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What Is Hand Therapy?

Working with a knowledgeable hand therapist can make the difference between success and failure in complex hand surgical cases. The therapist extends the continuum of our care, as well as functioning as coach and trainer for our patients.

Marybeth Ezaki, MD, Past President, American Society for Surgery of the Hand

Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper extremity (shoulder, arm, elbow, forearm, wrist and hand). Hand therapy uses a number of therapeutic interventions to help return a person to their highest level of function. It evolved from the need for a specialist with the knowledge and experience required to manage the challenging recovery of complex hand and upper extremity injuries.

What is a Hand Therapist?

A hand therapist is an occupational or physical therapist who, through advanced continuing education, clinical experience and integration of  knowledge in anatomy, physiology and kinesiology, has become proficient in treatment of pathological upper extremity conditions resulting from trauma, disease, congenital or acquired deformity.  A hand therapist may achieve advanced certification as a  certified hand therapist (CHT ). To obtain the CHT credential, a therapist must practice for a minimum of three years, accumulating at least 4,000 hours of treatment for hand and upper extremity disorders.  Certified hand therapists must also pass a rigorous certification exam to demonstrate their competency in the practice of hand therapy.

What Can a Hand Therapist Do for Me?

Hand therapists bridge the gap from medical management of upper extremity conditions to successful recovery, allowing individuals to function normally in their daily lives. Hand therapists provide non-operative interventions, preventative care and post-surgical rehabilitation for a wide variety of upper extremity disorders, from simple fingertip injuries to complex replanted extremities. Patients with chronic conditions, such as arthritis, or neurologic conditions, such as a stroke, can benefit from hand therapy through education on joint protection and energy conservation, and with recommendations for adaptive equipment or devices to improve function. A hand therapist employs a variety of techniques and tools, including activity and exercise programs, custom orthotic fabrication, management of pain and swelling and wound and scar care. A hand therapist can also be a consultant in the industrial world, training employees in healthy work habits.

Hand therapy is a specialty practice area under the allied health occupational therapy group. They are mainly concerned with treating orthopedic-based upper extremities

  • elbows
  • forearms
  • wrists
  • palms
  • fingers
  • thumbs

(skin, bones, joints, muscles, nerves etc) to optimize the functional and mobility use of the upper extremity. We address biomechanical issues underlying any hand and upper limb issues.

As primarily occupational therapists, the hand occupational therapist often uses an occupation-based and client centred approach to hand rehabilitation by identifying the needs of the clients, and then tailoring interventions to improve performance in their preferred activities and tasks - it can be wanting to drive again, using the mouse, cutting foods, open a can of Coke etc.

Common painful finger, hand, wrist, forearm and elbow conditions that we treat includes fractures in the bones of the arm or hand, sprains and strains of the ligaments in the joints and connective tissues, lacerations, cuts, amputations, burns and surgical repairs of tendons and nerves of the hand and arm.

Examples of hand conditions our senior hand therapist treat:

If patient doesn't need surgery (yet) ie conservative/non-surgical, then our senior hand therapist will focus on non-surgical hand therapy interventions such as:

  • pain relief/management
  • strengthening/stamina building exercises
  • return to normal function and movement

If patient already had surgery (considered as post-surgical), our senior hand therapist will work/support the treating surgeon and focus on:

  • decreasing post-surgical pains
  • managing wounds/stitches
  • restoring movements (when medically allowed)
  • hand therapy program to improve strength, stamina and coordination

Some of our hand therapists' treatment includes:

Our senior hand therapists will use a number of hand therapy interventions and approaches to improve the patient's hand function, movement and pain

  1. Joint mobilization
  2. Pain relief/management
  3. Hot therapy / cold therapy
  4. Hand and finger exercises
  5. Ultrasound therapy to accelerate soft tissue healing
  6. Tendon gliding exercises
  7. Scar management
  8. Sensory re-education (especially with scarring and post-amputation)
  9. Customized thermoplasting splinting
  10. Ergonomics: Decreasing Injuries At The Workplace
  11. Home exercises
  12. Wound care therapy (orthopedic)
  13. Removal of stitches (orthopedic)