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 2 October 2026.

The extensor tendons are the flat tendons on the back of your hand that straighten your fingers and thumb. They sit just under thin skin with almost no padding, so a cut, a jam or a knock reaches them easily. The sign of an injury is simple: a finger, or part of one, that you cannot straighten yourself but that someone else can straighten for you.

Where along the finger the tendon is hurt decides what you see, whether it needs a surgeon, and how long the splint stays on. That is what this page sorts out.

Hand therapy after surgery

Extensor Tendon Repair Recovery Program

The repair holds the tendon together. The weeks after it decide whether the finger bends again.

For extensor tendon repairs on the back of the hand and fingers, and for central slip and other extensor injuries treated in a splint. A staged hand therapy program run to your surgeon’s protocol, at five Singapore clinics.

WhatsApp us Get Assessed & Treated

No referral needed to start. Bring your operation note, discharge summary or scan report.

Start here

Where are you right now?

An extensor tendon injury is a different problem depending on the week you are reading this. Pick the one that matches.

I have just had the repairWhat the splint does, what you move, and what you must not. The splint is coming off and it is stiffMost of that is expected. Here is what is not. It straightens, but it will not close into a fistOr the scar is stuck to what lies under it. I need to know when I can type or driveKeyboard, driving, lifting and sport.

How the program runs

4-Stage Structured Recovery

You move up a stage when you meet the criteria for it, not when a number of weeks has passed. That is Criteria Before Clearance, and it is why the last appointment is a graduation rather than a discharge.

Stage 1

Calm & Protect

Splint fitted to your surgeon’s protocol. Swelling controlled. Protected movement taught so you can do it at home without stressing the repair.

Most people arrive here

Stage 2

Move & Mobilize

The splint comes down in steps. Active bending and straightening, and scar work so the tendon glides rather than sticks.

Stage 3

Rebuild & Strengthen

Grip and pinch measured in kilograms, a full fist, and graded load.

Stage 4

Return & Perform

The tools, the keyboard, the sport or the instrument the hand actually has to go back to.

The shape of it

What happens, week by week

The weeks below are the usual shape after an extensor tendon repair on the back of the hand. Repairs over the finger joints, and over the middle joint in particular, follow their own splinting rules. Your surgeon’s protocol takes precedence over anything on this page, every time.

Weeks 0 to 1Stage 1 · Calm & ProtectFirst hand therapy appointment, ideally within days of the operation. Custom splint shaped on the day. Swelling down. The protected movement your surgeon’s protocol allows.
Weeks 1 to 4Stage 1 · Calm & ProtectSplint on. Controlled movement inside it, every day, because a tendon held completely still sticks to everything around it.
Weeks 4 to 8Stage 2 · Move & MobilizeThe splint comes off in stages. Active bending, a fist built up gradually, and scar work.
Weeks 8 to 12Stage 3 · Rebuild & StrengthenStrength. Grip and pinch measured against the other hand. Load added as the repair allows.
Month 3 onwardStage 4 · Return & PerformFull use for work, sport and the specific things you do with your hands.

As the splint comes off

Is this normal?

Usually expected

A finger that will not fully bend when the splint first comes off.
A small droop at the end of a full straighten, which often improves over weeks.
Swelling over the back of the hand by evening.
A scar that feels tight and pulls when you make a fist.
Weak grip for some weeks.
Numbness near the scar.

Contact your doctor

Emergency department now: a finger or hand that turns pale, cold or blue, or pain under a cast or splint that keeps rising despite elevation and pain relief.
Doctor the same day: fever, or a wound that is red, hot, opening or leaking.
Surgeon soon: a sudden loss of straightening after a snap or a jolt, which can mean the repair has given way.
Surgeon soon: the splint has come off or broken. Do not move the finger freely until it is replaced.
Review soon: no change in bend or straightening over 2 to 3 weeks of therapy.

We would rather send you back to your surgeon early than be the reason you went late.

