Vicki introduces the relative motion protocol for zone 4 to 7 extensor tendon repairs (previously known as Immediate Controlled Active Motion) which was introduced by Wyndell Merrit in the late 1970s. This protocol uses a low-profile finger yoke splint to position the injured finger in 15-20° more extension than adjacent fingers. She shows that the splint is easy to fabricate and that the protocol is safe and produces good outcomes. At least one digit (but not the index or little finger) must be intact for this protocol to be appropriate.

Nicola uses a patient case to guide us through the three phases of the protocol. She demonstrates a focus on the client’s activities and participation and the importance of thorough patient education. Overstretching the healing tendon into flexion, and resisted extension need to be avoided in the early phase of rehabilitation. Nicola describes exercises for each phase of rehabilitation as well as strategies to address adhesions and other complications, complex presentations or resource restrictions. Many practical examples are provided and many therapists left the webinar less scared, and more confident to treat repaired extensor tendons using this approach.