Most people have never heard of hand therapy unless they were referred for treatment or know someone who has required the services of a hand therapist. What’s so special about hands that they require their own specialty? One hand alone (including the wrist) has 27 bones, 34 muscles, over 100 ligaments, many blood vessels and a whole lot of nerves. Your hands allow you to complete delicate fine motor tasks but also provide you with the strong grip to open a sticky pickle jar. They tell you whether something is soft or rough, sharp or dull, hot or cold. We all take the use of our hands for granted, until they’re injured.
The Hand Therapy Certification Commission (HTCC) defines hand therapy as:
“the art and science of rehabilitation of the upper limb, which includes the hand, wrist, elbow and shoulder girdle. It is a merging of occupational and physical therapy theory and practice that combines comprehensive knowledge of the structure of the upper limb with function and activity.”
Hand therapists are occupational or physical therapists who have completed a minimum of 3 years of clinical experience and over 4000 hours of direct practice in hand therapy. They have completed advanced education and have successfully passed the comprehensive test of advanced clinical skills and theory in upper extremity rehabilitation administered internationally by the HTCC. What hand therapists really are is a bunch of passionate health care professionals who strive to make a difference in people’s lives. What makes them special is their huge bag of tricks that they use everyday to help their clients regain one of the most important movements of the human body: a functional grasp. Hand therapists fabricate orthoses from scratch using thermoplastic, Velcro, leather, guitar tuners, rubber bands, safety pins and more! They can sew custom fitted sleeves and gloves to help control swelling. They can turn a game of Connect 4 into a therapeutic activity and turn range of motion exercises into a game. They are creative, highly trained therapists who deeply care about getting you back to the activities that matter to you.
The anatomy of the hand and wrist is very complex and delicate. An imbalance in the biomechanics of the hand and wrist can lead to a cascade of other symptoms manifesting as hand stiffness, pain and loss of function. The advanced skills and knowledge of a hand therapist are needed to pinpoint the source of injury and restore proper tissue mobility and optimal function.
Hand therapists can diagnose and treat acute injuries with a conservative approach (splinting, exercises, modalities, strengthening). They are also experts in the post-operative management of upper extremity injuries. With very specific and technical post-operative protocol, hand therapy is a crucial component of a successful surgical outcome.