What is a flexor tendon injury?

Flexor tendons are muscle tendons located at the palm side of the hand and fingers, which help to bend the wrist, fingers and thumb, thus allowing you to grasp an object or make a fist. Injuries to the flexor tendons can result in the inability to bend one or more of the joints in your hand.

Flexor tendon injuries typically occur from a cut on the palm side of the fingers, hand, wrist or forearm. The flexor tendon can also be torn when a finger or thumb is pulled away from you while you are attempting to grasp an object. In activities that require a lot of hand strength (e.g. rock climbing), flexor tendons and/or their sheaths can also be stretched or torn. The crimp-grip position of the fingers necessary for rock climbing places a great deal of strain on the pulleys of the flexor tendon sheath and can cause a rupture of the sheath. When this occurs, it can limit how much the finger can bend and can cause pain when moving the finger.

How do I know if I have a flexor tendon injury?

Signs and symptoms of a flexor tendon injury may include:

  • An open injury, such as a cut, on the palm side of the hand, wrist, or forearm
  • An inability to bend one or more joints of the finger on your own
  • Pain when you attempt to bend the finger
  • Tenderness along your finger on the palm side of your hand
  • Numbness in your fingertip

How is a flexor tendon injury diagnosed?

Your specialist Doctor will obtain your health history and perform a physical examination. Your Doctor may also order radiological investigations (e.g. X-rays, MRI scans, ultrasound scans) to help diagnose and assess the severity of the injury in the hand, wrist or forearm.

How is a flexor tendon injury treated?

It is important to seek early treatment for a flexor tendon injury as there is a high possibility of tendon injuries requiring surgical treatment. Flexor tendon injuries may be treated both surgically and non-surgically, depending on the severity of the injury.

Non-surgical Treatment

Flexor tendon injuries involving mild or partial tears of the tendon may be managed without surgery. Your specialist Doctor may refer you to a Hand Therapist, who will fabricate a customised splint for your finger/wrist. This splint will help to support your finger/wrist in an optimal position so that tendon healing can occur. It is often vital that the splint is worn at all times for at least 6 weeks, with the finger/wrist joints immobilised completely during this period of time. Once the flexor tendon is healing adequately, you will be able to see our Hand Therapist to start gentle finger/wrist exercises.

Surgical Treatment

Surgery is usually required for flexor tendon injuries that are more severe, such as a severe tear or complete cut of a tendon. The tendon is repaired by sutures during surgery and your specialist Doctor may order a customised splint to immobilise the affected wrist/finger for a period of 6 to 8 weeks after the surgery in order to protect the tendon repair while it heals. When there is adequate healing, your may commence Hand Therapy.

Hand Therapy

Joint stiffness, muscle tightness and loss of function of the finger, hand and wrist are common problems in the early stages of recovery from a flexor tendon injury. As such, daily activities such as self-care (e.g. dressing, showering, brushing of teeth), work activities and leisure pursuits (e.g. baking, sports, gym activities) are often affected. Hand therapy plays a pivotal role in the recovery of finger, hand and wrist movements, strength and function after a flexor tendon injury. Most flexor tendon injuries take around 3 to 4 months to heal before you are able to return to your normal daily activities, and full recovery from these injuries can take up to a year.

If you require protective immobilisation for your finger/wrist, your specialist Doctor may refer you to our Hand Therapist for a customised splint. Once you are able to start therapy for your finger, hand and wrist, our Hand Therapist can then help you in your recovery through treatment options such as:

  • Advice and education pertaining to your condition
  • Wax therapy
  • Ultrasound therapy
  • Exercises to improve finger/wrist joint and muscle movements
  • Management of swelling
  • Scar management
  • Strengthening exercises
  • Soft tissue mobilisation and release
  • Pain relief/management
  • Functional retraining of the finger, hand, and wrist
  • Personalised home exercise program