Contractual Tendon Release: What It Is and How It Helps

Have a joint or limb that won’t straighten no matter how much you stretch? That stubborn tightness can be a tendon contracture. Contractual tendon release is a set of techniques doctors use to free a tendon so you can regain motion and reduce pain.

People often confuse the words “contractual” and “contracture.” Here we use both—many teams call the surgery a contracture release or tendon release. The goal is the same: loosen or lengthen a tendon that’s holding a joint in a bad position.

When doctors recommend a tendon release

You might consider tendon release if stretching, splints, or injections don’t help. Common situations include a hand that stays clenched after a stroke, a foot that won’t dorsiflex (foot drop) after injury, or a finger stuck from long-term scarring. If stiffness limits everyday tasks—dressing, walking, feeding yourself—surgery becomes practical, not cosmetic.

Before surgery, teams usually try non-surgical options: targeted physical therapy, night splints, steroid shots for inflammation, or botulinum injections when spasticity from nerve injury is the issue. If those fail, release can restore useful motion.

How the procedure works and what to expect

There are a few ways to release a tendon. The choice depends on the tendon, scar tissue, and your overall health:

- Percutaneous tenotomy: a needle or tiny blade through the skin to cut tight bands. It’s quick and often outpatient.
- Open release: a short incision to directly see and adjust the tendon—used when more control is needed.
- Tendon lengthening or Z-plasty: the surgeon lengthens the tendon to reduce pull on the joint.
- Endoscopic release: small camera-assisted approach for select areas.

Most procedures are outpatient. You may have local or general anesthesia. After surgery your surgeon might splint the area in a better position for a few days to weeks, then start physical therapy. Expect swelling and soreness early on; steady rehab matters more than the operation itself.

Recovery timelines vary. Simple percutaneous releases can show motion improvements in days, but full strength and range often take weeks to months of guided therapy. Scar massage, graded stretching, and strength work help reduce recurrence.

Risks include infection, incomplete release, weakness, nerve irritation, or recurrence of tightness. Ask your provider how often these happen in their hands and what the rehab plan will be.

If you’re weighing options, ask three practical questions: what exact technique will you use, what will rehab look like, and what realistic gains can I expect for daily activities? A clear plan from a hand surgeon, orthopedic specialist, or physiatrist plus committed therapy usually gives the best results.

Want simple next steps? Try a focused physical therapy program first if you haven’t. If surgery is on the table, schedule a consult, get a rehab plan in writing, and expect therapy to be the real game-changer after the release.