The effect of mirror therapy in the rehabilitation of flexor tendon injuries after primary surgical repair

Review written by Dr Ian Gatt info

Key Points

  1. Both conventional and mirror therapy can improve pain and function post flexor tendon surgery.
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Hand injuries constitute approximately 20% of emergency room visits (1). Flexor tendon injuries can occur secondary to a sharp object (i.e. glass or knife) or result from blunt trauma from certain sports (e.g. football, basketball, wrestling), where injuries occur at tendinous attachments to the bone (1). Treatment of flexor tendon injuries includes surgical intervention, followed by rehabilitation approaches.

During mirror therapy (MT), a mirror is placed in the patient’s midsagittal plane, with the image of the healthy side projecting onto the affected extremity, thus creating a visual illusion of increased mobility of the affected extremity (2,3). The illusion of a moving hand has been observed to activate the cerebral cortex and can stimulate somatosensory activity (4).

The aim of this study was to reduce pain and enhance function in individuals with flexor tendon injury after primary surgical repair. Secondary outcomes were pain, range of motion (ROM), handgrip (HG) strength, functionality, dexterity and kinesiophobia.

Hand injuries constitute approximately 20% of emergency room visits.
Adding mirror therapy to conventional treatment post flexor tendon repair can likely provide superior results and be helpful at reducing pain and dysfunction.


  • In this randomized controlled study, 30 patients (53 fingers and 55 flexor tendon repairs) who underwent primary surgical repair after hand flexor tendon injury between October 2021 and February 2022 were included.
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