Your hand's flexor tendons control finger and thumb movement. These tendons are small and can be vulnerable to injury, such as when your fingers overstretch during a fall or when you jam one or more of your fingers. Surgery for a hand flexor tendon tear comes into play only after a complete rupture, where the tendon separates from the bone. After surgery, rehabilitation can start, typically lasting eight weeks or longer depending on the severity of the tear.
Stage 1
Physical therapy starts almost immediately after surgery. At this stage, the primary goal of rehabilitation is to control inflammation and reduce pain and discomfort following surgery. In the first stage of physical therapy, your hand and fingers are immobilized for several days to a week to begin healing. Cryotherapy, or cold therapy, may reduce inflammation and provide pain relief. Your physician also may prescribe anti-inflammatory medications to further reduce post-surgery discomfort and inflammation.
Stage 2
Once the inflammation is under control in your hand and fingers, your body can begin its healing. At this stage, your physical therapist may have you begin range of motion therapy. This involves different types of light stretches and movements involving your fingers, including lightly clenching your fingers into a fist or moving your fingers from side to side. The purpose is to increase the flexibility of the small joints in your fingers and to prevent the buildup of scar tissue, which can restrict mobility.
Stage 3
Once you regain adequate range of motion in your hand and fingers, you may begin hand strengthening exercises. Your hand flexor tendons attach small muscles on the palm of your hand and forearm to the bones of your fingers. When the tendons become damaged, these muscles will begin to atrophy, or lose strength and size. To regain normal function in your hand, these muscles need to be strengthened. Your physical therapist may have you conduct hand muscle strengthening exercises, such as squeezing a stress ball or gripping weighted objects to rebuild these muscles.
Stage 4
After several months of rehabilitation, your physical therapist may declare you ready to return to normal activity. However, you should continue performing the range of motion exercises as well as the strengthening exercises from the second and third stages of rehabilitation therapy. This is to ensure your hand flexor tendons and muscles remain strong and flexible and reduce the risk of re-injury.
References
- American Society for Surgery of the Hand; Flexor Tendon Injuries; 2009
- "Therapeutic Exercise: Foundations and Techniques"; Carolyn Kisner and Lynn Colby; 2007