What does not reverse on its own

Adhesions form in the first weeks

A repaired tendon heals by laying down scar, and that scar can bind the tendon to the skin and tissue around it. Once adhesions have matured, months later, they often do not release with exercise, and some people go on to a second operation called a tenolysis to free the tendon. That is why the protected movement in the first weeks is not optional. It is the part that keeps the tendon gliding. Your surgeon sets the limits, and we keep to them exactly.

If it is not going to plan

It straightens now, but it will not close into a fist

The repair held. The finger straightens. And it still will not tuck in when you make a fist, so it sticks out when you grip.

You hold the cup with three fingers. Pulling on a glove, that finger catches every time. You can see the scar move when you try to bend it, as if something under the skin is pulling the other way.

That is usually adhesion: the tendon has stuck where it healed. It is measured in degrees and worked on specifically, not waited out, because the window in which scar still responds to work does not stay open.

The Stalled Recovery Review is three appointments, one a week for three weeks, with the same therapist. The first finds what is holding you back. The next two measure how it responds, because what a joint does under load cannot be read in one visit. $690, nett, no GST.

Tell us where it stopped

More on what the three appointments cover: the Stalled Recovery Review.

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, light desk work	1 to 3 weeks	Splint on. Your surgeon allows it, and it does not move the repaired finger.
Driving	6 to 8 weeks	Out of the splint for driving, and a grip on the wheel you trust. Your surgeon agrees, and check your insurer.
Light lifting	8 weeks	Your surgeon has cleared load, and Stage 3 has started.
Heavy grip, tools, gym	12 weeks or later	Grip tested against the other hand.
Contact and ball sport	3 months or later	Stage 4 criteria met, and your surgeon’s clearance.
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.

The program

What it costs and what is in it

Extensor Tendon Repair Recovery Program, Stages 1 to 4

$230

Per 45-minute appointment, nett, no GST. The Extensor Tendon Repair 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.

An Assessment & Treatment first, at $230: which stage you are in, what is limiting you, and a written plan you walk out holding
A custom thermoplastic splint shaped during the appointment, adjusted as swelling changes
Scar care and staged movement work, progressed on criteria
Bend in degrees and grip in kilograms, measured against the other hand
A home program, written down
A one-page report to your surgeon at weeks 2, 6 and 12 if you were referred
Your next stage review dated into the diary, with the same therapist

Graduation, Not Discharge. The program ends when you meet the Stage 4 criteria for what your hands need to do.

WhatsApp us Get Assessed & Treated

Who you will see

Managed by our hand therapy team

Tendon repairs sit with the hand therapy team. All five of our hand therapists treat them, so you can start at the clinic nearest you. You stay with the same therapist through the program, and every appointment is one to one for the whole 45 minutes.

Mavis Tham

Principal Hand Occupational Therapist. Wrist fractures, TFCC and wrist ligament injuries, custom splinting.

Tanjong Pagar

Shamaine Soh

Principal Hand Occupational Therapist. Stiffness and scar tightness after hand or wrist surgery.

Orchard, Sundays

Yuna Zhuang

Principal Hand Occupational Therapist. Carpal and cubital tunnel, sports wrist and finger injuries, tennis elbow.

Orchard, Serangoon, Tampines

Nurul Nadzirah

Principal Hand Occupational Therapist. Finger and wrist fractures, De Quervain’s, wrist ligament injuries.

Orchard

Jasmine Ang

Principal Hand Occupational Therapist. TFCC and wrist ligament injuries, trigger finger, thumb and wrist pain after pregnancy.

Jurong East, from 25 October

This program runs Stages 1 to 4 of the Phoenix Recovery Protocol. It sits under hand therapy after surgery, alongside the other recovery programs.

Timings on this page are typical ranges, not predictions for any individual recovery, and your surgeon’s protocol takes precedence. Hand therapists assess, splint, exercise, educate and refer; doctors diagnose, inject, prescribe and order imaging. If we find something that needs medical review we refer you back to your doctor.

