EXTENSOR TENDON REPAIR:  ZONES 4 -7
Therapy guide

 OPA at 10 days post op
 POP wrist and MCPJ extended
 Physio begins at 1st clinic appt
 Volar splint, forearm based with IPJ’s free (if there is an extensor lag then splint should include the IPJ’s) MCPJ slightly flexed and wrist in extended position

Exercises:   0 –3 weeks
 Flexion/extension of IPJ’s over end of splint.  X10
 With splint off, MPJ flexion with IPJ’s extended.  X10
 Scar massage – once wound healed.  5 minutes every hour
 Advise not to use hand for anything else other than the exercises shown.
 Keep an eye on the splint.  Make sure fit is OK, adjust as necessary.

Exercises:   3 - 5 weeks
 Commence ‘place and hold’ exercises.  X5
 Make ½ fist. Repeat x10
 Advise patient not to rush rehab.  Reiterate tendon healing times, especially as the hand will be feeling a lot better now.

Exercises:   5 - 6 weeks

 Continue all other exercises
 Aim for full fist by 6 weeks – this is a gradual process
 Start some strengthening work – again graded
 Fist – hook fist.  X20
 Flat fist – shelf position

Exercises:   6 - 7 weeks

 Wean off splint.  To wear at night and ‘at risk’ times for next 10 days
 Full fist with overpressure. Sustained holds
 Can start light activities
 Not to lift anything heavier than a kettle

Exercises:   7 weeks +

8 weeks:   Can consider driving (if has a good grip) but remember it is their responsibility to safely do so.

10 weeks:  Can return to heavy work   

12 weeks:   Can return to full contact sport

 
 

The Hand to Elbow Clinic
29a James Street West
Bath BA1 2BT

Tel 01225 316895
Fax 01225 484949
info@handtoelbow.com
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