Tendon Rehabilitation Pre/Post Surgical Intervention

Hand therapy plays a crucial role in the rehabilitation process following tendon repair surgery. It aims to optimize the healing of the repaired tendon, restore normal range of motion, improve strength, and enhance functional abilities of the hand. Hand therapists work closely with surgeons and patients to develop a comprehensive treatment plan. Here are some key aspects of hand therapy for tendon repair:

1. Immobilization and Protection: Initially, after tendon repair surgery, the hand may be immobilized in a splint or cast to protect the repair and facilitate healing. The hand therapist ensures the proper application of the splint and provides instructions on its use, including when and how to remove or adjust it.

2. Controlled Movement: As the healing progresses, controlled movement of the repaired tendon is gradually introduced. Hand therapists guide patients through a series of passive and active-assisted exercises to prevent adhesions and maintain mobility while protecting the repair. The therapist may also utilize dynamic splinting or assistive devices to aid in controlled movement.

3. Tendon Gliding Exercises: Tendon gliding exercises help to promote smooth gliding of the tendon within its sheath and prevent the formation of adhesions. Hand therapists teach patients specific exercises that involve flexing and extending the fingers through various joint positions.

4. Strengthening Exercises: Once the repaired tendon has sufficient healing and range of motion, the focus shifts to strengthening the hand and restoring grip strength. Hand therapists prescribe progressive resistive exercises tailored to the patient's specific needs, gradually increasing the resistance over time.

5. Scar Management: Scar tissue can affect the mobility and function of the repaired tendon. Hand therapists employ scar management techniques such as massage, manual therapy, and the application of specialized scar management products to minimize scar adhesions and improve tissue mobility.

6. Functional Training: Hand therapists work with patients to simulate real-life functional activities, such as grasping objects, manipulating tools, and performing daily tasks. This helps patients regain the strength, coordination, and dexterity needed for their specific occupational or recreational activities.

7. Edema Control and Pain Management: Hand therapists may use various modalities, such as compression therapy, elevation techniques, and manual lymphatic drainage, to control swelling and reduce pain. They may also incorporate modalities like heat or cold therapy, electrical stimulation, or ultrasound to manage pain and promote healing.

Throughout the rehabilitation process, hand therapists closely monitor the patient's progress, adjust the treatment plan as needed, and provide education on self-management strategies. Compliance with the therapist's instructions and adherence to the prescribed home exercise program are vital for successful tendon repair rehabilitation.

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Sources:

1. American Society of Hand Therapists (ASHT)​

2. American Physical Therapy Association (APTA)​

3. PubMed​

4. Mayo Clinic​

5. OrthoInfo (American Academy of Orthopaedic Surgeons)