The tendons on the back of your hand

The muscles that straighten your fingers sit in the forearm. Their tendons cross the back of the wrist under a band of tissue, fan out across the back of the hand, and run to each finger. You can see them stand out when you lift your fingers off a table. The index and little fingers each get an extra tendon of their own, which is why they can point on their own. The thumb has three.

Over each finger the tendon flattens into a thin hood that splits and rejoins, with one slip ending at the middle joint and the rest ending at the fingertip. That arrangement is why a small injury in one place can make the finger sit in a shape that looks nothing like the injury.

Where it is injured decides what you see

Where	What you notice	What it is called	What usually happens next
Fingertip joint	The tip droops and you cannot lift it, often after a ball or a tucked-in bedsheet	Mallet finger	A splint holding the tip straight, worn continuously for six to eight weeks. See the Mallet Finger Recovery Program
Middle joint	The middle joint will not fully straighten after a jam or a cut. Over the next week or two the tip starts to bend back	Central slip injury, which becomes a boutonniere deformity	A splint holding the middle joint straight with the tip free to bend, usually for around six weeks
Knuckle	The tendon slips off to one side of the knuckle when you make a fist, and the finger drops	Sagittal band injury, sometimes called boxer’s knuckle	Often a splint that holds the finger slightly higher than its neighbors. Some need a surgeon
Back of the hand or wrist	A cut, and afterwards a finger that will not lift at the knuckle	Extensor tendon laceration	Usually repaired by a hand surgeon, then early protected movement in a splint
Thumb	Weeks after a wrist fracture, you cannot lift the tip of the thumb off the table	Extensor pollicis longus rupture	A hand surgeon’s decision, commonly a tendon transfer. See the wrist fracture program

The middle joint is the one people underestimate. A jammed finger that will not quite straighten at the middle joint looks minor for the first week. If the central slip has torn and nothing holds the joint straight, the finger gradually settles into the bent-middle, bent-back-tip shape of a boutonniere deformity. A boutonniere caught early is splinted. One that has set over months is a much harder joint to get straight, and some never fully do.

A cut on the back of the hand

Any cut on the back of a finger or hand that goes deeper than the skin needs a doctor the same day, even if you can still straighten the finger. A tendon that is partly cut can still work, and then tear through a week later when you grip something.

One cut needs an emergency department that day, not a clinic: a cut over a knuckle from a punch that met someone’s teeth. Human bites carry bacteria straight into the joint, and these wounds commonly need antibiotics and a washout by a surgeon. Tell the doctor honestly how it happened.

Extensor tendonitis is a different problem

If the back of your hand or wrist aches with typing, gripping or lifting, the finger straightens normally, and there was no cut or jam, that is usually an overuse problem with the tendon or its lining, not a torn tendon. It is treated with load changes, sometimes a splint, and graded strengthening. See wrist tendonitis, or De Quervain’s tenosynovitis if the pain is on the thumb side of the wrist.

After extensor tendon repair

A repaired extensor tendon is held by stitches for the first weeks, and it is fragile. It also sticks. The back of the hand has very little room between tendon, bone and skin, so a repair that is held completely still for weeks commonly scars down to what lies around it. The result is a finger that straightens but will not bend into a fist.

That is why most surgeons now move these repairs early, in a protected way. For injuries over the knuckles and the back of the hand, a common approach is a small relative motion splint that holds the repaired finger slightly higher than the ones beside it, so the hand can be used lightly while the repair is protected. Injuries over the finger joints are usually splinted straight instead. Your surgeon decides which, and their protocol takes precedence over anything on this page.

Typical weeks after repair	What the work is
0 to 4	Splint on as your surgeon directs, swelling control, protected movement within the splint, wound and scar care
4 to 8	Splint reduced, active bending and straightening, scar work so the skin glides over the tendon
8 to 12	Grip and pinch strengthening, getting a full fist back, heavier tasks introduced
12 onward	Return to heavy manual work and contact sport, with grip measured against the other hand

These are typical ranges only. They vary with the level of the injury, whether other structures were hurt, and your surgeon’s protocol.

