Hand therapy · Singapore
Mallet Finger Recovery Program
Written by Mavis Tham, Shamaine Soh and Yuna Zhuang, Principal Hand Occupational Therapists at Phoenix Rehab.Clinically reviewed by Nigel Chua, Principal Hand Occupational Therapist & Director, AHPC A1300362Z.Last reviewed 4 October 2026.
The tendon that straightens your fingertip is about as thick as a thread. If it heals long, the droop is permanent.
A mallet finger looks minor. A fingertip that will not straighten, often after a ball or a bedsheet caught it. What makes it different from other finger injuries is that the repair depends almost entirely on one thing, which is keeping the last joint straight without interruption while the tendon knits. Hand and wrist cases are managed by our hand therapy team.
No referral needed. Every first visit is one 45-minute Assessment & Treatment, $230, nett, no GST. Bring your operation note or scan report.
Where are you right now?
Four situations we see
- You were splinted today, or this week. The splint is the treatment. What you need is one that fits, a way to wash without letting the joint bend, and someone to check the skin.
- You are two or three weeks in and the splint keeps slipping. A loose splint is the same as no splint for the hours it is loose. This is fixable in one appointment.
- The splinting is finished and the tip still droops. Some lag is common at the end of splinting and some of it improves with graded work. How much, and how quickly, is measured rather than guessed.
- It happened weeks ago and you did nothing. A late mallet finger is still worth treating and splinting late still helps in many cases. What you want is an honest measurement of where the joint is now.
Crushed fingertip: is it a mallet finger?
A fingertip caught in a car door, a drawer or under a weight plate can be several injuries at once. Some need a doctor today. Only one of them is mallet finger.d
| What you see | Likely | Who first |
|---|---|---|
| Part of the fingertip is missing, or bone is showing | Fingertip amputation | Go to the emergency department now. Press firmly on the wound and raise the hand. Wrap the piece in gauze dampened with saline or clean water, seal it in a plastic bag, and put the bag in ice and water. The piece must not touch the ice. Call 995 if firm pressure does not stop the bleeding |
| A cut through the nail, or the nail lifted out of its fold | Nail bed injury | See a doctor the same day. The nail bed may need repair. In a child, a nail lifted out of its fold after a crush: go to the emergency department now, because the bone underneath may be broken through the skin |
| Throbbing, with dark blood under the nail | Blood under the nail (subungual hematoma) | See a doctor the same day if it is large or very painful |
| The tip droops and will not straighten on its own | Mallet finger | A doctor for an X-ray, then a splint and this program |
| Swollen and tender at the very end, with a normal-looking nail | Possible fracture of the end of the bone (tuft fracture) | A doctor for an X-ray; usually a short protective splint |
After the doctor, the hand therapy work is the same for most of them: swelling, the stiffness that creeps into the end two joints, and a tip that is too sensitive to tap on a phone screen. That sensitivity can last for months, and graded touch work is the usual treatment, which we teach.
Source: d. Lee DH, Mignemi ME, Crosby SN. Fingertip injuries: an update on management. J Am Acad Orthop Surg. 2013;21(12):756-766.
What does not come back
The droop that is left when the tendon heals long
The extensor tendon at the fingertip has no slack to spare. If the joint is allowed to bend during healing, the tendon knits at a slightly greater length, and the fingertip rests a few degrees lower than it should. That residual droop is called an extensor lag. Once the tendon has healed long, the lag does not train away, because the tendon is not short of strength. It is short of tension.
This is why the published protocols are strict about continuity rather than about duration. Mallet finger splinting is started as early as possible and run continuously, day and night, for around six to eight weeks, with further night splinting after that. Continuously means the joint is not allowed to bend at all during that period, including when you wash. The hand therapy job is to make that practical, because a protocol that cannot be lived with is not followed.
If you have a drooping fingertip and no splint on it, the useful next step is any clinician who can splint it, today if possible. That may be your GP, a hospital hand clinic or a hand therapist. Which one matters far less than the interval before the joint is held straight.
