A professional's guide to Hand Therapy
by Helen Griffiths
“Occupational therapy addresses real, down-to-earth, everyday life issues. We help people re-engage in activities that hold meaning, purpose and value for them.”
Ginny Stoffel, President of the American Occupational Therapy Association, 2012–15
What is hand therapy?
Not until something happens to our hands do we really appreciate how much we rely on them, or that they are needed for almost every activity required for day-to-day living. Even relatively minor hand injuries can cause considerable inconvenience and discomfort, but more traumatic injuries may be particularly distressing and debilitating.
Hand therapy is a highly specialised branch of occupational therapy and physiotherapy, covering the assessment and treatment of conditions of the hand and upper limb. It requires postgraduate-level training and many years of clinical experience to practise confidently.
Our nationwide network of occupational therapist hand therapists are in high demand, common reasons for referrals from case managers for hand and upper limb interventions include:
- Fractures
- Neurological impairments of the upper limb
- Lacerations
- Amputations
- Burns
- Surgical repairs to tendons and nerves
- Trauma or orthopaedic injury
How does a hand therapist assist recovery and rehabilitation?
A hand therapist initially manages physical symptoms such as:
- Pain
- Scarring
- Swelling
- Nerve or sensation changes
Following a thorough assessment of a client’s specific circumstances, they can then advise on how to maximise strength and range of movement in order to maximise hand function as well as avoid further injury. Carefully chosen adaptive equipment and aids to daily living may be provided, and ergonomic adjustments recommended to maximise independence in everyday life and participation at work.
Splints, sometimes called supports or orthoses, are often necessary during the recovery process to reduce pain, rest joints in specific postures and alleviate skin problems. A hand therapist will be able to judge which type of splint will be most effective, and explain to the client when and why one should be worn. They can then make and fit the splint, monitoring and making adjustments as the recovery progresses. As splinting technologies advance the variety and quality of ‘off the shelf’ splints increases. A hand therapist will be able to advise if there is a pre fabricated splint option available and provide advice on the make, model, size and supplier that would be most appropriate for your client.
Treatment can be provided in the client’s home or place of work. Hand therapists regularly collaborate as part of a multi-disciplinary team, and work with surgeons, both pre- and post-operatively, to implement rehabilitation programmes. Hand therapists are trained to understand the social, psychological and emotional impacts of hand injury, and so the relationship between therapist and client is crucial.
Hand therapy rehabilitation can take many forms and it is important that the OT advises on the most cost effective way for a client to achieve the maximum level of functional restoration. For a client with severer burns this may be intensive sessions several times per week. For others they may be able to complete a home exercise programme independently. A sound assessment, treatment programme, advice and training with regular support and reviews if often sufficient for successful rehabilitation. It is the skill of a hand therapist that will ascertain the injury combined with motivation and expected level of rehabilitation that will be able to guide the case manager as to the best course of action for their client.
If you would like more information, please contact one of our client managers at The OT Practice via telephone (0330 024 9910) or email (enquiries@theotpractice.co.uk). They will be able to recommend a hand therapist suitable for your client.
Helpful references and Links
British Association of Hand Therapists website
Cooper, C. (ed.), Fundamentals of Hand Therapy, Elsevier Mosby (2007)
Skirven T.M, Osterman A.L, Fedorczyk J., Amadio P.C., Rehabilitation of the Hand and Upper Extremity (6th Edition), St Louis: Moseby (2011)