Is this normal after an extensor tendon injury?

Usually expected: a finger that droops a few degrees when relaxed for some weeks after the splint comes off; a firm, raised scar that softens over months; a fist that closes gradually rather than all at once; swelling that is worse in the evening.

Contact your surgeon or doctor if you suddenly lose the ability to straighten the finger after it had been working, if the wound is red, hot or weeping, if you have a fever, or if the skin under the splint breaks down.

When to see a doctor

Call 995 or go to A&E now if:

a cut is bleeding heavily and has not stopped after ten minutes of firm pressure
the finger beyond the cut is pale, cold or numb
a cut over a knuckle came from a punch that hit teeth

See a doctor on the same day if:

any cut on the back of a finger or hand goes deeper than the skin
you cannot straighten a finger after a cut
you suddenly cannot lift the tip of your thumb off a table

Make an appointment soon, within the week, if:

a fingertip droops after a jam or a knock. It needs a splint on as early as possible
the middle joint will not fully straighten after a jammed finger
a knuckle tendon snaps sideways when you make a fist

Frequently asked questions about extensor tendon injuries

Can an extensor tendon heal without surgery?

Often, yes, if the tendon was torn by a jam rather than cut. Mallet finger, most central slip injuries caught early and many sagittal band injuries are treated in a splint that holds the tendon ends together while they heal. A tendon that has been cut through usually needs a surgeon to repair it. A hand surgeon or your doctor makes that call.

How long does an extensor tendon take to heal?

The tendon itself is usually protected for around six weeks, whether it was splinted or repaired. Getting back full bending and grip strength takes longer, commonly around three months, and heavy manual work or contact sport can take longer again. These are typical ranges; your surgeon’s protocol comes first.

Why can I straighten my finger but not make a fist after repair?

Usually because the repair has stuck to the tissue around it, or the finger joints have stiffened while the tendon was being protected. It is common, it is measured, and it is the main work of Stages 2 and 3. If it has stopped changing, that is when a review is worth having.

Can I move my finger after extensor tendon repair?

Only in the way your surgeon and hand therapist show you. Most protocols now include early protected movement, because it reduces sticking, but the wrong movement at the wrong time can pull the repair apart. Do not test it by making a hard fist or straightening it against resistance until you are told you can.

What is the difference between extensor and flexor tendon injuries?

Extensor tendons on the back of the hand straighten the fingers. Flexor tendons on the palm side bend them. Flexor repairs sit in tight tunnels and have stricter rules for the first weeks. See the Flexor Tendon Repair Recovery Program if yours was on the palm side.

If you train Muay Thai or box, Muay Thai and boxing injuries lists every injury we see from it.

Where are you with this right now?

1. It is settling on its own

Many hand problems settle with a well fitted splint, changes to what provokes them, and tendon gliding. A tender scar and weak grip for a few weeks after surgery are usual. If it is easing week on week, and grip is improving month on month, it is behaving as expected. You do not need us for this, and we would rather say so.

2. It has stopped improving

You hand the jar to someone else. You button the shirt one-handed. You have stopped using that hand for anything that matters and barely noticed when it started.

The hand is the part of the body where stiffness sets in fastest, because a hand that hurts gets used less within days rather than weeks. That is the gap worth measuring, and it is not measured by how you feel on the day.

The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.

3. You have had surgery, or you have a date

Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. See the recovery programs, or hand therapy after surgery if you are not sure which applies to you.

All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.

Next step

Find out which stage you are in

Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.

WhatsApp us

Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.

