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Date issued:July 2021

Review date: July 2023

Ref: C-464

Ref:  Repair of flexor tendon final July 2021.pdf[pdf] 197KB

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 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 you 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 to Week 6

Continue your exercises as in Week 3; and you can now curl the finger down to the palm.                                               

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

Other exercises in Week 4 to Week 6

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 

(active hold)

Continued Week 4 to Week 6                                  

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.

• Do not bend the wrist forwards (when not required) gently move your wrist backwards; your fingers will naturally curl up.

 

• 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 7 to Week 8

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.

Continue the exercises as in the previous week with the addition of some new movements;

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

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

Continued Week 7 and Week 8

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

Full fist

• Curl all your fingers to make a fist  

            Do not clench your fist tightly

• Straighten your fingers

Continued Week 7 and Week 8

Isolated movement

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

• Straighten the finger 

Week 9 to Week 12

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.

Gentle strengthening exercises

You can start to do gentle strengthening exercises using therapeutic putty starting from week 8.

Exercise with therapeutic putty 3 times a day for 5 to 10 minutes each time.

• Week 8 and Week 9, use yellow putty

• Week 10+, use red/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