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Related Experiment Video

Updated: Apr 8, 2026

Author Spotlight: Integrating Mechanical and Biological Analysis in Tendinopathy Research
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Author Spotlight: Integrating Mechanical and Biological Analysis in Tendinopathy Research

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In vivo flexor tendon forces generated during different rehabilitation exercises.

S Edsfeldt1, D Rempel1, K Kursa1

  • 1Department of Surgery, University of California at San Francisco, San Francisco CA, USA.

The Journal of Hand Surgery, European Volume
|June 28, 2015
PubMed
Summary
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Flexor tendon repairs.

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European journal of applied physiology·2002

Rehabilitation after flexor tendon repair should avoid isolated finger flexion, which generates high forces on the flexor digitorum profundus and flexor digitorum superficialis tendons. Gentle maneuvers like place and hold minimize stress on repaired tendons.

Area of Science:

  • Orthopedic Surgery
  • Rehabilitation Medicine
  • Biomechanics

Background:

  • Flexor tendon repair requires careful rehabilitation to ensure healing and prevent re-injury.
  • Understanding the in vivo forces generated during different rehabilitation exercises is crucial for optimizing patient recovery.

Purpose of the Study:

  • To measure the in vivo forces in the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons during common post-operative rehabilitation maneuvers.
  • To compare these measured forces with the reported strength of flexor tendon repairs to guide safe rehabilitation protocols.

Main Methods:

  • Buckle force transducers were placed on the FDP and FDS tendons of the index finger in 12 patients undergoing open carpal tunnel release.
  • In vivo forces were measured during various rehabilitation maneuvers, including isolated FDP/FDS flexion, active finger flexion, and place and hold exercises, with varying wrist positions.
Keywords:
Flexor tendonforcein vivorehabilitationrepair

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Main Results:

  • Isolated FDP flexion (24 N) and isolated FDS flexion (13 N) generated significantly higher forces than other maneuvers.
  • Wrist flexion to 30° increased FDS forces (6 N vs. 5 N in neutral).
  • Active finger flexion (6 N) generated higher FDP forces than place and hold (3 N). Place and hold, active flexion with a neutral wrist, and tenodesis produced the lowest forces.

Conclusions:

  • Rehabilitation maneuvers involving isolated flexion of the FDP or FDS tendons generate forces that may exceed the repair strength.
  • Gentler exercises, such as place and hold or active flexion with a neutral wrist, are recommended to minimize stress on repaired flexor tendons.