Early Motion After Primary Flexor Tendon Repair: When to Begin, and Passive Place-and-Hold or True Active Mobilisation

Physical therapists and physical therapist assistants who treat patients after primary flexor tendon repair, along with hand therapists and clinicians in outpatient orthopaedic and post-surgical settings who want a plain-language account of what the current evidence reports about the timing and type of early motion.

Physical therapists and physical therapist assistants; hand therapists and other licensed rehabilitation clinicians involved in post-surgical upper extremity care. Physical therapist assistants participate under the direction and supervision of a physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Wu X, Zhu X, Zhu C, Shi C, Xu Y. The impact of different early rehabilitation initiation times on functional recovery after flexor tendon repair. Medicine (Baltimore). 2026;105(28):e49465. doi:10.1097/MD.0000000000049465

Dahlgren A, Chevalley S, Strömberg J, Björkman A. Item-level reanalysis of DASH outcomes after flexor tendon repair using Svensson’s non-parametric method. BMC Musculoskelet Disord. 2026;27(1). doi:10.1186/s12891-026-09626-y

After completing this course, you will be able to:

1. Describe how the single-centre retrospective cohort reported finger motion, tendon adhesion, pain, stiffness and rerupture across its three rehabilitation initiation windows after primary flexor tendon repair.
2. State what the randomized trial's item-level DASH reanalysis reported when passive mobilisation with place-and-hold was compared with true active mobilisation through twelve months, including which patient-reported problems persisted.
3. Distinguish what a retrospective cohort and a randomized controlled trial can each support about when a repaired flexor tendon is first moved and how it is moved.

1. Start Here: Course Overview, Objectives and How to Earn Credit
2. Part One: Timing of the First Rehabilitation Session After Primary Flexor Tendon Repair
3. Who Was Studied and How the Three Initiation Windows Were Defined
4. The Standardized Protocol, the Outcomes Tracked and How the Records Were Reviewed
5. Motion, Adhesion, Pain, Stiffness and Rerupture Across the Three Windows
6. Limits of a Retrospective Cohort and What the Authors Concluded
7. Part Two: Passive Place-and-Hold Versus True Active Mobilisation on the DASH
8. Who Entered the Trial and How Patients Were Allocated
9. The Two Mobilisation Protocols and the Item-Level Look at the DASH
10. Stiffness, Weakness and Social Items Through Twelve Months After Repair
11. Between-Group Findings, Study Limits and the Authors' Conclusions
12. Bringing It Together
13. Where the Two Papers Agree About Moving a Repaired Tendon Early
14. Where They Diverge: A Timing Advantage Versus No Advantage for Either Protocol
15. Weighing a Retrospective Cohort Against a Randomized Trial at the Treatment Table
16. What Remains Open About Timing, Protocol Choice and Long-Term Recovery
17. Key Takeaways: The Answers Before You Take the Quiz
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Wu X, Zhu X, Zhu C, Shi C, Xu Y. The impact of different early rehabilitation initiation times on functional recovery after flexor tendon repair. Medicine (Baltimore). 2026;105(28):e49465. doi:10.1097/MD.0000000000049465
2. Dahlgren A, Chevalley S, Strömberg J, Björkman A. Item-level reanalysis of DASH outcomes after flexor tendon repair using Svensson's non-parametric method. BMC Musculoskelet Disord. 2026;27(1). doi:10.1186/s12891-026-09626-y