One of the most important concepts to understand when rehabilitating the hand and wrist is the concept of tendon gliding. Because of its importance, hand therapists use tendon gliding exercises for nearly all our clients after injury and surgery.
Tendons are the ropey structures that connect the muscles in the forearms to the bones in the hand and wrist. When your hand, wrist, fingers, and thumb move, tendons slide over the surface of the digits and hand to allow movement. When your fingers bend (or flex), the tendons in the palm side of your hand (flexors) slide down through the palm towards the elbow and wrist and when your fingers straighten these same tendons slide up.
The opposite happens on the back side of your hand and digits with the extensors. As you straighten your fingers, the extensor tendons slide down your hand and wrist towards your elbow and when you bend, they slide down towards the fingertips.
After injury or surgery, this normal tendon movement is often impaired either by adhesions (scar tissue), swelling or surgical fixation (plates, screws, k-wires). Often this restriction leads to pain, stiffness and lack of ability to move the hand. Restoring tendon motion is key to reducing pain and restoring normal movement.
Because tendon gliding is normal and puts little stress on the tissues, they are often the first simple and pain-free exercises hand therapists use with their clients.
Try out some pain-free tendon gliding exercises and let us know if you find them helpful!