Flexor tenolysis is an elective surgical procedure that may be performed after primary tendon repair, grafting, or staged tendon reconstruction. It may be indicated if active range of motion (AROM) is significantly less than passive range of motion (PROM) secondary to scar adhesions.1 This situation may arise despite optimal surgery and postsurgical therapy. Close surgeon-therapist communication is helpful in optimizing postoperative therapy. The therapist needs to be aware of the quality of the tendon lysed and the need for any ancillary procedures. If the therapist is able to observe the surgery, this communication is greatly facilitated. After surgery, two different treatment approaches may be used during the first 4 to 6 weeks. Both approaches involve early mobilization. With a good-quality tendon and good-quality pulleys (as noted by the surgeon intraoperatively), the more progressive approach may be used.1,2 The “frayed tendon” protocol1 is used with a poor quality tendon and/or pulley reconstruction. The frayed tendon guideline is used to decrease demands on the involved tendon or pulley while maintaining the tendon excursion achieved during surgery. If crepitus is noted during use of the more progressive approach, it is important to use the frayed tendon guideline, because this may be a sign of impending rupture.1 Initial AROM is ideally begun in the operating room or in the recovery room on the day of surgery, followed by daily formal hand therapy during the first postoperative week.