Hand Therapy following Extensor tendon repair Zones 4-7: ICAM regime (Immediate Controlled Active Motion)

Information for patients at 3 weeks post operation

Now that it is 3 weeks after your surgery, the tendon repair is beginning to gain strength, but is not yet strong enough for full, normal movement or use. This leaflet will explain how you can progress your exercises and functional use without risking damage to your tendon.

This advice and change in exercises should only be started once your hand therapist has confirmed you are moving well enough to progress.

Splint advice

From 3 weeks after surgery you may begin to use your hand in medium activities whilst wearing both splints.

You may remove the wrist splint, but must continue to wear the yoke finger splint during light activities only. Examples of activities are provided below.

Light Activities - wearing yoke finger splint only

• Using the phone
• Handling money
• Playing cards
• Zips / light clothes / shoe laces
• Writing, signing your name
• Light switch
• Using remote control
• Reading a newspaper
• Fastening / unfastening buttons

Medium Activities - wearing both wrist and yoke finger splint

• Combing hair / shaving
• Ring-pull on can
• Using a fork
• Putting on socks, tights
• Hanging up clothes,
• Wiping up
• Sweeping up
• Reading books
• Holding a glass
• Unscrewing jar lids / holding a cup / holding a pint glass

Heavy Activities - from week 10 as advised by your therapist

• Using a knife
• Ironing
• Hoovering
• Cooking, lifting a saucepan / kettle / using a tin opener
• Lifting boxes / carrying shopping
• Making a bed
• Hand washing clothes
• Gardening
• Sports: rugby, football, swimming, golf
• Cleaning a car
• Lifting children

Wrist exercises beginning from week 3

Only once the above exercise feels comfortable are you advised to begin the exercise below.

Please continue all previous finger exercises with the yoke splint on.

Scar care

It is important to continue with regular, firm scar massage as advised. If you are unsure of the technique or how often to complete it then please discuss this with your therapist.

My Chart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on My Chart.

Contacts / Further information

The Occupational therapy department is located in clinic 30 in the Addenbrooke’s Treatment Centre (ATC).

The Occupational therapy reception telephone number: 01223 216769

References / Sources of evidence

• Collocott SJ, Kelly E, Ellis RF(2018). Optimal early active mobilisation protocol after extensor tendon repairs in zones V and VI: A systematic review of literature. Hand Therapy; 23(1):3-18
• W. Howell, W.H. Merritt, S.J. Robinson(2005): Immediate controlled active motion following zone 4-7 extensor tendon repair. Journal of Hand Therapy. 18 (2):182-190
• Svens, E. Ames, K. Burford, et al (2015): Relative active motion programs following extensor tendon repair: a pilot study using a prospective cohort and evaluating outcomes following orthotic interventions. Journal of Hand Therapy. 1:11-19

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.