Tendon Release Surgery Rehabilitation.
What is tendon release surgery?
Tendon release surgery is a broad term covering several procedures that address tendons that have become restricted, contracted or trapped, preventing normal joint movement. The specific procedure depends on the underlying condition, but all share the common goal of restoring free tendon movement and improving joint function. Common indications for tendon release include:
Why is physiotherapy essential after tendon release?
The surgery addresses the structural restriction — but the surrounding tissues, joints and muscles have often been in a compromised state for some time before surgery, and the post-operative period creates its own challenges. Scar tissue formation is the primary risk after any tendon release — the same healing process that can restore function can also create new adhesions that limit tendon gliding if not managed actively with early movement.
Scar tissue management is a critical component of physiotherapy after tendon release — physiotherapy techniques reduce adhesions that can limit movement. For most tendon release procedures, early movement is not just permitted but essential — the window for preventing re-adhesion is relatively short, and patients who are too cautious in the early weeks often find their range of motion gains from surgery are partially lost to scar tissue.
What does rehabilitation involve?
The specific rehabilitation approach varies considerably by procedure — trigger finger release has a much shorter and simpler rehabilitation pathway than Dupuytren's contracture surgery, and tenolysis after complex tendon injury repair requires the most intensive rehabilitation of all.
Passive range-of-motion exercises are often initiated within a few days post-surgery to prevent stiffness, with active movements typically introduced after one to two weeks under physiotherapy supervision.
For trigger finger release, the focus is on restoring full active and passive finger motion — both flexion and extension — and desensitising the surgical scar. Most patients achieve full function within four to eight weeks with consistent home exercise compliance.
For Dupuytren's contracture release, the focus is on maintaining the extension achieved by surgery through consistent splinting and stretching. A night extension splint is typically worn for several months to maintain the corrected position while the tissues remodel. Flexion exercises are also important — the hand needs to retain full grip function alongside the newly gained extension.
For tenolysis, the rehabilitation is the most demanding — the benefits of surgery depend almost entirely on how aggressively tendon gliding is pursued in the early post-operative period before new adhesions can form. Intensive hand therapy with specific tendon gliding exercises multiple times daily is the cornerstone of tenolysis rehabilitation.
For all procedures, scar management using silicone gel, pressure and massage is introduced once the wound has adequately closed — typically two to three weeks post-operatively — and continues for several months to optimise scar maturation and minimise its impact on tendon gliding.
Functional strengthening to prepare for daily activities and fine motor skill tasks complete the rehabilitation program before return to demanding hand use.
Recovery timeline
Recovery times depend on the severity of the condition and the tendon involved. Generally: the first two weeks focus on pain and swelling management with gentle motion exercises; weeks two to six introduce gradual strengthening and functional exercises; six to twelve weeks allow full return to daily activities; and three to six months covers complete recovery for complex cases or large tendons.
For patients whose tendon condition developed in a workplace context — trigger finger from repetitive gripping, or contracture from occupational injury — WorkCover funded physiotherapy and capacity assessment may be available.
Our physiotherapists Bethany Kippen, Eliane Machado and Mauricio Bara both have experience in hand and upper limb rehabilitation and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Tendon release surgery is a broad term covering several procedures that address tendons that have become restricted, contracted or trapped, preventing normal joint movement. The specific procedure depends on the underlying condition, but all share the common goal of restoring free tendon movement and improving joint function. Common indications for tendon release include:
- Trigger finger (stenosing tenosynovitis) — where the flexor tendon of a finger becomes caught in a narrowed pulley at the base of the finger, causing the finger to lock or click when bent. Surgical release involves cutting the constricted pulley to allow free tendon movement. It is one of the most common hand surgery procedures and has an excellent prognosis with appropriate rehabilitation.
- Dupuytren's contracture release — where thickened fibrous tissue in the palm draws the fingers into a permanent flexed position. Release can be performed by cutting the contracted cord (fasciotomy), removing it (fasciectomy), or by needle aponeurotomy. The rehabilitation focus after Dupuytren's release is on maintaining the extension gained by surgery against the strong tendency for the hand to revert toward flexion.
- Tendon contracture release — where a tendon has shortened following injury, immobilisation or neurological condition, preventing full range of joint motion. Release procedures sever or lengthen the contracted tendon to restore passive range of motion. Real time ultrasound can assist in retraining tendon and muscle activation following these procedures.
- Tenolysis — release of scar tissue adhesions that have formed around a tendon following previous injury or surgery, preventing the tendon from gliding freely. Tenolysis is often performed after previous tendon repair where adhesion formation has limited functional recovery.
Why is physiotherapy essential after tendon release?
The surgery addresses the structural restriction — but the surrounding tissues, joints and muscles have often been in a compromised state for some time before surgery, and the post-operative period creates its own challenges. Scar tissue formation is the primary risk after any tendon release — the same healing process that can restore function can also create new adhesions that limit tendon gliding if not managed actively with early movement.
Scar tissue management is a critical component of physiotherapy after tendon release — physiotherapy techniques reduce adhesions that can limit movement. For most tendon release procedures, early movement is not just permitted but essential — the window for preventing re-adhesion is relatively short, and patients who are too cautious in the early weeks often find their range of motion gains from surgery are partially lost to scar tissue.
What does rehabilitation involve?
The specific rehabilitation approach varies considerably by procedure — trigger finger release has a much shorter and simpler rehabilitation pathway than Dupuytren's contracture surgery, and tenolysis after complex tendon injury repair requires the most intensive rehabilitation of all.
Passive range-of-motion exercises are often initiated within a few days post-surgery to prevent stiffness, with active movements typically introduced after one to two weeks under physiotherapy supervision.
For trigger finger release, the focus is on restoring full active and passive finger motion — both flexion and extension — and desensitising the surgical scar. Most patients achieve full function within four to eight weeks with consistent home exercise compliance.
For Dupuytren's contracture release, the focus is on maintaining the extension achieved by surgery through consistent splinting and stretching. A night extension splint is typically worn for several months to maintain the corrected position while the tissues remodel. Flexion exercises are also important — the hand needs to retain full grip function alongside the newly gained extension.
For tenolysis, the rehabilitation is the most demanding — the benefits of surgery depend almost entirely on how aggressively tendon gliding is pursued in the early post-operative period before new adhesions can form. Intensive hand therapy with specific tendon gliding exercises multiple times daily is the cornerstone of tenolysis rehabilitation.
For all procedures, scar management using silicone gel, pressure and massage is introduced once the wound has adequately closed — typically two to three weeks post-operatively — and continues for several months to optimise scar maturation and minimise its impact on tendon gliding.
Functional strengthening to prepare for daily activities and fine motor skill tasks complete the rehabilitation program before return to demanding hand use.
Recovery timeline
Recovery times depend on the severity of the condition and the tendon involved. Generally: the first two weeks focus on pain and swelling management with gentle motion exercises; weeks two to six introduce gradual strengthening and functional exercises; six to twelve weeks allow full return to daily activities; and three to six months covers complete recovery for complex cases or large tendons.
For patients whose tendon condition developed in a workplace context — trigger finger from repetitive gripping, or contracture from occupational injury — WorkCover funded physiotherapy and capacity assessment may be available.
Our physiotherapists Bethany Kippen, Eliane Machado and Mauricio Bara both have experience in hand and upper limb rehabilitation and are members of the Australian Physiotherapy Association.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