Clinics across Singapore

ORCHARD

400 Orchard Road #12-12

Orchard Towers, S238875

NS22 Orchard MRT

Physiotherapy and hand therapy in Orchard →

WhatsApp 8800 1830

TAMPINES

9 Tampines Grande #01-20

Asia Green, S528735

EW2DT32 Tampines MRT

Physiotherapy and hand therapy in Tampines →

WhatsApp 8780 9608

SERANGOON

265 Serangoon Central Drive #04-269

S550265 · Lift C only

NE12CC13 Serangoon MRT

Physiotherapy and hand therapy in Serangoon →

WhatsApp 8892 4121

TANJONG PAGAR

10 Anson Road #02-77A

International Plaza, S079903

EW15 Tanjong Pagar MRT

Physiotherapy and hand therapy in Tanjong Pagar →

WhatsApp 8227 7074

JURONG 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

What our patients say

Google reviews from our clinics in Singapore.

       
 Excellent5.0555 reviews
 5.0
 Excellent555 reviews
  Write a review 
 
 
 
    
 
 
      Posted on Google  
   
   Micah 
 53 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Amazing experience with Phoenix Rehab, was assisted by Mavis. She’s very kind and professional and did thorough check on my wrist. I feel very comfortable during the process.

I went in for thermoplastic splint, and everything went smoothly. She was able to address my needs on my left wrist sprain.

They were prompt with appointment process and inquiry. Also the clinic is very close to Tanjong Pagar MRT. I highly recommend!
  
 
     Posted on Google  
   
   Chiky Phan 
 57 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Fist time doing ultrasound for my tennis elbow!! Let’s hope it gets better the next few weeks!! Thank Mavis Tham!!
  
 
     Posted on Google  
   
   XIN WANG 
 74 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Great treatment from my therapist. My painful wrist felt a lot of relief after the session. I’m glad I can slowly get back to doing my usual activities without constant pain.
  
 
     Posted on Google  
   
   Abby Lee 
 90 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Very helpful and friendly !
  
 
     Posted on Google  
   
   雪梅Cui 
 128 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
The masseur is very professional and provides excellent service ，yati is very good!
  
 
     Posted on Google  
   
   Tra Nguyen 
 219 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
I wasn’t able to close my fingers due to an injury. Nurul at Phoenix Rehab has helped me tremendously with my recovery process. I have been able to resume my daily activities and exercises after only a few sessions. Nurul has been very professional and positive throughout the entire process. Thank you so much for your help!
  
 
     Posted on Google  
   
   Juzer K 
 257 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Huge shoutout to Yuna Zhang from Phoenix Rehab for helping in my recovery from golfer’s elbow 🙌

I walked in with persistent elbow pain that was affecting workouts and everyday tasks, and Yuna immediately made me feel confident I was in the right hands. She took the time to properly assess my condition, explain the root cause, and tailor a treatment plan to my specific needs instead of using a one-size-fits-all approach.

What I really appreciated was how personalised every session felt. The exercises she gave me were practical, easy to follow, and actually worked. Within a short time, the pain reduced significantly and my strength and mobility improved much faster than I expected.

On top of that, the pricing is very reasonable and affordable, which made committing to recovery much easier.

Professional, knowledgeable, and genuinely caring — highly recommend Yuna at Phoenix Rehab if you’re dealing with hand-related sports injuries 💪
  
 
     Posted on Google  
   
   Fazal Hanafi Chaudhry 
 341 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
I enjoy coming to Phoenix rehab as they offer a wide variety of services. I had a finger accident and was working with a very experienced hand therapist. Place is clean and comfortable.  Staff were friendly and appointment was on time
  
 
     Posted on Google  
   
   Stella Yam 
 482 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Very good
  
 
     Posted on Google  
   
   Juliana 
 484 days ago
 
 
 Trustindex verifies that the original source of the review is Google. +0
Have both physio n Tcm visits here, highly recommend!
  
 
 
  
 
 
   Verified by Trustindex  Trustindex verified badge is the Universal Symbol of Trust. Only the greatest companies can get the verified badge who has a review score above 4.5, based on customer reviews over the past 12 months. Read more

Extensor Tendon Injury: Cuts, Mallet Finger and Rehab After Repair