Flexor Tendon Repair Recovery
Flexor Tendon Repair (Zone-dependent)
What the operation does
The tendons that bend your fingers run up the palm side of the hand inside narrow tunnels called sheaths. When one is cut, the ends retract and cannot be reached by the finger's own muscles. The operation finds both ends, brings them back together and stitches them with fine, strong suture, so the tendon can heal at the right length and glide inside its sheath again.
The impossible-sounding rule
A repaired flexor tendon must MOVE or it glues itself to the sheath around it, and must not be USED or it pulls apart. Everything in this recovery is a way of doing both at once. That is why the phases are named for exactly what you are allowed to do, and why the instructions are so specific — the difference between the right movement and the wrong one is very small and very consequential.
Why the other hand does the bending
For the first weeks, the finger is bent by your other hand and never by its own muscles. Passive bending glides the tendon inside its sheath while putting almost no load on the stitches; actively making a fist puts many times more force through the repair than it can take. Later, place-and-hold adds the smallest possible active contraction — just enough to keep the finger where the other hand put it.
The splint
A splint holding the wrist and knuckles in a particular position is worn continuously for around four to six weeks, including at night. Its shape is not arbitrary — it stops the tendon being stretched to its full length, which is where the repair is most vulnerable. Taking it off to use the hand, even briefly, is the commonest cause of rupture.
When rupture is most likely
Between about the third and sixth week — precisely when the finger is comfortable, the swelling has settled, and it feels ready to be used. The repair is at its weakest around then while feeling at its best. Most ruptures happen during an ordinary unthinking action: catching something, pulling a door, or using the hand out of the splint for a second.
Adhesions, and why they matter as much as rupture
The other way this goes wrong. A tendon that heals but sticks to its sheath cannot slide, so the finger stays stiff even though the repair is intact — a fully healed tendon in a finger that does not bend. That is what all the early movement is preventing, and it is why doing the exercises exactly and often matters more here than almost anywhere else on this site.
Zone two, if it was mentioned
The stretch of tendon between the base of the finger and the middle joint, where two tendons share one tight sheath. Repairs here are the most difficult in hand surgery and were once considered unrepairable — it was called no man's land. Results have improved greatly, and it remains the zone where stiffness is most likely and the protocol is followed most strictly.
Working with a hand therapist
Almost everyone having this repair is referred to a specialist hand therapist, and that relationship matters more than for any other operation in this block. They will set your exact repetitions, adjust the splint, and progress you based on how the finger is behaving. Where their instructions differ from anything general, follow theirs.
What movement to expect
Honest framing. Many people regain good, functional movement. Getting back exactly the range of the other hand is less common, particularly after a zone two repair, and losing some of the last part of the bend or the last part of the straightening is frequent. Judged against a finger that could not bend at all, the result is usually worthwhile.
If the finger stays stiff
Where movement plateaus despite good therapy, an operation to free the tendon from scar — a tenolysis — is sometimes considered, usually not before six months and only when the finger is otherwise supple. It is a recognised second step rather than a sign of failure.
The wound and the injury
Most of these follow a cut, often from glass or a blade, and the wound may have been contaminated. Nerves and blood vessels run alongside the tendons and are frequently repaired at the same time. If a nerve was repaired, sensation returns over many months and separately from the movement.
Swelling and elevation
Keeping the hand above heart level in the first weeks reduces the swelling that stiffens fingers and makes the exercises harder. It is easier to do while the hand is out of action anyway, and it pays back through the whole recovery.
Driving and work
Driving generally waits until you are out of the splint and can grip the wheel securely — commonly around eight weeks, and your insurer expects full control rather than managing. Desk-based work is sometimes possible earlier one-handed. Manual work involving gripping commonly waits three to four months, and heavy work longer.
How the first year usually unfolds
Four weeks splinted with passive movement only. Four to six weeks adds place-and-hold. Six to eight weeks brings active bending — a large step, and the point at which many people first believe the finger will work. Two to four months brings grip strengthening. Four to twelve months brings full use, and movement continues improving through much of it.
Staying in touch with your care team
Which tendon, which zone, and what else was repaired all change this recovery substantially. Your surgeon and hand therapist know those details. If something about your recovery is worrying you or does not match what is described here — particularly a sudden loss of the ability to bend the finger, which can mean the repair has given way — contact your care team straight away rather than waiting.
Exercises for Flexor Tendon Repair
An illustrated, phase-by-phase exercise program for this procedure. View the Flexor Tendon Repair exercise program.
Recovery education · Condition guides · Exercise programs
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This guide is general education and doesn't replace evaluation by a licensed provider. Recovery and treatment vary by person — follow the guidance of your own surgeon or care team.