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Date issued: July 2021

Review date: July 2023

Ref: C-467

PDF:  exercise regime following repair of flexor tendon final July 2021.pdf [pdf] 409KB

This is your exercise regime after the surgery. Your exercises will be increased as you progress through the stages of recovery.

Exercise Regime (forearm based splint for 6 weeks + 2 weeks)

Exercise 6 times a day. Each time do 6 repetitions of each movement. Do not force any movements. Movements should not be more painful than it would be expected after the surgery. Do not clench into a tight fist.

Actively means moving a finger joint by yourself without help from your unaffected hand.

Passively means using your unaffected hand to move a joint.

Week 1 (the week from the operation) and Week 2 (stitches are removed at the end of week 2)                                                 

Using your unaffected hand, passively bend the top 2 joints of each finger into a hook; and  passively hold for 5 seconds (passive hook)

Continue from the passive hook; use your unaffected hand to bend the knuckles joints down together into a fist. Passively hold for 5 second (Passive fist).

Continued Week 1 and Week 2                                  

Actively straighten the fingers to the   splint without help from your unaffected hand              

Place 3 fingers of your unaffected hand across the palm of your operated hand. This is to guide how far you can bend your finger in each stage of recovery without forcing the tendon too far.

Continued Week 1 and Week 2

Actively curl your fingers down from the top joint of your fingers to touch

• The top finger of your unaffected hand in the palm in Week 1                                             

• Actively straighten your fingers towards the splint                                                                          

• The middle finger of your unaffected hand in the palm in Week 2

• Actively straighten your fingers towards the splint

Week 3

• Commence scar massage after removal of stitches and when the wound is fully healed.

• Massage scar 3 times a day with a non-perfumed moisturising cream (E45®; Diprobase®; Aveeno®, Nivea® etc.)

• Massage each finger or the palm for 3 to 5 minutes each time.

• Your Occupational Therapist may put a wide strap on your splint at your fingers if you are not able to straighten the middle joint of your finger well. This strap should be applied loosely. You need to remove this additional strap when exercising your fingers.

Continue exercises as in Week 2; but you can now actively bend the finger down to touch the last finger of the 3 fingers guide of your unaffected hand.

Week 4 and Week 5

Continue your exercises as in Week 3; and  you can now actively curl the whole finger down, starting from the top joints into a loose fist (Active fist).

 Do not attempt to make a tight fist or force your hand into a fist.

Continued Week 4 and Week 5

Place and hold exercise

Use your unaffected hand to bend the fingers down into the palm (passive fist); then, hold the fingers down without the help from your unaffected hand for 5 seconds 

Continued Week 4 and Week 5                                 

Place your unaffected hand on the back of your operated hand keeping the knuckle.

Joints bent. 

Gently straighten the top 2 joints of your finger without help from your unaffected hand.                                

Commence active wrist movement

• Remove your splint.

• Rest your arm and hand on a table

• Keeping the fingers in a relaxed posture; gently move the wrist forwards, your fingers will naturally straighten.

Gently move your wrist backwards; your fingers will naturally curl up.

• Do not bend the wrist forwards when  your hand is in a fist.

•  Do not straighten your wrist backwards when your fingers are straight.

•  Put the splint back on after wrist exercises.

Week 6 and Week 7

Starting from _____________________________, you can exercise your wrist and hand out of your splint. You need to put the splint back on when your fingers are at risk of being injured and when you are in bed.

From Week 6, your therapist may make a small finger splint for you if you have difficulty in straightening the top two joints of the finger. This small splint is to keep the top 2 joints straight. You need to wear the small splint inside your forearm based dorsal splint at night.

Exercise 6 times a day. Each time do 6 repetitions of each movement.

Continue exercise as per Week 5 but exercise your hand out of the splint.

Keep the knuckle joint of the operated finger bent and use your unaffected hand to gently straighten the middle joint of your operated finger.

Additional exercises:

Keeping your wrist in neutral flat position, gently straighten all your fingers without help from your unaffected hand.                      

Continued Week 6 and Week 7

Hook fist (clawing)

• Hold the knuckle joints flat

• Bend the top 2 joints of fingers down

• Straighten your fingers

Flat fist            

• Bend all the fingers down as if making a fist but keep the end joint of the fingers straight

• Straighten your fingers

Continued Week 6 and Week 7               

Isolated joint movement of finger

• Use your unaffected hand to support just below the top joint of your operated finger

• Gently bend the end joint of your finger down

• Straighten the finger

Week 8

Starting from_______________________________, you do not need to wear your forearm based dorsal splint anymore.

Your therapist may make you a hand extension splint if you have difficulty in straightening the fingers yourself.

You can increase your exercises up to every hour. For each set, do 10 repetitions of each movement.

As well as continuing your wrist and hand exercises, you need to add in the following sets of exercises.                                                                                        

Fingers apart and together

Keep your wrist in a neutral position

1. Spread your fingers apart.

2.Then move your fingers close together.

Full fist

• Curl all your finger to make a fist   

           Do not clench your fist tightly

• Straighten your fingers

Week 8 to Week 12

You need to continue your exercises as per the previous week. You may start to do gentle strengthening exercises from Week 8 and you can increase the strength gradually over the next 4 weeks.

Gentle strengthening exercises

Use therapeutic putty with increasing resistance 3 times a day up to 10 minutes each time.

• Week 8 and Week 9, use yellow putty

• Week 10, use red putty

• Week 11, use green mixed with red putty or continue with red putty

• Week 12, use green putty

If you have any questions about this information, please contact your Occupational Therapist.

Your Occupational Therapist is:_______________________

The telephone number of Occupational Therapy Department is 01752 432220