What is post-release tendon gliding and why is it important after surgery?

Post-release tendon gliding refers to specific therapeutic exercises performed after tendon release surgery (such as for trigger finger or after tendon repair). These exercises help prevent scar tissue from restricting tendon movement, reduce stiffness, and promote smooth, pain-free motion, contributing to better recovery and functional outcomes.

When should I begin the 6-week tendon gliding progression plan?

Typically, your surgeon or hand therapist will advise when to start the progression plan, which is often within a few days post-surgery once the initial swelling decreases and your incision is stable. Always follow your healthcare provider’s specific instructions before starting any new exercises.

What are the phases of the 6-week tendon gliding progression plan?

The plan generally consists of three main phases:

Are there any signs that I should stop tendon gliding exercises and contact my doctor?

Yes, stop exercises and contact your healthcare provider if you experience increased pain, swelling, redness, warmth, pus at the incision site, sudden loss of movement, or numbness. These signs may indicate infection or complications requiring prompt attention.

Can I perform tendon gliding exercises at home, and how often should I do them?

Most tendon gliding exercises can safely be done at home after your hand therapist teaches you the proper technique. Typically, they are performed 3–5 times a day, with 5–10 repetitions per session. However, exact frequency and progression should always be tailored by your therapist to your specific surgery and healing status.

Post-Release Tendon Gliding: The 6-Week Progression Plan

person Olivia Williams

Post-Release Tendon Gliding: The 6-Week Progression Plan

Introduction

A. Definition of Tendon Release Surgery

Tendon release surgery is a procedure aimed at restoring movement and function in fingers or hands when tendons have become fixed or restricted. This surgery typically addresses conditions such as contractures or adhesions that limit mobility.

B. Importance of Postoperative Recovery

Successful surgical outcomes heavily depend on the quality of postoperative recovery. Structured rehabilitation is crucial to regain motion, prevent complications, and ensure optimal hand function.

C. Overview of Tendon Gliding

Tendon gliding refers to specialized exercises that promote smooth movement of tendons through the surrounding sheath after surgery. These exercises are vital to prevent scar tissue and maintain flexibility.

D. Purpose and Scope of the 6-Week Progression Plan

This 6-week progression plan guides patients through safe, stepwise recovery, focusing on effective tendon gliding exercises designed to optimize surgical outcomes and minimize risks.

Understanding Tendon Gliding

A. What is Tendon Gliding?

Tendon gliding involves carefully controlled movements that allow tendons to slide within their sheaths and across joints. These movements prevent the formation of adhesions and maintain joint mobility.

B. Why is it Essential Post-Surgery?

After tendon release surgery, gliding exercises are crucial to prevent restrictive scarring and stiffness. They help preserve the natural, intuitive function of the hand.

C. Risks of Adhesion and Stiffness

Without proper tendon gliding, scar tissue can bind tendons, limiting movement and resulting in long-term disability or loss of hand function.

D. Goals of Gliding Exercises

Promoting mobility and flexibility
Reducing pain and inflammation
Preventing adhesions
Restoring functional hand movement

General Principles of the 6-Week Progression Plan

A. Collaboration with Healthcare Providers

It’s essential to work closely with your surgeon and hand therapist, ensuring all exercises and progressions are tailored to your unique needs and surgical outcomes.

B. Gradual Progression and Individualization

Every patient heals differently. The plan should be adjusted based on healing, swelling, strength, and comfort, without rushing or skipping steps.

C. Importance of Pain Monitoring

Pain is an important indicator. Gentle discomfort is expected, but sharp or increasing pain may signal a problem. Immediate communication with your care team is necessary if pain escalates.

D. Necessary Precautions

Adhere strictly to splint use and motion restrictions in early weeks. Avoid forceful or repetitive movements that compromise healing.

Week 1: Protection and Passive Motion

A. Goals: Minimize Inflammation, Prevent Adhesion

The primary focus is reducing swelling and keeping tendons moving gently to avoid the formation of adhesions.

B. Splint Use and Immobilization

Consistent use of prescribed splints is essential. Protection from accidental strain or bending of the healed area is critical.

C. Passive Range-of-Motion (PROM) Techniques

Assisted finger bends and extensions without active muscle effort
Support from a therapist, family member, or your unaffected hand

D. Frequency and Repetition Guidelines

Perform PROM exercises 3-5 times per day
Each session: 10-15 gentle repetitions per movement

Week 2: Gentle Active Assisted Motion

A. Introduction of Assisted Tendon Gliding

Begin to actively participate in tendon gliding with support, gradually engaging your muscles while still protecting the tendon repair.

B. Maintaining Edema Control

Continue elevation, gentle movement, compression, and cold therapy as directed by your therapist to manage swelling.

C. Sample Exercises and Tips

Tabletop, hook, straight fist, and full fist gliding with assisted movement
Move within the pain-free range and avoid resistance

D. Monitoring for Early Complications

Watch for increasing pain, redness, or swelling
Report abnormal findings to your care provider immediately

Week 3: Progressing to Active Motion

A. Transition to Active Range-of-Motion (AROM)

Shift to active movement by using your own muscles, increasing tendon independence and glide across the healing site.

B. Encouraging Full, Safe Movement

Perform all possible gliding exercises within the prescribed motion arc, not exceeding pain or resistance encountered.