Usually expected, and what is not
Is this normal in the first weeks?
The honest answer for most of this list is yes, and the ones that are not are specific.
Usually expected
- The fingertip looks swollen and a little purple for the first couple of weeks.
- The skin under the splint is pale and wrinkled when it is changed.
- The joint feels stiff when the splint finally comes off. Stiffness at the end of splinting is expected and is worked on, not waited out.
- A small residual droop at the end of splinting that reduces over the following weeks.
Contact your surgeon or doctor
- Skin under the splint that is broken, weeping, or has a sore that is not just redness.
- The fingertip going white or numb when the splint is on. That is a fit problem and needs to be seen the same day.
- An open wound over the joint, or the injury happened with a cut rather than a jam.
- The whole finger becoming hot, red and swollen with throbbing pain.
If you have sudden severe pain with a hand or arm that is cold, white or losing sensation, or you are unwell with fever and a hot swollen wound, that is an emergency department today, not a therapy appointment.
If it is not going to plan
The splint is off and the tip still will not come up
This is the point where most people are told to give it time. Some of it is time. Some of it is that the last joint has stiffened in the weeks it spent held straight and the joint above it has taken over, and no amount of waiting sorts that out on its own.
What is measurable is the difference between how far the joint moves when you lift it and how far it moves when someone else lifts it. That gap tells you whether you are dealing with a tendon that healed long or a joint that has gone stiff, and the two are worked on differently.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what tissue does under graded work cannot be read in one visit. $690, nett, no GST.
The shape of it
What happens, week by week
A mallet finger program is mostly splint for six weeks and careful weaning after. The weeks below are the common shape for a tendon or small bony mallet treated in a splint. Your doctor’s or surgeon’s plan takes precedence.
- Weeks 0 to 6Stage 1 · Calm & ProtectThe splint holds the fingertip straight, day and night, without a single bend, including when you wash and change it. The middle joint keeps moving.
- Weeks 6 to 8Stage 2 · Move & MobilizeThe splint comes off for short periods in the day with gentle bending of the tip, and stays on at night. If the tip starts to droop, the splint goes back on full time.
- Weeks 8 to 10Stage 3 · Rebuild & StrengthenDay splinting stops. Pinch and grip go back into normal use, with a night splint if your therapist advises it.
- Weeks 10 to 12Stage 4 · Return & PerformFull use: keyboard, sport, ball handling. The droop is measured again after loading.
The weeks are typical ranges, not a promise. You move up a stage when you meet its criteria, and your surgeon’s protocol takes precedence over anything on this page.
The program
The four stages, and what moves you up
- Stage 1, Calm & Protect. The splint fitted properly, checked for skin tolerance, and a washing routine that keeps the joint straight. Swelling managed. Nothing is asked of the tendon at this stage and that is deliberate.
Move up when: six weeks of unbroken splinting are complete (often eight for a tendon injury), and on the check out of the splint the tip holds straight. - Stage 2, Move & Mobilize. Splinting reduced in the sequence your surgeon or the protocol sets, and controlled movement begun at the middle joint and then the tip. Criteria to move up are about how the joint holds its position after movement, not about comfort.
Move up when: the droop measured after a day of weaning is no worse than it was before weaning started. - Stage 3, Rebuild & Strengthen. Grip and pinch reintroduced, and the finger asked to work as part of the hand rather than on its own.
Move up when: pinch is measured and rising, and the droop is unchanged after loading. - Stage 4, Return & Perform. The demands you actually have. A keyboard, a steering wheel, a racquet, a toolbag. Measured against the other hand before we call it done.
Graduate when: the droop, in degrees, is the same at two reviews in a row, and the finger does what your tasks need.
Measured at your first appointment and again at graduation: a score for three tasks you name yourself, and how far the fingertip droops and bends, in degrees.
