Physiotherapy for Flexor Tendon Repair Rehabilitation

What is a flexor tendon repair?

Lacerations to the deep flexor tendons of the hand (FDS and FDP) often occur from glass cuts, kitchen knife accidents, or industrial machinery across India. Zone II ("no man's land") injuries are notoriously challenging due to the narrow fibro-osseous tunnel. Complete immobilisation leads to catastrophic scarring that freezes the finger, whereas premature loading causes tendon rupture. Early controlled mobilisation by an experienced hand physiotherapist glides the repair within its sheath, nourishing the tendon via synovial diffusion and minimizing adhesions without risking suture rupture.

How physiotherapy helps

• Custom dorsal blocking splint fabrication
• Passive flexion and active extension drills
• Early active motion within protected ranges
• Tendon glide differentials between FDS and FDP
• Oedema control and gentle scar massage

Common signs

• Inability to bend the fingertip or middle knuckle following a cut to the hand or wrist
• Surgical incision site pain and tightness along the volar aspect of the digit
• Post-operative finger swelling and stiffness requiring controlled movement within a splint
• Adhesion sensation where the finger moves as a single block rather than curling smoothly
• Loss of fine pinch and grasp coordination during functional hand activities

Clinical rehabilitation framework

Evidence-informed clinical progression and starter exercise targets for a flexor tendon repair.

Frequently asked questions

Related conditions & care

Trigger FingerTrigger finger (stenosing tenosynovitis) occurs when inflammation, thickening, or nodule formation on the flexor tendon restricts its smooth glide through the first annular (A1) pulley at the base of the finger or thumb. In India, repetitive gripping, heavy domestic activities (such as wringing clothes, chopping, and sweeping), manual tool use, and underlying conditions like diabetes commonly precipitate the condition. As the nodule catches within the tightened pulley sheath, the digit snaps, clicks, or locks in a flexed posture. Conservative physiotherapy combines custom MCP joint splinting to prevent pulley irritation, tendon gliding exercises, gentle deep friction massage, and ergonomic utensil adaptations to restore smooth, painless finger excursion.

Carpal Tunnel SyndromeCarpal tunnel syndrome develops when the median nerve becomes compressed as it passes through the carpal tunnel on the palmar side of the wrist. Increased pressure within the tunnel, often linked to repetitive wrist bending, sustained gripping, fluid retention, or inflammatory changes, causes tingling, numbness, and burning pain in the thumb, index, middle, and radial half of the ring finger. For mild to moderate presentations, conservative physiotherapy focuses on relieving nerve compression, reducing flexor tendon friction, and preserving hand function.

Colles FractureA Colles fracture is a complete fracture of the distal radius bone in the forearm with dorsal displacement of the wrist, typically sustained by falling onto an outstretched hand (FOOSH). It is particularly common among older adults with underlying osteopenia or osteoporosis in India, frequently occurring from slips on wet bathroom tiles or unpaved streets. Following 4 to 6 weeks in a plaster cast or surgical fixation with a volar locking plate, patients invariably experience severe wrist joint stiffness, restricted forearm turning (pronation and supination), finger puffiness, and diminished grip power. Post-immobilization physiotherapy focuses on gentle passive and active joint mobilisations, edema reduction, tenosynovial gliding, and graded resistance training to safely restore independence in carrying groceries, preparing meals, and personal care.

Repetitive Strain Injury (RSI)Repetitive strain injury (RSI) refers to cumulative musculoskeletal pain and tissue strain affecting muscles, tendons, and nerves in the neck, shoulder, forearm, or wrist. It frequently arises from sustained posture, repetitive typing, smartphone use, manufacturing assembly, or manual instruments. Physiotherapy identifies the mechanical drivers of strain, relieves localised muscle and tendon tension, and corrects workstation ergonomics, movement patterns, and load pacing so symptoms do not keep recurring.

Clinical guides & articles for a flexor tendon repair

Evidence-informed articles, recovery timelines, and home care advice from our clinical library.