What is hand therapy?
According to the Hand Therapy Certification Commission, hand therapy is "the art and science of rehabilitation of the upper limb, which includes the hand, wrist, elbow, and shoulder girdle. It is a merging of occupational and physical therapy theory and practice that combines comprehensive knowledge of the structure of the upper limb with function and activity. Using specialized skills in assessment, planning, and treatment, hand therapists provide therapeutic interventions to prevent dysfunction, restore function and/or reverse the progression of pathology of the upper limb in order to enhance an individual’s ability to execute tasks and to participate fully in life situations."
“Hand therapy is the practice and care for individuals who have injuries or disabilities that prevent them from using their hand(s) or upper extremity for daily living tasks, work or leisure activities that give purpose and pleasure in people’s daily lives,” explained Steven Rodgers, an occupational therapist at Comprehensive Rehab.
In addition to being an occupational therapist, Rodgers, an Iowa native, has been a Certified Hand Therapist (CHT) since 2017, a designation that requires passing a certification exam as well as more than 4,000 hours of direct hand therapy treatment.
“Many of my patients are not aware that there are therapists who just treat hand and upper extremities,” said Rodgers.
Diagnoses that typically receive a referral to hand therapy services can vary greatly, he noted.
“It can be conservative care for a sprain or strain of the wrist or elbow to a post-surgical visit following a carpal tunnel release or trigger finger release. These can also be extremely complex injuries such as burns, tendon and nerve repairs, injuries from motor vehicle accidents, and generalized upper extremity trauma,” explained Rodgers.
Most hand therapy patients are adults, but Rodgers said age ranges can vary anywhere from young toddlers to older seniors.
“During football and baseball season, we do see an influx of sports-related injuries. For motor skill delays, we can see children as Comprehensive Rehab is set up nicely for children with an extensive variety of activities and treatment options,” he said.
What does a hand therapy appointment involve?
Treatment plans involve a three-part involvement between the patient, their physician, and the therapist.
During a typical hand therapy appointment at Comprehensive Rehab, a patient’s pain or symptoms will be discussed upon arrival.
“Any concerns, questions, or problem areas are addressed immediately,” said Rodgers.
Following that, moist heat may be used. “Every one of my patients loves the moist hot packs,” said Rodgers, adding, “Many, I think, would come just for that if allowed.”
Treatment usually begins with a combination of active and passive stretching of the affected hand or upper extremity while maintaining as much of a pain-free experience as possible.
Occasionally dressing changes will need to be made at the beginning of the session and suture may need to be removed per the physician’s order.
“I always attempt to follow stretching by a functional exercise or activity that promotes the newly increased range of motion or function,” he said.
Throughout the session, an assessment is made of the patient’s pain or if their symptoms change.
“If splinting changes need to be made due to fit or for progression of stretch, those are made at the end of the session. I usually end each session by re-assessing pain and symptoms and confirming or adding home exercise program stretches or exercises,” said Rodgers.
For patients attending a hand therapy session, Rodgers recommends wearing short sleeves, if possible.
“This can be tricky with our weather changes in the Midwest, but essentially, we need to gain access to the areas of concern,” he explained. “For elbow and shoulder injuries, especially if we’re doing dressing changes or wound care of if there’s a splint in place, a tank top and over-shirt or button-down shirt work well.”
What happens after the appointment?
“Over the years, I’ve learned that what is most important to the patient are their specific goals,” said Rodgers. “That could be tying shoes, making meals, playing with their children or friends or, if they’re young, returning to sports. It could be as simple as reducing pain, numbness, or tingling.”
Patients find the most success with their treatment when their motivated to get well, observed Rodgers. “Attending treatment sessions and remaining consistent and compliant with your home exercise program are the two most important steps. It is important to stay positive. We all have good days and bad days, and it is important to remember that.”
Home exercise programs or “homework” is extremely important in each patient’s recovery. This is what ensures patients are taking an active and invested role in their recovery.
“Meaningfulness of the treatment and progression can get lost if we solely focus on numbers and measurements. I always remind the patients some things will happen quickly, but most will take time. It is important to be consistent with the home exercise program and positive about their recovery,” said Rodgers.
“The most rewarding point of my job is seeing the patient improve and return to the normal functional use of the affected area. I realize we will not be able to help everyone reach their final goals. My goal during our first treatment is to be honest with the patients about any limitations that may be present by the time of discharge but consult then that we will do everything we can to attempt and return to 100% improvement,” said Rodgers.
Why choose Comprehensive Rehab for hand therapy?
“The feedback we’ve received from patients is that they’re thankful for the specific exercises and stretches we provided them with,” said Rodgers. “Many of our older patients may have had surgeries in the past and did not get referred to therapy. If they have recently had a procedure, I know many have said that getting that referral for treatment did improve their overall outcome and lessened pain.”
As part of Comprehensive Rehab’s hand therapy approach, wound care, suture removal, evaluation, and treatment are all available.
“Wound care for surgical incision sites and problematic wounds can be done on a basic to intermediate level, but any specific needs per wound care should be discussed prior to a referral to Comprehensive Rehab,” noted Rodgers.
“We are focused on exceptional outcomes for each of our patients,” he said. “We also work to build a strong relationship between therapist and physician so questions or concerns can be addressed quickly and accordingly.”
Comprehensive Rehab has Iowa locations in Clinton, Muscatine, Davenport, and Maquoketa. For more information, contact Comprehensive Rehab at (877) 530-6356.