EXTENSOR TENDON REPAIR:  ZONES 4 -7
Therapy guide

· OPA at 10 days post op
· POP wrist and MCPJ extended
· Physio begins at 1st clinic appt
· Volar splint, forearm based with IPJ’s free (if there is an extensor lag then splint should include the IPJ’s) MCPJ slightly flexed and wrist in extended position

Exercises:   0 –3 weeks
· Flexion/extension of IPJ’s over end of splint.  X10
· With splint off, MPJ flexion with IPJ’s extended.  X10
· Scar massage – once wound healed.  5 minutes every hour
· Advise not to use hand for anything else other than the exercises shown.
· Keep an eye on the splint.  Make sure fit is OK, adjust as necessary.

Exercises:   3 - 5 weeks
· Commence ‘place and hold’ exercises.  X5
· Make ½ fist. Repeat x10
· Advise patient not to rush rehab.  Reiterate tendon healing times, especially as the hand will be feeling a lot better now.

Exercises:   5 - 6 weeks

· Continue all other exercises
· Aim for full fist by 6 weeks – this is a gradual process
· Start some strengthening work – again graded
· Fist – hook fist.  X20
· Flat fist – shelf position

Exercises:   6 - 7 weeks

· Wean off splint.  To wear at night and ‘at risk’ times for next 10 days
· Full fist with overpressure. Sustained holds
· Can start light activities
· Not to lift anything heavier than a kettle

Exercises:   7 weeks +

8 weeks:   Can consider driving (if has a good grip) but remember it is their responsibility to safely do so.

10 weeks:  Can return to heavy work   

12 weeks:   Can return to full contact sport