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Advice and exercises following repair of your extensor tendons - Norwich Regime

This leaflet has been written to provide you with information following your surgery to repair your extensor tendons. A cut in these tendons, even if only part way through, is a serious injury. It is important that you follow the advice of your hand surgeon, therapist and this leaflet to achieve the best possible outcome.
What Are Your Extensor Tendons?

Extensor tendons allow you to straighten your fingers and thumb. They run from muscles in the back of your forearm into your hand where they attach to the bones of your fingers and thumb. They are important in allowing you to open your hand during activity and are essential in allowing your hand to function normally.

Why have these been repaired?

Your tendon has been repaired to restore normal movement, and you will need to undergo a strict hand therapy programme following your surgery to maximise your recovery and functional use of your hand.

Swelling

It is normal to have swelling in your hand after an injury or surgery.

To help drainage of this swelling whenever possible:

Do rest your hand above the level of your heart. Use a cushion to support your arm if this is comfortable.

Do move your elbow, shoulder and neck regularly to prevent stiffness in these joints.

Do not allow your hand to hang by your side.

Early movement of your fingers as described in this leaflet will help to manage your swelling and prevent stiffness later.

0–3 Weeks after surgery

Splints

Picture of hand and lower arm held out from body in a splint
Hand and lower arm in a splint

Splints J7A3270-Edit

Within the first week following your repair you will be seen by the hand therapy team. A small “yoke” splint will be made and a separate wrist splint given to protect your surgical repair.

The repair will be weak and will require protection in a splint to prevent movements and activity that will risk rupturing your tendon. You should wear the splints 24 hours a day.

While wearing your splints you will need to check your skin on a regular basis for red or sore areas and inform your therapist if you have any concerns.

Your arm and splint will need to be covered with a plastic bag when showering or bathing (please do not remove your splints).

Do not place your splint in hot water or near a heater as this will affect its shape/fitting and result in the splint becoming uncomfortable to wear.

Exercises

You will not stop your tendon healing by moving your thumb and fingers. Bending and straightening your fingers will help regain movement and reduce swelling.

You should complete the following exercises wearing your splint:

1. With your other hand lift your fingers up away from the splint. J7A3271-Edit

Picture shows other hand lifting fingers up and away from the splint.
hand lifting fingers away from splint.

2. Actively straighten your fingers away from the splint. J7A3273-Edit

Picture shows how to actively straighten your fingers away from the splint
Straighten fingers away from splint

3. Actively straighten your fingers away from the splint then curl your fingers. J7A3274-Edit

Actively straighten your fingers away from the splint then curl your fingers
Curl your fingers
Scar Massage

Massage helps make your scar more mobile, so it does not limit movement of your fingers. Once the stitches are removed and the wound looks dry you can start to massage the scar.

Use a simple moisturiser such as E45, Nivea or aqueous cream. Massage the cream over the scar in circular movements.

Perform this 3-4 times a day for 5 minutes.

Day to Day Dos and Don’ts

Dos

You can use your hand for light activities for example:

• Doing up buttons/shoelaces.

• Dressing with light clothes.

• Holding paper.

• Using a mobile phone.

Don'ts

You must not use your injured hand for heavier activities, such as:

• Carrying a cup of tea or plate of food.

• Pulling up your jeans/trousers/shorts.

• Opening doors.

• Driving.

5 Weeks After Surgery

You can stop wearing the splint during the day. Your therapist will advise you if you need to continue to wear the splint when you go to bed.

Exercises

1. Support your forearm on a table. Bend your wrist downwards relaxing your fingers. J7A3257 - Edit

Exercise shows forearm supported on a table with hand raised and wrist bent downwards.
Forearm supported on table with hand raised and wrist bent downwards.

2. Support your forearm on a table. Bend your wrist upwards. J7A3258 – Edit

Exercise shows forearm supported on a table with hand raised and wrist bent upwards.
Forearm supported on table with hand raised and wrist bent upwards

3. Rest your elbow on a table. Straighten your fingers. J7A3259 – Edit

Picture shows elbow resting on a table, hand raised with straight fingers
Hand raised with straight fingers

4. Rest your elbow on a table.  Bend your fingers at the knuckles whilst keeping your finger joints straight. J7A2048 – Edit

Elbow resting on a table, fingers bent at the knuckles, finger joints straight
Fingers bent at the knuckles, finger joints straight

5. Rest your elbow on a table, curl and open your fingers without making a full fist. J7A3260 – Edit

Picture shows elbow resting on a table, arm raised, hand curled and fingers open without making a full fist.
Fingers curled, hand open without making a full fist

6. Rest your elbow on a table. Close your hand to make a full fist. J7A3268 – Edit

Picture shows elbow resting on a table with arm raised and hand closed to make a full fist
Elbow rests on table with hand raised in full fist
Day To Day Dos and Don’ts

Dos

You can use your hand for medium heavy activities for example: 

  • Carrying a cup of tea or plate of food.
  • Pulling up jeans/trousers/shorts
  • Opening doors.
  • Driving if safe.
  • Cycling.

Don'ts

You must not use your injured hand for heavier activities until you are 12 weeks following repair:

  • Heavy lifting/labour.
  • Contact sports.
Important Information

Do not complete any activity that causes pain. Your tendon is not 100% strong until 12 weeks after repair.

Contact the plastics clinic or therapy department immediately if:

  • You are suddenly unable to straighten your fingers.
  • You still have an open wound and are concerned that you have a wound infection. Signs of infection are:
    • increased redness around the wound
    • redness spreading down your forearm
    • throbbing, increased swelling
    • a fever
    • discharge from the wound that is foul smelling or coloured
  • Your hand or fingers become more swollen, reddened, or blistered.
  • Your splint becomes uncomfortable or is showing signs of rubbing or irritation such as redness.
Contact Details

Plastics clinic on: 01274 364397

Available: Monday to Friday 8.00am – 5.00pm

or

The Hand Therapy Team on: 01274 382874

Available: Monday to Thursday 8.00am – 6.00pm, Friday 8.00am – 3.30pm

Accessible Information

If you need this information in another format or language and are in the hospital, please ask a member of staff. If you are accessing this leaflet online or on your phone you can see our Google Translate automated guidance on the Digital Patient Information Hub home screen.

People with hearing and speech difficulties

You can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted.

Smoking

Bradford Teaching Hospitals NHS Foundation Trust is a smoke-free organisation. You are not permitted to smoke or in use e-cigarettes in any of the hospital buildings or grounds.

Published by
, , Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ.

Date of publication: Aug 2025
Review Date: Aug 2028
MID Ref: 25081302