Inside the three-month rehab of New York Giants defensive end Jason Pierre-Paul, who suffered a hand injury after a fireworks accident on July 4th, resulting in his right index finger being amputated.
This story appears in the Nov. 16, 2015, issue of Sports Illustrated. Subscribe to the magazine here.
In late August, strength coach Mike Alessi walked into Impact Sports Performance in Boca Raton, Fla., and saw Giants defensive end Jason Pierre-Paul crouched over his size-14 sneakers, using his right foot to hold a shoelace in place so he could tie it with his left hand. By then, Alessi was used to seeing JPP get creative in the gym.
The knot-tying routine was just one of the many adjustments the 26-year-old had to make after a Fourth of July fireworks accident that caused the amputation of his right index finger and the tip of his right thumb while also severely damaging his middle finger. Alessi, who started off-season training with Pierre-Paul in March, says every session since the incident had to be modified because Pierre-Paul couldn't hold weights with his right hand.
"For three to four weeks we only trained his left side," says Alessi. "Then we started manipulating things to get the right side working."
Alessi altered Pierre-Paul's standard upper body lifts by wrapping an ankle strap around the wrist of his injured hand, allowing him to do rows, shoulder presses and other movements on the cable pulley machine. He also did various multidirectional footwork and running drills for agility and pulled a sled that was attached to his waist with a belt and harness—a modified version of the traditional sled push—to build power and leg strength.
Pierre-Paul did most of the same lower body lifts he was doing before the accident, including leg press and single leg squats with a weighted vest or barbell on the back. “The only thing we couldn’t reincorporate was deadlifts,” Alessi says. “Before he was deadlifting near 450 pounds but he couldn’t hold onto the barbell in that movement.”
After each workout Pierre-Paul met with occupational therapist and hand-rehabilitation specialist Deborah Austin, who guided him through a multi-stage therapy program based on the healing of his various surgical procedures.
“Jason came in still with open wounds from the explosion injury and pinning for fractures in his hand,” says Austin. “He had several procedures and every time we would have to hold up waiting for the integrity of the skin and sutures to heal.”
Initially Pierre-Paul’s sessions with Austin were focused on wound and scar care as they waited for the fractured bones and stitches to heal. While waiting, Austin was able to work with Pierre-Paul on his wrist and other parts of his hand.
"The ring and small fingers were just soft tissue injuries, so we were able to strengthen those," says Austin, adding that those two outer fingers are the key to grip strength. "When it was time to use the thumb and middle finger, we were ahead of the game."
Because Pierre-Paul's position requires a lot of pushing, Austin incorporated wall and tabletop push-ups, and used other tools—such as soft putty, hand grippers and pinch pins—to increase upper-body flexibility and dexterity and to build strength. Austin was able to see instant feedback on Pierre-Paul’s progress with the soft putty, a moldable substance like Play-Doh that changes colors as its temperature increases with each stretch, pinch and squeeze. Pinch pins (like clothespins) and hand grippers (also called hand exercisers) offered varying resistance levels to build strength and coordination on individual fingers. Austin even had Pierre-Paul dribble and catch a basketball to apply impact to his hand, and shooting helped with wrist extension and flexion.
"You can miss your pointer finger. [The surgeons] allowed Jason to be where he is today," Austin says. “He has a fully controlled hand. He can hold a football and write with his hand.”
During his time working with Austin and Alessi, Pierre-Paul also worked on his stance, trying out different ways to lean and place his hand on the ground. Defensive line coach John Blake also came to Florida to work on technique, hand placement and leverage.
Alessi says that Pierre-Paul looks "as good ever." He’s now transitioned to working with the team’s training staff and therapists in New York. On Sunday he played 47 snaps in New York's 32–18 win over the Bucs.
Says Austin, "He exceeded all his goals in therapy, and then some. You would give him an A-plus, and he’s not done yet."
Jason Pierre-Paul's hand rehab tools
- Soft Putty: This moldable substance changes colors as it gets hot, providing visual feedback during squeezing, stretching and pinching exercises.
- Hand Grippers: While a standard, two-prong tool works well, Pierre-Paul used hand exercisers that can work individual fingers.
- Pinch Pins: Similar to clothespins, these devices offer varying resistance levels to build strength and coordination.
- Basketball: Pierre-Paul dribbled and caught a basketball to apply impact to his hand, and shooting helped with wrist extension and flexion.