Tendons connect muscle to bone and transmit the force that moves the fingers, thumb and wrist. A tendon can be cut by glass or another sharp object, pulled apart in an injury, or damaged gradually by inflammation or wear.
A hand can sometimes still move after a tendon injury because neighbouring structures compensate. That is why a wound with new loss of bending or straightening should be assessed rather than judged by appearance alone.
Flexor and extensor injuries
Flexor tendons run along the palm side and bend the fingers and thumb. Extensor tendons run along the back of the hand and straighten them. Each has different zones, blood supply and repair considerations.
Symptoms
- Inability to bend or straighten a finger or thumb normally
- A finger resting differently from its neighbours
- Pain or a gap along the tendon after an injury
- A cut on the palm or back of the hand with changed motion
- Swelling, catching or weakness with an overuse-related tendon problem
Why timing and examination matter
The hand is examined with each joint tested separately. The position of the fingers at the moment of injury, the wound location and the ability to isolate movement help identify which structures are involved. Nerve, vessel and bone injuries may occur at the same time.
A divided tendon may retract or develop scar tissue. Early assessment helps clarify whether direct repair is possible or whether grafting, transfer or staged reconstruction would be needed later.
Treatment and rehabilitation
Some tendon problems improve with activity changes, splinting, therapy or treatment of inflammation. A divided tendon that will not heal by itself may need repair. After repair, the therapy protocol protects the tendon while gradually restoring glide and strength.
Adherence to the therapy plan is part of the treatment. Both too much force too early and too little movement can create problems.
Sources and further reading
Frequently asked questions
Can a tendon injury heal without surgery?
Some partial injuries and inflammatory tendon problems can be treated without surgery. A completely divided tendon often needs repair or reconstruction because the ends cannot reliably reconnect on their own.
Should I move a finger after a tendon injury?
Do not create your own exercise plan after a suspected tendon injury. Protect the hand and get instructions because the safe amount of motion depends on the structure and injury.