Flexor tendon injuries are one of the most common hand injuries that require surgery.
It’s also one of the most complex and frustrating therapy processes to go through.
Those injuries are usually from knife injuries, glass breaking, and even saw injuries. All are complete accidents.
You might have heard of “avocado hands”? That is a flexor tendon injury.
A famous tennis star Petra Kvitova, who was attacked by a knife lacerated her flexor tendons.
Enrique Iglesias, the famous singer most likely suffered a flexor tendon laceration when he was cut by a flying drone.
I remember way back when Rosie O’Donald had a flexor tendon and was wearing her splint during a talk show.
Flexor tendon injuries can happen at various levels of the hand. It can be in the fingers, palm, wrist, and even the forearm.
All flexor tendons need to be repaired if the hand is to function properly. Without the surgery to reattach the two pieces, the muscle can not pull the fingers down into a fist which is required to be able to use the hand without pain.
Most articles or things that you might research about flexor tendons tell you about the surgery itself or the protocols which is a guided outline of how to progress.
I’m going to share with you from a therapist’s perspective how I’ve treated them in the past 20 years and what I look for in order to get the best possible results.
There are 3 most important factors when it comes to taking care of a flexor tendon.
- The surgeon.
They must do a great job putting the tendon together in a strong way in order for therapy to get started on time.
- The therapist.
Getting started on time is not always up to us but working in a diligent manner, in a particular order, and paying attention to details usually can translate to great results.
- You, the person with the surgery.
Your body is going to respond how it’s going to respond in terms of swelling and scarring. But you play a huge role in being able to get the results you want by making the commitment to do the work.
Getting started.
The BEST time to get started is within 3-5 days after surgery. Most people after a flexor laceration and surgery are UNCERTAIN about when to get started even when instructed to get started fast.
It seems like it’s too early – but it’s not. I’ve worked with people after major joint replacements get up the same day after surgery and walk.
It’s NOT too early to get started in the right way. There’s a safe way to get the tendon gliding and reduce the risk of complications.
If you can’t get started right away, talk to your therapist about how you can catch up no matter when you get started.
I’ve worked with people coming in weeks after or having been to other therapy centers – it doesn’t matter.
If you are uncertain about what is possible, request a Discovery Visit and come show our certified hand therapist your injuries and we can discuss what we can do to help.
The splint.
The splint (aka custom-made brace) needs to be created to fit you and only you. You cannot purchase it online or at the drugstore.
You will wear the splint for up to 6 weeks. The most important aspect of the splint is in HOW your hand is positioned. If positioned WRONG, you can develop complications such as a stiff middle knuckle or even have continued swelling of your hand.
The splint must be comfortable! It’s custom-fitted so be honest with your therapist if it’s NOT comfortable.
Here’s my rule of thumb….if you are doing great you may need to wear it longer. If you are stuck and scarring down, we may be able to get rid of it faster.
Get your fingers moving.
We first need passive motion, which means you and I moving it. Then we have to progress to moving it actively meaning you use your muscles to pull your fingers down.
There is a series of positions and specific exercises done in a SAFE manner so that you don’t rupture the tendon. If one finger is cut, all fingers cannot be used and that’s because it shares one muscle belly that gets divided into 4 separate tendons.
Rupturing the tendon will sometimes require 2 more surgeries. Not moving your fingers out of fear can result in the tendon getting stuck and requiring 1 more surgery.
This is by far the most frustrating part of the whole process. It might take you longer than you thought.
Passive motion in a pain-free range is the most important so that you can actively move it.
Patient Success Story
Recently, I was working with a gentleman who lacerated his small finger. He had a persistent wound that would not close. He said he started on time but had a lot of swelling from the beginning. He said he did what he was supposed to do in terms of the exercises.
The red flags for me are:
- Wounds that take too long to heal
- Swelling that sticks around too long
- Finger stiffness at the joints
He had them all. He came to our clinic for a second opinion and treatment. One thing he asked me was “ what tools do you use to reduce the scar? Do you use ultrasound, or cupping or instrumental tools?”
I told him the best tools I have to help him are my hands and my brain – how I solve these types of problems in order to help him get his fingers moving and help him avoid having to have a second surgery called a tenolysis.
Yes, I have all the extra tools….but they don’t help when used in the wrong order or are not even needed for his particular problems!
See, the biggest problem with flexor tendons, especially in certain parts of the hand is the ability to get that tendon to glide.
Scarring plays a huge role in scarring down the tendon, and it is up to your therapist to know how to progress based on how good or bad you are progressing.
Honest conversation with your hand therapist is crucial
It’s important to have honest conversations with your certified hand therapist about what you are able to do and what you are not able to do. It’s the only way to get the best possible results after a flexor tendon repair.
Find yourself a certified hand therapist in your area with the experience to take you through the process and help you progress through your flexor tendon journey.
Flexor tendon injuries can be extremely frustrating but with a great certified hand therapist, it’s possible for you to see the light at the end of the tunnel.
It’s possible to make a fist. It’s possible to use your hands the way you want to use your hands. And it’s possible to avoid another surgery if you can get the help sooner than later.
If you or someone you know suffered from a hand injury such as a flexor tendon laceration, give us a call at the clinic or request a Discovery Visit. We always make time for post-surgery cases because we know that time is of the essence.
Let me know if you have any questions, I’m happy to answer them for you.
Written by Hoang Tran
About the author – Hoang Tran; an expert in physical & occupational therapy
Hoang Tran is a certified hand therapist, the owner of Hands-on Therapy Services, and the author of the book “The Hands-On Approach”. She loves helping people with hand, neck, and shoulder problems because she knows how bad and debilitating they can get if not addressed and treated properly (once and for all!).
The aim of her Miami occupational therapy practice is to bring patients back to full functionality, without pills, injections, or surgery. Occupational and Physical Therapy are both offered at Hands-On Therapy by our experienced therapists who provide a comprehensive approach to your care.
If you are struggling with hand and wrist pain, including
- Flexor Tendon Laceration
- Carpal Tunnel Syndrome
- Mallet Finger
- Trigger Finger Or Trigger Thumb
or any other hand condition, speak with one of our specialists for FREE by signing up for a 30-minute Discovery Visit here! Talk to our specialist first before booking any paid session. We like to ensure that we can help you before taking you on as a client.
PS. Seven step-by-step tips that you can start right away to recover quicker after hand, wrist, or shoulder surgery. Click for the After Surgery Guide.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions or concerns you may have regarding your health.
