Clients who sustain a flexor tendon injury can typically engage in light functional tasks at approximately 5-6 weeks post-operatively. Prior to this time the client will be in a forearm based dorsal blocking orthotic and engaging in protective passive and gentle AROM per protocol and surgeon preference. Any type of resistive or strengthening exercise should be avoided until at least 8 weeks post-operatively (not all therapists will complete strengthening exercises with clients who have sustained flexor tendon injuries). Full tendon healing is typically 12 weeks post surgical intervention.
Modified Duran is a common flexor tendon rehabilitation protocol*. It starts with passive range of motion and tenodesis exercises at the wrist to facilitate tendon excursion to decrease the potential of scarring. AROM is typically initiated around 5 weeks post-op and blocking typically around 6 weeks post-op as appropriate depending on tendon integrity.
Kleinert is another well-known protocol that involves rubber bands connected to the client's finger nails to keep the fingers in flexion and allows active finger extension by the client. Kleinert protocol is well-known, but is not frequently used by many therapists and surgeons today. While it's important to be familiar with this protocol, it is rarely used in clinical practice.
