By: Brian Rog and Julianne Lessard, OTR/L,CHT
Our hands and fingers are among the most important assets to our body, so an injury, specifically to the hand’s control center, the flexor tendon, can open the door to a lengthy and exhausting road to recovery.
What is a Flexor Tendon Injury?
If you are not familiar with the flexor tendon system, it consists of strong cords of tissue that connect the muscles of the forearm, through the wrist, and across the palm to the tips of the fingers and thumb. All four fingers connect to one primary muscle, which is responsible for controlling the middle knuckles and another muscle that controls the fingertips.
Flexor tendons are essential in enabling movement in the fingers and allow us to engage in simple activities like writing, holding a coffee cup, holding hands and zipping a coat. Unfortunately, this often overlooked muscle group can be damaged in an instant. It’s important to understand its susceptibility to an injury that leads to an inflamed tendon in the hand , the symptoms of flexor tendon injury, and how you can recover.
The speed with which ruptured flexor tendon injury can occur isn’t mirrored by the recovery time, which can be long and drawn out. Flexor tendon injury treatment requires comprehensive therapy, so that the injury can properly heal and full usage can be restored.
Causes of Flexor Tendon Injuries
A ruptured flexor tendon injury can happen so quickly that the individual affected by it does not have time to comprehend the severity of the damage. It’s important to know that almost any injury to the palm-side of the hand will involve the flexors.
When an injury does occur, more often than not, the cause of the injury is traumatic and can involve something as simple as a laceration from the tip of a knife while cutting a vegetable, or a bit more harrowing such as a major contact injury from a table saw.
The immediacy of the wound, and the shock that can cause, can actually mask the severity of the injury. The affected area mostly involves the tip of the finger, which is prone to avulsions and laceration injuries to the tendons.
There are also closed injuries such as “jersey finger” that can result when a player grabs another player’s jersey as they pull away. This torn tendon in the finger is the result of an abrupt tear at a strange angle. It can also happen while lifting things, especially if a person is already suffering from conditions such as rheumatoid arthritis. Neither of these need to be full tears to be painful and debilitating; a ruptured flexor tendon injury can be extremely damaging and limiting.
Not all issues with the flexor tendon are caused by injuries. Some of them, ones involving the covering of the tendons called sheaths, can also occur. These conditions are generally categorized as flexor tendonitis.
Flexor tendonitis in the hands is usually caused by repetitive stress, like from a throwing motion. This can be seen in factory jobs as well as office jobs. Symptoms of tendon damage in the hand are more subtle with a deep ache, swelling of the elbow, and sometimes a triggered or locked finger. This condition can, at times, make it easier to lead to a flexor tendon strain of tear.
As we see, there are a lot of ways that these can happen, and as with most injuries, there is no “good” kind of flexor tendon injury or condition. But there are treatments that can help people reduce pain and get back the movement they want.
Flexor Tendon Injury Treatment Options
There are several stages of flexor tendon injury treatment. Less severe cases, in strains or flexor tendonitis, require some occupational hand therapy and an orthosis or brace. These can often help reduce swelling, regaining functionality. That’s not always enough, though, and in the case of a cut, tear, or severe strain, other measures may be required.
These measures can include an injection, and in some cases surgery is needed for ruptured flexor tendon repairs. Flexor tendon surgery is not a complex procedure, but it is one that often requires physical therapy afterwards to protect the repair. In fact, whether or not you have surgery, some degree of therapy is usually beneficial for regaining full functionality.
Physical Therapy for Flexor Tendon Injury Treatment
Surgery will often yield great results, but there are times when more work has to be done. That’s when you will need to see a hand therapist, who can work you through exercises to gradually regain functionality. However, there is rarely such a thing as a “full recovery”, which is why more therapy may be periodically needed.
Of course, there are also flexor tendon treatment options you can do in-clinic or in the comfort of your home through online physical therapy. Supervision and a rigorous methodology both speed up healing and help it be more sustainable.
Home-Based Flexor Tendon Treatment and Hand Therapy
The Table-Top. Hold your fingers straight in the air, and bend at the back knuckle to create a flat surface. Raise and repeat.
The Fist. Start with your fingers straight and slowly make a fist. You don’t have to squeeze or tighten, but curl your fingers forward.
The Hook. Start with fingers straight, and bend the fingers at the top knuckle, creating a hook-shape.
Stress-Ball. This one is easy- gently squeeze a stress ball.
None of these should be done to the point where they cause pain. You don’t want to reinjure, which is why being able to do them under the supervision of a physical therapist will be your best bet for a better recovery.
There’s no denying that minor accidents will occur from time to time, so the more you know, the better you can prepare. The good news in all of this is that treatment for an inflamed tendon in the hand can be effective. If you have sustained an injury to your hand and are unsure of the steps needed to get back to life before the injury, contact your nearest ATI Physical Therapy clinic and ask for a complimentary injury screening. Our team will assess your injury, provide next steps on a treatment plan and get you on the road back to feeling like yourself!