Applying Controlled Stress During Flexor Tendon Rehabilitation of the Hand and Wrist

presented by Kristin Valdes

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What are the effects of different hand motions and positions used during early-protected motion rehabilitation on tendon forces? Though these are usually not well understood by rehabilitation professionals, this course will provide the current evidence regarding tendon rehabilitation and flexor tendon forces generated during different rehabilitation exercises to maximize the result and limit the risk of tendon rupture. From clinical applications and guidelines for treatment to application to ADL impairment, Dr. Kristin Valdes guides the participant through the rehabilitation process using controlled stress. Join Dr. Valdes as she explains the nuances of applying controlled stress through illustrative graphics, dynamic demonstrations, and thorough course materials.

Meet Your Instructor

  • Kristin Valdes, OTD, OT, CHT

    Kristin Valdes, OTD, OT, CHT, is the owner and Director of Hand Works Therapy in Sarasota, Florida. She is an associate professor at Gannon University. She has been in private practice for over twenty years and specializes in the treatment and rehabilitation of the upper extremity. Her clinical expertise includes treatment of the hand, wrist, and elbow, shoulder, splinting, and arthritis. Dr. Valdes has published articles in the Journal of Hand Therapy, Hand Magazine, Journal of Manipulative and Physiological Therapeutics, and The Journal of Physical Therapy Science. She serves as a member of the Board of the American Society of Hand Therapists and American Association of Hand Surgery. Dr. Valdes has published chapters on hand, elbow, and shoulder fractures and dislocations in Advanced Concepts of Hand Pathology and Surgery. She is an assistant editor of the Journal of Hand Therapy. Dr. Valdes received her OTD degree with a specialization in hand rehabilitation from Rocky Mountain University of Health Care Professions in Provo, Utah. Dr Valdes is member of the Guatemala Healing Hands Medical Mission.

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Chapters & Learning Objectives

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  1. Clinical Application of Controlled Stress to Healing Tendons

    1. Clinical Application of Controlled Stress to Healing Tendons

    It has been reported that 4%–18% of repaired flexor tendons rupture. Excessive stress and high force during finger motion may cause gap formation and eventually rupture of the repair. Dr. Valdes explains how rehabilitation exercises should ideally apply enough force on the tendon to induce excursion without causing gap formation.

  2. Clinical Guidelines for Treatment Following Flexor Tendon Repair

    2. Clinical Guidelines for Treatment Following Flexor Tendon Repair

    Designing effective rehabilitation protocols requires understanding actual forces generated in the flexor tendons during various commonly used rehabilitation maneuvers with different wrist positions. With this information, your protocols will allow maximal tendon gliding without causing rupture of the repair.

  3. ADL Impairment

    3. ADL Impairment

    Dr. Valdes then reports the research exploring ways to adequately address issues of ADL impairment during flexor tendon rehabilitation. Helping patients who have undergone flexor tendon repair adapt to a change in ADL function is an important part of hand therapy practice and this chapter will address ways to approach and measure ADL function during rehabilitation.