sixty people with Parkinson's disease were randomised to a single 15 minute hand training session using therapeutic putty or to active upper limb exercise, and manual dexterity, hand grip and pinch strength all improved straight after the putty session. The published results report that improvement within the group rather than a clear advantage over the comparison exercises, and one session is not a training programme. It does show the tool loads the hand rather than just occupying it.

How resistance levels work, and why colour is not a standard

Putty firmness is graded by how much force it takes to deform. Manufacturers then attach a colour to each grade so a therapist can say "stay on red for another fortnight" without weighing anything. The grading is real, but nobody has agreed a shared colour code for it.

This causes more wrong purchases than anything else. The hand therapy department at Chelsea and Westminster Hospital NHS Foundation Trust publishes a patient guide to therapy putty purchase for exactly that reason, setting six purchase options side by side and telling patients that colours vary across providers, so buy on the strength your therapist recommended rather than on the colour. Read down its table and you get five separate vocabularies for the same ladder: extra soft to firm, super soft to extra firm, extra soft to extra strong, extremely easy through to very difficult, and xxlight through xfirm. A red pot from one brand is not necessarily the same firmness as a red pot from another.

Two practical consequences. If you are replacing a pot your therapist gave you, match the firmness word, not the shade. And if you are moving between brands mid-programme, expect the step up or down to feel slightly off for a session or two.

Pot size is the other spec nobody explains. That same guide lists patient-sized pots from 56 g up to 113 g, and bulk tubs from 450 g up to 2.3 kg for clinic use. Our pots are 53 g for the two softest colours and 57 g for the rest, printed on the lid next to the firmness. Guidance on how much putty you actually need varies between trusts, and the Royal Wolverhampton leaflet asks for a 100 g pot as a minimum for most hand exercises, so if you have large hands or want a bigger ball to work with, order a second pot at your working level.

The flexa.fit colour and firmness chart

Our own range runs across five graded levels. Here is what each one is for.

The ladder matters more than any single rung. Sheffield Children's NHS Foundation Trust puts it plainly in its putty grip and strengthening sheet: you start with softer putty and work up to a stronger one, guided by your therapist. Buying one pot in isolation means guessing where on that ladder you sit today, then buying again in a month.

Which hand therapy putty resistance should you start with?

If a hand therapist or physio has prescribed a level, use that one and ignore everything below. The Royal Wolverhampton leaflet is blunt about it: choose the correct strength for your current stage of rehabilitation, and your therapist will advise you. Nobody reading a web page knows your tendon repair protocol.

With no prescription, match your situation:

• Fresh out of a cast, splint or surgery and cleared to start moving: pink. It should feel almost too easy at first.
• Arthritis, general stiffness, hands that need ten minutes to wake up: yellow, moving to red once the stiffness eases.
• Keyboard, mouse and phone strain, or forearm ache from long screen days: red, then green. If you also have numb hands, pins and needles, or a weak thumb, read the NHS page on carpal tunnel syndrome and get it looked at before you start loading the hand.
• Healthy hands, building grip for lifting, DIY or general strength: green, progressing to blue.
• Climbing and finger strength: green and blue, mostly for the extension and pinch work that climbing itself neglects. Our guide to therapy putty for climbers goes into the specifics.

Then sanity check it in the hand. A level is roughly right when the putty deforms under steady effort and your hand feels tired but not sore at the end of a set. Too firm and you will find yourself jerking at it, or feeling it in the joints rather than the muscles. Too soft and the set finishes with nothing happening at all. Severe pain or discomfort, a skin rash or itching means stop using the putty and speak to your therapist, which is the precaution the Wolverhampton leaflet lists.

How much to use it

Look at any NHS putty exercise sheet and you will notice something odd: the repetition counts are blank. Guy's and St Thomas' publishes thirteen putty exercises and says only that your hand therapist explains how many times and how often to do each one. Sheffield's sheet prints a gap for the therapist to fill in. That is dosing rather than vagueness: a tendon three weeks post-repair and an arthritic hand on a good day need very different volumes.

If you are training rather than rehabbing, the thing that decides whether it works is whether you keep doing it. The same Cochrane review found that people given exercises alongside strategies for sticking with them were more likely to still be doing them at three to eleven months than people on routine care alone. A few minutes while the kettle boils, most days, survives a busy week better than one long Sunday session. Our walkthrough of nine putty exercises covers the movements themselves, and how to build grip and hand strength sets them in a wider programme.

Buying: one pot or the set of five

The whole point of graded putty is moving up it. That makes the maths straightforward.

A single pot of flexa.fit Hand Therapy Putty is £5.89 in whichever colour you pick. The pack of five is £14.99, which is £3.00 a pot, and it covers every level from extra extra soft to firm. If you are mid-rehab you will outgrow your starting level, and if you are training you will want a softer pot for warm-ups anyway. Three single pots come to £17.67, so the full set of five costs less than buying your way up one colour at a time. For a sense of the wider market, the options in that Chelsea and Westminster patient guide run from £3.36 to £65.75 depending on size and quantity.

