Tendon healing does not mean that the tendon can function. For the tendon to function, the tendon needs to be able to glide without resistance in the body. The tendon healing process is inevitably accompanied by tendon adhesions, which prevent the tendon from gliding. Functional exercises are designed to loosen and break these scarred adhesions through hand movements, restoring the tendon’s gliding properties and transmitting muscle contraction. Functional exercises need to be started at the right time, and after they are started, they should be done in a gradual manner as prescribed by the doctor. If functional exercises are started too early or done too aggressively, the tendon rupture point will not be healed yet and the chance of tendon rupture will become greater. If you start too late or are too conservative, the tendon adhesion scar bands become hard and large and cannot be pulled loose. The best way to do functional exercises is to have a medical professional provide one-on-one instruction and treatment to the patient, along with some complementary therapies. It is the physical rehabilitation department that undertakes this work within the hospital. However, very few patients actually receive treatment in the physical rehabilitation department throughout the entire process. The main reason for this is that patients do not pay enough attention to functional exercises after tendon injuries. The rehabilitation of this type of injury is a long-term process, usually taking about 2 months, and most patients are unable to guarantee the time. Methods of functional exercises: 1. Start functional exercises from the day the cast is removed. First, active flexion and extension activities should be performed for two weeks. The so-called active flexion and extension activity is to use the affected limb’s own strength to do flexion and extension activities. The force will be light to heavy, and the maximum force will be used at the end of two weeks. The purpose of active flexion and extension activities is to strengthen the forearm muscles, move the stiff joints, and loosen the adhesions formed when the tendon rupture point heals through the activities. Active activities cannot be performed with other forces. It is also important to protect your fingers from injury when you are not active, so as not to scrape your fingers on other objects. 2.At the beginning of the activity, the fingers will not move, as if the fingers do not listen to the instructions, but persist, you will find daily progress. Do flexion and extension activities, each to a direction of force, to feel pain, and persist in this state for more than half a minute, can be repeated to do, every day in multiple groups, at least four times a day morning, noon, night and before bed, each time more than an hour. Focus on quality not quantity! Before the event, such as soaking the injured hand with hot water for fifteen minutes, the effect will be better. Pay attention to prevent burns. The limbs should become swollen after the activity, which is normal. 3, the daily practice, first of all, to consolidate the previous day’s results, followed by a further. Specifically described as, first to adapt to the pain overcome the previous day, and then challenge the new pain. Only in this way can we get good results. Too conservative and you may be delayed; too aggressive and you may pull the tendons out. In reality, it is very difficult to accidentally rupture a tendon when you follow the normal method. The two-week period of active functional exercises is boring, painful and energy consuming, and it is not easy to do well. 4. In milder cases, after two weeks of active flexion and extension exercises, more than 50% functional recovery can generally be obtained. However, for heavier cases, passive functional exercises are also needed. The so-called passive functional exercise is to use external force to passively flex or straighten the joint to loosen or break the adhesion band of the proximal tendon. For example, using the other hand or another person’s hand, or a traction support. Injuries to the flexor tendon (for example, in the wrist), by passively straightening the finger joint, the tendon is pulled toward the fingertip, while pulling in the opposite direction can only rely on continued, stronger active activity; injuries to the dorsal tendon, by passively flexing the joint, the tendon is pulled toward the fingertip, and pulling in the opposite direction also relies on active activity. 5.Passive functional exercises usually start from the seventh week. Cases that require passive activity are heavier, involve multiple fingers, and are operated finger by finger. Although the tendon should normally be fully healed by six weeks, it is still strictly forbidden to flex or straighten the fingers at once with violent force. Each force should be applied at a resistance for half a minute, at which point the patient should and must feel pain, otherwise the force may not be sufficient. The force used is progressive each day. A breakthrough sensation may be felt at one time, and as long as the finger can still move actively in the other direction, it means that the tendon is not broken, but the adhesive band is completely pulled. 6. Doing passive activities for the patient is a tiring task and the patient may also feel pain due to the pain, but can only persist. Passive activities cannot replace active activities. All functional exercises, for patients with unilateral injury, should be done for three months. Soaking the hand in hot water before activity is more effective. It is normal for the swelling of the injured hand to increase after activity. Traction brace can reduce the amount of labor for passive activities. But need to emphasize again, focus on quality not quantity, no pain and strain of the activity is not effective! 7, if accompanied by bone and joint and other tissue damage, although in the method is roughly the same, but the specific point of time and precautions, but also according to the specific situation. In lighter cases, through functional exercises, satisfactory results can be obtained and the treatment ends there; while in heavier cases, the later surgical treatment – tendon release – is inevitable. The timing of tendon release is usually about six months after the first surgery.