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Flexor Tendon Injuries: Causes, Symptoms, and Treatment

Tendons refer to a strong, cord-like tissue that attaches the muscles to the bones. When you move, your muscles contract, allowing the tendons to pull the bone structure and facilitate motion. One specific example of a tendon muscle that you use to accomplish day-to-day tasks is called flexor tendons.

The flexor tendon system connects your forearm muscles to the bones of your thumb and fingers. These long tendons extend from the forearm's muscles into the palm side of the wrist, then connect into the bones of the fingers and thumb.

From the forearm muscles, the flexor tendons run through a tight tunnel in the wrist called the tendon sheath. This protects the flexor tendon's structure while securing its attachment to the bones.

Despite their protective sheath, flexor tendons can still sustain damages since they lie just underneath the skin of your fingers. Read on below as our leading hand doctor discusses flexor tendon injuries, their causes, and treatment options.

What Does a Flexor Tendon Injury Look Like?

According to studies, the most common cause of injury to the flexor tendon is lacerations. This can be a deep cut to the tendons located at the forearm, wrist, fingers, or thumb. An injury may also appear as a torn tendon that got severed from its connection to the bone.

Additionally, tendon injuries can be classified as partial or complete cut or tear. Here's how these two injuries differ:

  • A partial tear to the flexor tendon still allows the affected structure to bend or move slightly, albeit painful.

  • On the other hand, a completely torn or ruptured tendon means that the injury severed the flexor tendons into two torn ends. Plus, it's also impossible to move the affected fingers, wrist, or forearms when there's complete damage to the tendons.

When cut or torn, flexor tendons tend to pull farther away from each other since they're like rubber bands under tension. So, unlike other muscle tissues, tendons cannot heal independently.

What Are Its Causes?

Research suggests that tendon injuries have an incidence rate of 33.2 injuries per 100 00 person-years. Besides lacerations, some of the most common causes of flexor tendon injuries include the following:

  • Highly physical sports, such as rugby, wrestling, and football may cause tears in the tendon.

  • Activities that put pressure on the hands and arms, such as rock climbing, may damage the tendon sheath.

  • Occupation requiring extensive use of the hands and arms may cause the tendons to wear over time, causing tissue rupture.

  • Health conditions, such as rheumatoid arthritis, can wear out the tendons, making them prone to tears.

What Are Its Symptoms?

Injuries due to laceration or tear can either render the affected area immobile (complete) or with limited mobility (partial).

However, the level of impairment of a specific body structure will depend on the location and severity of the tendon injury. For example, an injured index finger tendon will only affect that finger alone. On the other hand, a lacerated wrist tendon may cause an inability to bend one or more fingers in the hands.

Some other signs and symptoms that you might encounter during an injured flexor tendon include:

  • An evident wound in the arms, wrist, or hands.

  • Tenderness on the palm side of the hands or along with the fingers.

  • Numbness or tingling sensation on fingertips.

  • Affected fingers seem more extended or straightened out than others.

  • Bleeding when the injury affected nearby blood vessels.

How to Diagnose a Flexor Tendon Injury?

If you think you have a damaged flexor tendon, you should immediately seek an orthopedic hand specialist. For deep cuts, it's important to apply some basic first aid practice while waiting for the emergency team. This includes:

  • Resting the affected area and applying ice to reduce swelling.

  • Wrapping it with a bandage or cloth to try and stop the bleeding.

Your doctor will physically examine the injury to confirm flexor tendon damage. This may include manually manipulating the affected area to see its strength, mobility, and extent of the damage.

Additionally, your doctor may also order other tests, like X-ray or MRI, to check if there are fractured bones or other damages to nearby tissues.

How Does an Orthopedic Hand Doctor Treat a Flexor Tendon Injury?

Your orthopedic doctor will assess the type of tendon injury (partial or complete) and base their treatment strategy on that. Typically, treatment options vary between nonoperative or operative.


Orthopedic hand doctors may opt for nonoperative procedures for partial cuts with <60% of tendon width. It can be a combination of wound care, splint, and hand therapy.


Most cases of flexor tendon injuries require surgery, especially if the cut is >60% of the tendon width. Your orthopedic hand surgeon may put you under general or regional anesthesia to surgically stitch the torn or ruptured tendon ends.

After the surgery, your doctor may put the affected hand and arm in a splint to protect the repaired tendons and improve healing. You'll be prescribed to wear the splint for at least 5 to 6 weeks; then, after that, it'll be a gradual return to mobility.

Most orthopedic specialists also recommend hand therapy as a vital part of your tendon's healing process. It's a rehabilitation program that will help your arms and hands regain their normal strength and function again.

Moreover, hand therapy prevents the healing tendons from sticking to the wrist "tunnel" by moving it in a gentle and therapeutic way.

Where to Find the Best Orthopedic Hand and Wrist Surgeon Near Me?

At Pinnacle Orthopaedics, we can help restore your normal body functions so you can achieve the highest quality of life possible. We do this by providing a specialized form of patient and orthopedic care that can treat different musculoskeletal conditions一from flexor tendon problems to spinal injuries.

Don't hesitate to contact us at 770-427-5717 or visit one of our orthopedic centers conveniently located near you:

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.