Occupational therapists, specifically certified hand therapists, combine comprehensive knowledge of the upper limb with function and activity.
Using specialized skills in assessment, planning, and treatment, certified 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 participate fully in life situations.
Hand therapy is beneficial to patients who are either post-surgery or faced with any type of injury that may not require surgery, explained Danielle Sandstrom, MOT, OTR/L, CHT, a certified hand therapist with Trinity Health’s Occupational Therapy department.
“We see anybody who has a repetitive strain injury, maybe a fracture, a dislocation in a finger joint, or even a shoulder injury,” Sandstrom said. “We see tendon injuries and repairs, osteoarthritis, sports-related injuries in the upper extremity, rheumatoid arthritis, patients who have burns, and anybody who has a neuropathy.”
Taylor Erdmann of Newburg is one of those patients. In April 2017, he suffered an upper extremity loss when the neuromuscular system in his arm deteriorated after he suffered carbon monoxide poisoning; he was laying on his left arm for 16 hours, during which time, he damaged tendons and nerves.
After a little under a week in the hospital, Erdmann began the therapy process.
“I got to start therapy shortly after to get my nerves to wake up and my hand to start working again,” he said, noting that from May to December, he attended hand therapy twice a week for hour-long sessions. “Then, I got down to once a week, and then once every two weeks, weaning me off of it.” The length of time that patients participate in hand therapy also varies, depending on the patient’s diagnosis. “Some patients may come for a one-time appointment to be instructed on a home program, or to be placed in a splint for protection,” Sandstrom explained. “Other patients can be scheduled for therapy twice a week for four to eight weeks.”
On December 21, 2017, Erdmann traveled to Mayo Clinic and had tendon transfer surgery performed. In February 2018, Erdmann returned to Trinity for hand therapy. “Dani was the lucky one to get my hands working again,” he said.
Patients are often referred from a provider, such as an orthopedic or hand surgeon, after surgery or after any type of injury that may not necessarily require surgery, Sandstrom added.
Therapies can vary, depending on the injury and the patient’s goal. Some examples of treatment methods:
• Joint protection instruction, more for arthritis
• Manual therapy
• Custom splints, basically for post-op or post-injury, for protection
• Scar management
• Sensory reduction
• Training in activities of daily living, with use of assistive devices (such as opening a toothpaste cap, brushing hair, peeling potatoes)
• Wound care
• Desensitization and compression therapy
Sandstrom did scar massage, as well as an ultrasound for scar management and swelling, with Erdmann in the initial acute phase. Then, during his therapy, Erdmann completed several physical tasks that involved him using his hand. He would take clips, each with different resistances, and put them on a “laundry board.” Other exercises helped with his basic range of motion and stretching, including weighted exercises to help with his wrist, forearm, elbow, and shoulder.
Since he started hand therapy, Erdmann has seen major improvement. “My doctor at Mayo who did the surgery said I’m eight to nine months ahead of schedule.”
In addition to hand therapy which is located at Health Center-West, Erdmann also completes exercises – stretches, at home. “I use my hand as much as possible,” he said.
Erdmann credits the rest of hand therapy team – Nicole Kutch, OTR/L, CHT, CLT; Amanda Hetzler, OTR/L; and Kara Thomas, OTA/L – with also helping with his recovery.
Hand therapy is “working great,” he said, noting that he has about one month to go. “I recommend it to anybody. From what I started with to what I’ve got now, it’s pretty awesome.”