Flexor Tendon Injury
A cut or ruptured flexor tendon needs precise rehabilitation before the finger will bend properly again. Carefully staged treatment to protect the repair, restore movement and rebuild grip.
- Certified Hand Therapist (CHT)
- Consultant Hand Therapist
- Hand, wrist & upper limb specialist
What is Flexor Tendon Injury?
Flexor tendons are strong cord-like structures that run along the palm side of the thumbs and fingers, connecting the forearm muscles to the hand bones. They are responsible for bending your digits an are essential for grip, pinch as well as manual tasks.
Flexor tendon injuries are among the most complex hand injuries to manage, requiring highly specialist rehabilitation. The tendons pass through a series of tight fibrous tunnels. Even minor disruption to the healing process can result in tendon rupture, adhesions, stiffness and permanent loss of function. Hand Therapy from the outset is essential for the best outcome.
What you might notice
- Inability to bend the thumb end joint or both joints of the affected finger
- A finger that rests in an abnormally straight position compared to adjacent fingers
- Pain and tenderness along the palm side of the thumb, finger or hand
- Weakness of grip or pinch
- A visible cut or wound over the wrist, palm, thumb or finger in acute injuries
- Swelling and bruising following acute injury
Why it happens
- Lacerations from sharp objects: the most common cause - involving cuts to the palm, thumb or fingers
- Forced straightening of a bent thumb finger against resistance, causing tendon rupture
- Deep bites or puncture wounds, penetrating the tendon sheath
- Sporting injuries - particularly contact sports and martial arts
- Rheumatoid arthritis causing tendon weakening and spontaneous rupture
- Post-surgical division during procedures for other conditions
How it's treated
After a thorough assessment, a personalised treatment plan is built around your needs and goals.
Following surgical repair, Ms Razo fabricates a custom dorsal blocking splint and initiates a carefully controlled early active mobilisation programme. It typically starts within a few days of surgery, to prevent adhesion formation while protecting the tendon repair.
Specific tendon gliding exercises are introduced in a precise sequence to encourage the repaired tendon to move and prevent the adhesions that lead to stiffness and restricted motion.
Scar tissue around a flexor tendon repair can significantly restrict movement. Ms Razo provides specialist scar massage, silicone therapy and desensitisation to optimise scar remodelling and tendon glide.
Once the tendon repair has sufficiently healed, a graded strengthening programme is introduced to restore grip, pinch and functional hand use. Progressing towards a return to work and sport are also considered.
Common questions
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Most complete flexor tendon lacerations require surgical repair for a good functional outcome. Partial tendon injuries can sometimes be managed non-operatively Hand Therapy. Ms Razo works alongside Hand Surgeons and can provide rehabilitation following surgical repair.
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Ideally, Hand Therapy should begin at the 72 hour mark post-surgical repair. Early controlled active mobilisation is critical to prevent tendon adhesions that cause stiffness and restrict finger movement. Ms Razo provides specialist post-operative rehabilitation from the earliest stage.
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Recovery after a flexor tendon injury typically takes 3–6 months, depending on the zone of injury, surgical technique and the patient's commitment to rehabilitation. Zone 2 injuries (within the finger) are the most complex and require the longest rehabilitation.
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Without specialist rehabilitation, flexor tendon repairs can either rupture or develop scar tissue that sticks the tendon and prevents it from gliding. This results in a stiff finger that cannot bend properly, potentially requiring further surgery to release the adhesions.
Related hand conditions
Clinically reviewed by Ms Michelle Razo CHT · May 2026