Rehabilitation following tendon repairs

Strickland “Indianapolis” method –

Uses two splints – One for rest. One for active exercise.

Splint for rest –

• Dorsal blocking splint – wrist in 20-30° flexion, MCPJ – 50° flexion, IPJ – neutral

Splint for exercise –

• Tenodesis splint – has a hinge @ wrist joint allowing extension of wrist. Extension of wrist causes passive flexion of fingers.

0-4 weeks –

• Exercise –
• Extend the wrist leading to passive composite fist à hold for 5 seconds
• Do this 25 times per hour while awake.

4-5 weeks –

• Active digital flexion and extension with dorsal blocking splint.
• Tenodesis splint is discontinued.

5-6 weeks –

• Active composite fist f/b active extension of wrist and digits.
• Active IP flexion with MCPJ extension f/b full digital extension

6-7 weeks –

• Blocking exercises if active tip to distal palmar crease is >3cm

8-14 weeks –

• Progressive resistive exercise.

14 weeks –

• • Unrestricted use of hand.

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