Hand Therapy & Upper Extremity Rehabilitation

Diagnoses

• All upper extremity fractures, dislocations, sprains and strains
• Tendon lacerations with a focus on early mobilization in order to prevent function limiting adhesions
• Nerve injuries, including compressions, lacerations and plexus injury
• Compression syndromes, including carpal tunnel, cubital tunnel syndromes etc., conservative & post-operative
• Upper extremity pain syndromes, including thoracic outlet syndrome
• Cumulative trauma disorder
• Elbow pathologies - pre and post-op management
• Shoulder pathologies - pre and post-op management
• Arthritic conditions - pre and postoperative

Treatments

• Assessments with objective measures for range of motion, strength, sensation and function.
• Mobilization of joints and soft tissues using progressive exercises designed to increase movement of joints, tendons, and nerves. Massage, joint mobilizations, stretches, continuous passive motion machine and muscle stimulation may be used to help increase range of motion.
• Development and monitoring of a strengthening program: using specific hand strengthening equipment, pulleys, and weights. Along with a home exercise program, treatment is designed to assist in reaching functional goals.
• Splinting: custom splints are selected and fabricated, as required, for support, protection, pain relief, function and mobilization.
• Management of scar tissue: A comprehensive program is developed for management of scar tissue to prevent contractures and thickened painful scars.
• Management of swelling: retrograde massage, compression pump, pressure garments, elevation, ice and exercise work together to help decrease swelling. Other modalities such as contrast baths, ultrasound, TENS, HVGS and muscle stimulation may also be part of the program.
• Development of techniques to reduce neural tension: Nerves, like muscles and joints, can become tight and require special exercises, known as nerve glides, to decrease symptoms. Massage & muscle stretches are used as adjuncts.
• Normalization of sensation by desensitization or re-sensitization: addresses hypersensitivity or numbness around the scar. A program of desensitization helps minimize the uncomfortable sensations. Re-sensitization is used to reorganize the perception of touch as the nerve recovers.
• Preventative care management education.