Stenosing tenosynovitis, commonly known as trigger finger, occurs when a flexor tendon in the finger or thumb becomes inflamed, causing it to catch or lock as it moves through its protective tunnel. This is often due to a thickening of the tendon or the A1 pulley wall, which prevents smooth gliding. Surgical intervention, known as A1 pulley release, cuts this thickened portion, allowing the tendon to move freely and eliminating the locking sensation. This procedure is typically an outpatient operation, and while relief from catching is often immediate, physical recovery involves a defined timeline of tissue healing and strength restoration.
The Immediate Post-Operative Phase (Days 1–7)
The first week focuses on managing the normal inflammatory response and protecting the surgical incision. Immediately after the outpatient surgery, patients will experience some pain, swelling, and bruising at the incision site. To control this, keep the hand elevated above the heart level, particularly during the first few days, and apply ice packs for short intervals.
The surgical wound must be kept clean and dry until the first post-operative check-up, typically within the first week. Gentle finger movement is encouraged immediately after surgery to prevent stiffness and tendon adhesion. Temporary stiffness or numbness near the incision is common and typically improves as the local tissue heals.
Functional Recovery Milestones (Weeks 1–6)
The period between one and six weeks marks the transition from acute healing to the resumption of most daily activities. Gentle movement of the fingers, such as wiggling and light stretching, should be performed to maintain mobility. By the end of the first week or into the second week, patients can typically resume very light tasks, such as dressing, using a computer mouse, and writing, provided it does not cause significant pain.
Sutures are often removed around 10 to 14 days post-surgery, allowing the incision site to be gently washed. Driving can often be resumed around the two-to-three-week mark, especially if the non-dominant hand was operated on and the pain has subsided. Light office work, including typing, is usually comfortable and encouraged during this time, as it helps to decrease residual swelling.
As patients progress into weeks four to six, the focus shifts to regaining strength and endurance. Moderate gripping activities, like carrying light groceries or using tools, can typically be attempted by the end of this period. While most basic functions are restored within six weeks, heavy lifting or strenuous repetitive gripping should still be avoided.
The Path to Full Healing and Strength Restoration (Months 2–6)
Although the hand feels functionally recovered by six weeks, complete tissue remodeling and strength return continue for several months. The incision scar may remain firm, tender, or sensitive to pressure, often peaking in bothersome symptoms around one month after the procedure. To encourage softening and flexibility, scar massage, often using a moisturizing cream, should be performed daily and continued for up to six months.
Regaining maximum grip strength is a gradual process extending into the two-to-six-month window. While the tendon glides freely, muscles and soft tissues need time and specific exercises to rebuild power lost due to pre-operative guarding or post-operative inactivity. Hand therapy, which may involve therapy putty or small hand strengtheners, is often introduced to ensure the full return of dexterity and endurance.
Residual stiffness, particularly noticeable in the morning, is common and can persist for up to six months, requiring continued gentle stretching. The goal during this final phase is to achieve 90 to 100 percent of the grip strength of the unaffected hand and ensure the tendon sheath remains supple. Complete recovery, including scar resolution and full strength, typically spans three to six months.