• Five sealed pots, one per resistance level, so you can step up without reordering.
• Non-toxic and reusable, and small enough to live in a work bag.
• Free UK delivery with no minimum spend, and 30-day returns.
• Single pots stay available if your therapist has named one level and you only need that.

Shop the putty

What else belongs alongside the putty

Putty is good at the things a sprung gripper cannot do: finger extension, thumb work, pinch, and spreading the fingers against resistance. It is less good at heavy crush strength, where a sprung gripper gives cleaner progression. If you want the honest comparison, we wrote about whether hand grippers work and where they fall down.

If you want one purchase that covers more than a single movement, the Grip Strength Kit is £13.99. Worth checking the contents against your stage before you pick it over the five-pack, because the putty inside it is the green medium pot only, which suits a healthy hand rather than early rehab.

• Finger gripper with a textured squeeze ball and individual finger loops, so the closing and the opening both get loaded.
• One pot of medium putty for squeeze, pinch and finger spread work.
• Massage eggs for tight palms and forearms after a session.

Shop the Grip Strength Kit

For pure crush strength on top of that, the Hand Gripper Set is £11.99, and the rest of the recovery range covers the forearm and shoulder work that hand training usually exposes.

Looking after it, and when it needs replacing

Putty picks up everything. NHS leaflets are consistent on the handling rules, and they are worth following from day one rather than after you have lost a pot to a jumper.

• Wash your hands before use. The putty stays cleaner and lasts longer for it.
• Work on a hard surface such as a laminate table or a tray. Avoid polished furniture, because the oil in the putty can stain it.
• Keep it away from carpet, fabric, hair and paper. If it does get embedded, rub an ice cube over it to harden it, then work it out.
• Put it straight back in its sealed pot and store it at room temperature, out of direct heat and sunlight.
• Keep a pot to one person, which is the infection control line NHS trusts take.
• Do not eat it, and keep it away from small children and pets.

A well-kept pot lasts a long time. Replace it when it goes dry, crumbly or sticky, or when it has softened so much with use and warmth that it no longer matches the level printed on the lid. A short spell in the fridge firms it up temporarily if a warm room has made it slack, but that is a rescue, not a fix.

FAQs

What is hand therapy putty used for?

It is used to rebuild strength and movement in the fingers, thumb, hand and forearm. Occupational therapists and physios prescribe it after fractures, tendon repairs, nerve surgery and carpal tunnel release, and for ongoing conditions like arthritis where joints need moving without heavy load. Outside clinics, people use it for grip training, keyboard and mouse strain, and finger strength for climbing and racket sports.

What resistance hand therapy putty should I start with?

Start with the level your hand therapist prescribed. Without a prescription, start softer than you think you need: pink or yellow if you are recovering from injury or surgery, red if you have general stiffness or desk-related strain, green if your hands are healthy and you are building grip. Move up when a full set finishes without your hand tiring at all.

Is therapy putty the same as a stress ball or slime?

No. A stress ball and a novelty slime have no graded resistance, so you cannot progress and you cannot repeat a prescribed load. Therapy putty is manufactured to firmness grades so a therapist can prescribe one level, then step you up. It also holds a shape, which is what makes finger extension and spreading exercises possible.

What is the best putty for hand therapy?

The best putty is the one at the right firmness for your current stage, from a range you can progress through. Because suppliers do not share a colour code, buy on the firmness word rather than the shade, and check a set covers soft through to firm. Our five-level pack covers extra extra soft up to firm for £14.99.

Does therapy putty actually improve grip strength?

Hand function improves more than measured grip does. A Cochrane review found hand exercise probably improves hand function slightly against usual care, while showing little or no benefit on measured grip in kilograms in rheumatoid hands over the medium and long term. Improvements in dexterity, grip and pinch strength were recorded straight after a single putty session in people with Parkinson's disease.

How often should I use hand therapy putty?

Follow the repetitions and frequency your therapist sets, which is why NHS exercise sheets leave those numbers blank. If you are training rather than rehabbing, short sessions on most days are easier to stick with than one long weekly one, and sticking with it is what the evidence rewards. Stop a session if you get sharp pain rather than ordinary muscular tiredness.

Where can I buy hand therapy putty in the UK?

Clinical suppliers, pharmacies, mobility shops and online retailers all stock it, and NHS hand therapy departments publish supplier lists without endorsing any one of them. Patient-sized pots commonly run from 56 g to 113 g, with tubs from 450 g up to 2.3 kg sold for clinics. We ship the five-level pack anywhere in the UK free of charge with no minimum spend.

So which one do you buy?

If someone in a clinic has named a level, buy that level. If nobody has, buy the ladder rather than a rung, because the point of graded putty is the progression and a single pot leaves you guessing where you sit today. Then judge it on whether jars, kettles and door handles get easier, not on a number from a dynamometer.

This article is for informational purposes only and is not medical advice. Consult a qualified healthcare professional before starting any new exercise programme, especially if you have an existing condition or injury.