Tendon Gliding Exercises

Introduction

Tendon gliding exercises are therapeutic movements designed to improve finger mobility, reduce stiffness, and prevent adhesions in conditions like carpal tunnel syndrome and tendon injuries.

These exercises involve specific hand and finger positions—such as straight, hook, fist, tabletop, and straight fist—to promote smooth tendon movement within the hand. Regular practice can enhance flexibility, dexterity, and overall hand function.

Increased edema, scarring, and adhesion from a hand or finger injury can restrict tendon glide, which in turn can impact joint range of motion, strength loss, impaired coordination, and diminished hand function. Here, we examine a few beneficial tendon gliding exercises. To be able to move your fingers freely, form a firm grip, the flexor tendons must glide when you move your hand. The Flexor Digitorum Profundus and Flexor Digitorum Superficialis are the names of the two flexor tendons found in your fingers.

These tendons are kept in place near the bones underneath by a sheath that holds them together. To produce joint mobility, the tendons must be able to slide both individually and collectively within this sheath, a process known as differential gliding.

To assist you move the tendons both individually and collectively for optimal mobility, your hand therapist can lead you through tendon gliding exercises. They also have the advantage of lowering edema.

Tendon Gliding Exercises: What are they?

After trauma or surgery, tendon adhesions may form in the hand, and inactivity may cause stiffness. Tendon gliding exercises can help avoid or lessen adhesions and stiffness. The exercises enable each tendon to move independently of the others and to its maximum range of motion.

They also aid in the restoration of a functioning grasp and the reduction of hand edema.

Hand, wrist, and elbow repetitive stress can be avoided using tendon glide exercises. Like any fitness program, there can be some initial soreness, but that should go away in a day or two. Consult your healthcare provider if it doesn’t get better or go away.

Indication

• Post-Trauma/Surgery: Tendons may become “stuck” or stick to surrounding tissues following hand trauma or surgery, resulting in stiffness and restricted range of motion. By promoting the tendons’ smooth movement along their sheaths, tendon gliding activities aid in the prevention of these adhesions.

• Scar Tissue formation: Following an injury, scar tissue may develop, limiting the range of motion of a tendon. Exercises that include tendon gliding can help release these adhesions and increase tendon mobility.

• Disuse Stiffness: Extended periods of inactivity or immobility can also cause stiffness and decreased tendon gliding. In these situations, tendon gliding exercises aid in regaining normal function and movement.

Enhancing Range of Motion and Hand Function:

• Restoring grasp Strength: By enhancing tendons’ capacity to move and contract correctly, tendon gliding workouts can aid in the restoration of a functioning grasp. A stronger and more functioning hand can result from combining grip strengthening exercises with tendon gliding to increase the efficacy of rehabilitation.

• Increasing Finger Mobility: These exercises can increase the range of motion in the fingers and wrist, enabling improved function and dexterity by encouraging smooth tendon movement. Hand edema is a common issue following surgery or injury, and tendon gliding exercises can help minimize it.

• Carpal Tunnel Syndrome: By increasing tendon and nerve mobility within the carpal tunnel, tendon gliding exercises can help reduce the symptoms of carpal tunnel syndrome. People with disorders like carpal tunnel syndrome (CTS), which can impair grip strength, may find these exercises especially helpful.

• Trigger Finger: By increasing tendon mobility and decreasing inflammation, tendon gliding exercises can help lessen the pain and stiffness related to trigger finger. Inflammation and thickening of the flexor tendons cause trigger finger, which makes it challenging to move smoothly via the A1 pulley, a thin band of tissue at the base of the finger. This fluid gliding action can be restored with the use of tendon gliding exercises.

• Hand and Wrist Injuries: Sprains, strains, and fractures are among the hand and wrist injuries for which tendon gliding exercises are frequently incorporated into a rehabilitation regimen.

How are they performed?

Warm water may make these exercises easier for you, especially in the beginning or first thing in the morning when your hands could feel more rigid. Always begin with your wrist and fingers straight, then switch back to that posture after each step.

Try to complete each exercise ten times before going on to the next one. You could be told to repeat the exercises by your therapist. The degree of dysfunction you have will determine how many repetitions you need.

Method

The exercises, which move from the open palm position to the full fist posture, can be performed one at a time or in a series. Do each exercise two to five times a day, with five to ten repetitions each time, under the supervision of your hand therapist.

Open Palm

Consider holding your hand flat on a wall or making a motion for someone to stop. Start by lining up your fingers and palm in a straight line. After completing each of the exercises listed below, return to this position. Before proceeding to the next exercise, hold for two to three seconds to reset.

Hook

Keeping your knuckles straight, carefully curl your fingers down to form a hook shape from the open palm position. Your fingers and wrist should feel stretched, and your fingertips should be in contact with the pads at the base of your fingers.

Tabletop

To make a tabletop or L shape, bend your fingers straight down from the open palm posture. For this exercise, only the joints where your fingers and palm touch should be used. Keep your thumb loose and your knuckles pointed up.

Half Fist

Only your knuckles and first finger joints will be used when you make a half fist. To place your fingers on the base of your palm, bend the knuckle and middle finger joints. Make sure your fingers are straight.

Full Fist

Using your thumb, fingers, and joints, slowly form a fist from the open-palm posture and give it a light squeeze. Return to the straight position and start the sequence again after holding the position for two to three seconds.

