Hand Therapy

Child getting hand therapyMany hand or upper extremity injuries can be caught early through education, exercise, modalities and splinting to prevent unnecessary discomfort. Further injury can be prevented by educating the patient about proper posture, joint protection, stretching and pain relief. Our hand therapy program helps patients take control of their symptoms and prevent chronic problems.

Our hand therapy program is staffed by certified hand therapists (CHT) and occupational therapists (OT) who specialize in the treatment of traumatic, post-surgical and repetitive strain injuries in the upper extremity. Our hand therapists individualize each patient’s plan of care based upon the physician’s treatment orders and the patient’s functional goals and limitations.

Frequent diagnoses with successful conservative hand therapy treatment include:

  • Arthritis, including the very common  carpometacarpal (CMC) arthritis which effects the thumb
  • Carpal tunnel syndrome as well as other nerve compressions/injuries
  • Tendonitis, including de Quervain’s syndrome (a painful condition affecting the tendons on the thumb side of your wrist) and lateral epicondylitis (tennis elbow)

About Hand Conditions

The Hand

is a very complex tool that, until injured, we may not fully appreciate it’s value. Within our hands/forearms there are many structures we need to protect and care for.

Bones

Our supporting structure. Includes the phalanges (bones in the fingers), metacarpals (bones in the hand), carpals (bones in the wrist) and the radius and ulnar (long bones in the forearm.) Fractures are the most common injuries to our bones

Joints

The point where bones meet and allow movement. Joints can be affected by fractures that include a disruption to the articular surface, as well as conditions such as rheumatoid arthritis and osteoarthritis

Ligaments

Strong fibrous tissue connecting bones and stabilizing the joint. Ligaments can be stretched causing a sprain, disrupted with a dislocation of the joint. Full tears can also occur, commonly found in sport’s injuries. The most common ligament injury of the hand involves the ulnar collateral ligament of the thumb.

Nerves

These structures allow us to feel, coordinate movemement and protect our hand from heat and sharp objects. There are 3 main nerves in the hand, with many small branches that are also susceptible to injury. The median nerve can become compressed causing Carpal tunnel syndrome. Cubital Tunnel syndrome involves a compression of the ulnar nerve, and the radial nerve is less commonly injured but can become compressed at the radial tunnel.

Muscles/Tendons

These structures allow movement and provide strength. Muscles connect to bones frequently by a tendon, a rough fibrous tissue. Both muscles and tendons are frequently injured during daily activity and repetative forces. Lateral epicondilitis, medial epicondilitis and deQuervan’s Tenosynovitis are common forms of tendonitis found in the upper extremity. Other common hand injuries include trigger finger which can involve one or multiple digits and often develops over time. A mallet finger is a more traumatic injury with a disruption to the tendon on the back of the finger.

Hand Conditions

Fractures

Fractures can be very varies in severity including soft tissue injuries including potentially an open wound with the fracture causing the skin to open up. A removable splint may be utilized to protect the structure but allow hygiene and exercise if appropriate. More frequently a cast is utilized to immobilize the structures and allow healing. In more severe cases, surgery is needed to reposition the bones or to insert hardware to stabilize the bone

COMMON FRACTURES

  • Colles’ Fracture – A fracture to the distal radius (large bone in the forearm). Most common wrist fracture, typically caused by a fall on an outstretched hand.
  • Smith’s Fracture – A fracture to the distal radius, less common and typically caused by a fall on the back of the hand.
  • Barton’s Fracture – A distal radius fracture that extends into the joint.
  • Scaphoid Fracture – The most common of all carpal bone fractures. Typically caused by a fall on an outstretched hand. Healing can be difficult due to the blood supply to this bone. The proximal end of this bone can develop avascular necrosis (dying of the tissue due to lack of blood supply).
  • Boxer’s Fracture – A fracture to the small finger