What is Hand Therapy?
Hand and Upper Limb rehabilitation, as a specialty area of hand therapy, is not yet very well known in South Africa. Excellent outcomes for patients with hand, elbow and shoulder (upper limb) injuries/ surgeries is achieved by good medical management in synergy with effective, high quality rehabilitation.
Hand therapy includes evaluation and treatment of injuries, disease processes and disorders of the hand and upper limb. It includes pre-operative/conservative therapy for disorders that do not require surgery. It also includes rehabilitation following surgery in order to maximize and hasten recovery.
Techniques used include:
- Making custom splints and braces for the hand and elbow
- Advising on appropriate non-custom braces and splints
- Therapeutic Exercise
- Therapeutic Modalities like heat, ice, ultrasound, electrical stimulation and others
- Mobilisation of Joints
- Management of Swelling
- Management of Scars
- Wound Care
Who needs Hand Therapy?
Hand therapy can be vital to maximising your hand and upper limb function following an injury, surgery, in arthritic conditions and in instances where pain or dysfunction limit the use of your hand and/ or upper limb. In most instances, early initiation of hand therapy results in the best outcomes. You may need to discuss this with your doctor or hand surgeon in order to begin therapy at the most appropriate time. In South Africa you do not need to be referred by your doctor or surgeon. If you have any concerns about your hand function you are free to contact a hand therapist directly. At your first appointment the therapist will do a thorough assessment by
carefully listening to your concerns and physically evaluating the different aspects of your injury and/ or function. The results of this evaluation will guide the process of hand therapy and the techniques that are used. Frequently the hand therapist will re-evaluate your progress and will upgrade or alter the treatment accordingly. The therapist and client are always a team, with the shared goal of reaching your best possible hand and upper limb function in order for you to return to the activities that are important and meaningful to you.
Conservative therapy generally refers to instances where there has been no surgery, but therapy is needed to restore normal or useful hand function for daily life, work and sports/ hobbies.
Examples of conditions which may be treated conservatively (ie without surgery) include:
- Traumatic Injuries of the Hand, elbow and shoulder
- Sprains and strains
- Some fractures
- Soft Tissue Disorders
- Trigger finger
- Ligament Injuries
- Carpal Tunnel Syndrome
- Cubital Tunnel Syndrome
- Rotator Cuff Pathology
- Impingement Syndrome
- Tennis Elbow/ Golfer Elbow
- Most forms of arthritis affecting the hand and upper limb benefit from therapy to reduce pain and improve function.
Rehabilitation is necessary following surgery to maximize and hasten recovery. Often following injury or surgery one is unsure of whether to move or immobilize the injured part, what to do about swelling and pain, and what activities are safe to perform and which may be harmful. A Hand Therapist would be able to advise a client on these issues to ensure the best possible outcomes.
Examples of conditions treated post-operatively include:
- Fractures that have required surgery (including K-wires, pins, screws and plates) to stabilize the fracture.
- Tendon Injuries
- Nerve Injuries and Repairs
- Joint Replacements
- Thumb joints due to arthritis
- Finger joints and knuckle joints due to trauma and/or arthritis
- Joints due to trauma or arthritis
- Bone grafts and skin grafts and flaps
- Infections that have been medically/ surgically treated
- Trigger finger releases
- Carpal Tunnel and Cubital Tunnel releases
- Rotator Cuff Repairs
- Crush Injuries
Who is a Hand Therapist?
A hand therapist may be an occupational therapist or a physiotherapist, who through advanced study and experience, have a special interest in treating people with conditions affecting the hand and upper limb. Effective and high quality hand therapy leads to the best possible results, that allows clients to regain meaningful use of their hands in returning to work tasks, as well as participating in their hobbies, sports and other daily activities.