C. Maintaining Surgical Protection

Continue splinting as recommended. Avoid forceful gripping, lifting, or stretching that may jeopardize healing.

D. Identification of Progress Markers

Improved joint flexibility
Reduced stiffness or swelling
Ability to move fingers independently

Week 4: Increasing Range and Initiating Strength

A. Focus on Flexibility and Complete Gliding

Emphasize moving through the largest safe range of motion, aiming for full tendon excursion without significant discomfort.

B. Introduction of Light Strengthening

Begin gentle resistance exercises using putty, spring devices, or soft balls as instructed by your therapist
Continue all previous gliding drills

C. Adjusting Splint Use

You may be allowed to reduce reliance on the splint during certain activities, but always according to your provider’s guidance.

D. Importance of Adherence and Consistency

Regular participation in exercises and therapy sessions is key to steady progress and optimal results.

Week 5: Functional Integration

A. Emphasis on Functional Movement Patterns

Reintegrate real-world tasks and movements, using patterns that mimic daily activities such as holding objects, typing, or buttoning clothing.

B. Simulated Daily Activities

Picking up small items
Pinching or grasping light objects
Practicing coordinated movements

C. Intermediate Resistance Training

Gradually increase resistance as tolerated, building endurance and functional strength without causing pain or swelling.

D. Monitoring Swelling or Discomfort

Pause and notify your therapist if you notice new or worsening pain, swelling, or loss of motion during activities.

Week 6: Advanced Mobility and Return to Normal Activity

A. Near-Normal Range-of-Motion Goals

Aim to regain near-complete motion in affected fingers or hand, preparing for unrestricted, everyday usage.

B. Building Functional and Occupational Strength

Engage in exercises specific to your occupation or preferred activities
Gradually increase resistance and complexity

C. Preparation for Full Activity Resumption

With your therapist’s approval, start returning to work, sports, and hobbies while continuing home-based exercises.

D. Final Precautions and Transition to Maintenance

Monitor for relapse or delayed complications, maintaining good exercise habits to support long-term outcomes.

Tips for Maximizing Tendon Gliding Success

A. Following Therapist Instructions

Carefully adhere to all instructions given by your surgeon and hand therapist for the safest and best recovery.

B. Avoiding Overuse

Do not exceed recommended exercise frequency or intensity. Overdoing it may jeopardize your repair.

C. Importance of Patience and Persistence

Recovery can be slow. Stay motivated and patient, knowing that steady effort leads to the best results.

D. Addressing Setbacks Promptly

If you notice a decline in movement, increased pain, or other issues, notify your therapist promptly for early intervention.

Red Flags and When to Seek Help

A. Signs of Infection

Fever, increasing redness, heat, or pus from the surgical site require urgent medical attention.

B. Unusual Pain or Swelling

Persistent or escalating pain and swelling are not normal—contact your provider if these occur.

C. Stiffness or Loss of Motion

Difficulty moving fingers, sudden loss of range, or unusual joint locking should be evaluated immediately.

D. Communication with Providers

Stay in regular contact with your surgeon and therapist, especially if you experience setbacks or have concerns during recovery.

Common Mistakes and How to Avoid Them

A. Skipping or Rushing Steps

Moving too quickly or ignoring parts of the plan can hinder healing and risk permanent limitations.

B. Improper Technique

Be sure your motions follow correct form; ask your therapist for clarifications as needed.

C. Non-adherence to Splinting Regimens

Removing or misusing your splint outside advised times can threaten the success of your procedure.

D. Neglecting Other Aspects of Recovery

Nutrition, rest, medication adherence, and general self-care all support tendon healing and overall recovery.

Role of the Rehabilitation Team

A. Surgeons

Your surgeon’s recommendations are critical for safe progression and complication management.

B. Hand Therapists

Specialized therapists provide individualized exercise plans, hands-on care, and real-time feedback.

C. Patient and Family Involvement

Your active participation and supportive family involvement are vital for daily exercises and motivation.

D. Follow-up and Progress Assessment

Regular follow-up appointments ensure the plan stays aligned with healing and provides targeted adjustments as needed.

Frequently Asked Questions

A. Expected Recovery Timelines

Most patients achieve noticeable improvement by week 6, but full recovery may continue for several months based on individual factors.

B. Pain Management Strategies

Use prescribed medications, ice, elevation, and relaxation as advised. Persistent pain should be reported.

C. Returning to Work or Sports

Return timing varies. Light, non-strenuous work can resume as soon as safety permits, while sports may require full motion and strength clearance.

D. Long-Term Prognosis

The majority regain good function with adherence to the plan; ongoing exercises may be recommended even after the formal plan ends.

Conclusion

A. Recap of 6-Week Progression Plan

Structured, progressive tendon gliding is crucial for maximizing recovery after tendon release surgery. Each week focuses on safety and steadily improving motion and strength.

B. Encouragement and Motivation for Patients

Stay committed and patient. Your effort and diligence will make a significant difference in your hand function and quality of life.

C. Highlighting the Value of Guided Rehabilitation

Partnering with your healthcare team ensures optimal, customized recovery and reduces long-term complications.

D. Additional Resources/References for Further Reading

Consult your therapist for recommended hand exercise guides, or visit national hand therapy association websites for more in-depth resources.

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