Logistics
When can I…
Your surgeon decides, based on healing and what your job demands. These are typical points, not permissions.
| Activity | Typical point | What has to be true first |
|---|---|---|
| Typing, desk work | From the first days | Splint on, with the fingertip supported. |
| Washing and changing the splint | From day one, carefully | The tip is held straight on a flat surface every time the splint is off. Your therapist shows you how on the first visit. |
| Driving | Usually throughout | Splint on and a grip you trust. Check with your insurer. |
| Out of the splint by day | 6 to 8 weeks | No droop when it is tested, and your therapist agrees. Night splinting usually carries on for a few more weeks. |
| Ball sport | 10 to 12 weeks | Weaning finished, with a protective splint or taping for the first weeks back. |
| Medical certificate | Your doctor issues it | Hand therapists do not issue MCs. We can write a report on your functional limits for your doctor or employer. |
Who you will see
The hand therapy team that runs this program
Hand, wrist and elbow cases are managed by the hand therapy team. You are matched to the therapist whose declared clinical interest fits what happened to you and the clinic that suits you, and you stay with the same therapist through the program. Every appointment is one to one with your therapist for the full 45 minutes. All are registered with the Allied Health Professions Council.
Principal Hand Occupational Therapist. Wrist fractures, TFCC and wrist ligament injuries, custom splinting.
Tanjong Pagar
Principal Hand Occupational Therapist. Stiffness and scar tightness after hand or wrist surgery.
Orchard, Sundays
What our patients say
Google reviews from our clinics in Singapore.
Principal Hand Occupational Therapist. Carpal and cubital tunnel, sports wrist and finger injuries, tennis elbow.
Orchard, Serangoon, Tampines
Principal Hand Occupational Therapist. Finger and wrist fractures, De Quervain’s, wrist ligament injuries.
Orchard
Principal Hand Occupational Therapist. TFCC and wrist ligament injuries, trigger finger, thumb and wrist pain after pregnancy.
Jurong East, from 25 October
The program belongs to Phoenix, not to one therapist. Your plan, your measurements and your surgeon’s protocol move with you if you change clinic.
What it costs
$230 per 45 minute appointment
One to one with your therapist for the whole 45 minutes. Nett, no GST. Same price for your first appointment and your last. Most of the work in Stage 1 is the splint and the routine around it, so the early appointments are spaced while the splint does its job. The Mallet Finger Recovery Program is 12 appointments, $2,760 in all. You pay for each appointment as you attend it. If you need more, your therapist shows you which stage criteria are still open, and each extra appointment is $230.
This program runs Stages 1 to 4 of the Phoenix Recovery Protocol, and sits under hand therapy after surgery alongside the rest of our recovery programs.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Timeframes on this page are typical ranges, not promises. Where your surgeon has given you a protocol, that protocol takes precedence over anything written here.
Where we are
Clinics across Singapore
ORCHARD
400 Orchard Road #12-12
Orchard Towers, S238875
NS22 Orchard MRT
Physiotherapy and hand therapy in Orchard →
WhatsApp 8800 1830TAMPINES
9 Tampines Grande #01-20
Asia Green, S528735
EW2DT32 Tampines MRT
Physiotherapy and hand therapy in Tampines →
WhatsApp 8780 9608SERANGOON
265 Serangoon Central Drive #04-269
S550265 · Lift C only
NE12CC13 Serangoon MRT
Physiotherapy and hand therapy in Serangoon →
WhatsApp 8892 4121TANJONG PAGAR
10 Anson Road #02-77A
International Plaza, S079903
EW15 Tanjong Pagar MRT
Physiotherapy and hand therapy in Tanjong Pagar →
WhatsApp 8227 7074JURONG EAST
2 Venture Drive #02-02
Vision Exchange, S608526
NS1EW24 Jurong East MRT
Opening 25 October 2026
Physiotherapy and hand therapy in Jurong East →
WhatsApp 8242 7340