Benefits

The main objective of tendon gliding exercises is to enhance the hand and finger tendons’ capacity to glide freely within the surrounding tissues, which can become constrained or rigid as a result of trauma, surgery, or other circumstances.

By encouraging the tendons to move freely, these exercises serve to enhance hand function overall and avoid or lessen adhesions, which are scar tissue that can bind tendons to surrounding tissues.

• Reduced stiffness:

These exercises can assist to enhance range of motion and lessen stiffness in the fingers and hand by encouraging tendon movement. Tendon gliding exercises can help avoid or lessen adhesions and stiffness. The exercises enable each tendon to move independently of the others and to its maximum range of motion. They also aid in restoring a functional grip and reducing hand edema.

• Improved mobility:

The purpose of these exercises is to improve the hand and finger tendons’ ability to move freely, both through the surrounding tissues and alongside one another. They can aid in regaining the hand and finger range of motion that is necessary for day-to-day tasks.

• Reduced swelling:

In certain instances, hand swelling can also be lessened with tendon gliding movements. Tendon gliding exercises can aid in the reduction of hand and finger swelling by increasing blood flow and encouraging the flow of fluids.

• Preventing adhesions:

These exercises can aid in preventing adhesions from forming in the first place by promoting tendon movement, which can be especially crucial following surgery or injury. Adhesions occur when tendons adhere to surrounding tissues, causing stiffness and decreased mobility. Tendon gliding exercises are essential for preventing and minimizing adhesions.

Exercises for Tendon Gliding to Restore Complete Hand Motion

The following exercises assist your hand and wrist tendons to become more flexible and robust by combining stretching and strengthening activities. Strength and flexibility work together to help break up adhesions and prevent re-injury.

These exercises provide each tendon the maximum amount of movement possible, even though they seem rather gentle when you perform them. The exercises will lessen swelling and restore the vital blood flow needed for the healing process to take place.

Contraindications

Active inflammatory disorders, recent tendon repairs, cancer, complex regional pain syndrome, and circumstances where a definitive diagnosis is not available or protective sensibility has been lost are among the conditions that preclude the use of tendon gliding exercises.

• Active Inflammatory Conditions: Since the increased movement and stress might make the situation worse, tendon gliding activities should be avoided when inflammation is active.
• Recent Tendon Repairs: To prevent re-injury or rupture of the repaired tendon, tendon gliding activities should be introduced gradually and gently after tendon repair surgery, under the supervision of a medical practitioner.
• Malignancy: Tendon gliding exercises should only be performed carefully and under a healthcare provider’s supervision in people who have a known or suspected malignancy.
• The persistent pain disorder known as Complex Regional Pain Syndrome (CRPS) may be caused by trauma or injury. Exercises that involve tendon gliding should be avoided as they may worsen the disease.
• Lack of a Specific Diagnosis or Loss of Protective Sensibility: Tendon gliding exercises might not be suitable and should be reviewed with a healthcare provider if the underlying reason of the hand or wrist problem is unclear or if protective sensitivity has been lost.

Tendon Gliding Exercises & Occupational Therapy

Restoring the wrist joint’s and hand’s entire range of motion and minimizing or eliminating symptoms are the goals of occupational therapy for hand tendon gliding rehabilitation. Although the aforementioned exercises are a useful component of hand rehabilitation treatment, depending on the type of initial injury, complete recovery can only be attained by combining them with additional therapies.

Numerous therapies, such as manual therapy, splint treatment, low-level laser therapy, and more, can be administered by a certified occupational therapist or hand physiotherapist. Conservative, non-surgical therapy can typically be used to restore complete grip strength, pinch strength, and a normal range of motion while also reducing discomfort and sensory disturbances (such as tingling, numbness, and pins and needles) and promoting a full recovery.

FAQs

Reference

• Great Western Hospitals NHS Foundation Trust, Royal United Hospitals Bath NHS Foundation Trust, Salisbury NHS Foundation Trust, & Wiltshire Health and Care. (2022). Tendon gliding exercises. https://wiltshirehealthandcare.nhs.uk/wp-content/uploads/sites/8/2023/01/Tendon-Gliding-Leaflet.pdf
• Abdolrazaghi, H. A., Khansari, M., Mirshahi, M., & Pishkuhi, M. A. (2021). Effectiveness of tendon and nerve gliding exercises in the treatment of patients with mild idiopathic Carpal tunnel syndrome: a randomized controlled trial. Hand, 18(2), 222–229. https://doi.org/10.1177/15589447211006857
• Hand therapy – tendon gliding exercises – North Tees and Hartlepool NHS Foundation Trust. (2024, July 17). North Tees and Hartlepool NHS Foundation Trust. https://www.nth.nhs.uk/resources/hand-therapy-tendon-gliding-exercises/
• Wajon, A. (2020, June 11). Tendon gliding exercises for hand injuries – Hand Therapy Group. Hand Therapy Group. https://www.handtherapy.com.au/tendon-gliding-exercises/
• Tendon glide Exercises – Minnesota Counties Intergovernmental Trust. (2023, July 13). Minnesota Counties Intergovernmental Trust. https://www.mcit.org/blog/resource/tendon-glide-exercises/
• Sussex MSK Partnership. (n.d.). Tendon glides and finger range of movement exercises. In Sussex MSK Partnership (pp. 1–3). https://www.sussexmskpartnershipcentral.co.uk/wp-content/uploads/2024/03/Tendon-Glides-and-Finger-Range-of-Movement-Exercises.pdf
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