Learn the causes and treatment options of this common hand tendon injury.

How to approach flexor tendor injuries

To understand a flexor tendon injury, you first must understand a bit about how the hand works. The muscles that bend your fingers are located in your forearm. They are attached to your fingers by long cables called flexor tendons.

These flexor tendons slide in and out of the finger as we make a fist and then straighten our fingers. If one of these cables is cut or breaks, the end connected to the muscle often slides back into the palm. There is no way this can heal on its own. It is important to understand that hand is made of a lot of small precise parts that must work together.

The most difficult problem that people have after a tendon injury isn’t stiffness – it’s the tendon and all the hand’s small parts getting stuck together. The same thing that holds the repaired cables together, can also hold them to all the small parts in the hand, gumming up the works.

What causes tendon injuries?

  • Most commonly, this injury occurs from a cut to the bottom of your fingers, hand or wrist. 
  • Less commonly, these cables can break, tear off of the bone or be part of a more severe hand injury.

What can the doctor do to help?

  • Confirm that this is the problem
  • Sew the tendon ends back together or back to the bone
  • Together with your therapist, determine the therapy game plan

What can the therapist do to help?

  • Starting soon after surgery, specialized hand therapy often involves making a custom splint and designing special exercises. These are designed to help shape the body’s glue that holds things together.

What can you do to help?

  • Comply with your after surgery precautions 
  • Comply with your therapy game plan
  • Remember, you are the most important team member. Although you may need your doctor and therapists help, realize that they also need your help.

How successful is treatment?

  • In general, if you get 50 to 75 percent of your motion back in the middle and finger tip joints, that is considered a good result. If you get more than 75 percent of your motion back that is considered excellent. 
  • After a flexor tendon injury, loosing some movement in the finger, despite all efforts is fairly common. 
  • However, it is amazing what time can do. Most of these injuries have more finger motion a year down the road. 
  • Finally, most people learn to adapt to some movement loss and have very good hand use.


About the Author

Joe Hromisin is an occupational therapist with clinically specialized skills in both hand therapy and industrial rehabilitation.  He is a certified hand therapist and has been practicing for more than 25 years.  He has an extensive program development background in setting up both hand therapy and industrial rehabilitation programs.  Flexor tendon injuries are an area of special interest because they epitomize the need for early controlled motion to shape the scar tissue that holds together the injured tendons.