Hand Therapy Services
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Arthritis
Whilst we cannot remove the arthritis, there is a number of options that can help to reduce the symptoms of the arthritis and help you manage more effectively at home, at work, or for sport or other leisure activities. These options may include making orthoses (splints) to either rest the joint/s or support the joints to enable better functional use of the hand. You will likely benefit from customised hand/wrist exercises to assist in maintaining range of movement and strength but an important aspect of learning to manage your arthritis is advising in ways to make tasks easier and less painful for you. Occasionally surgery may be advisable; but surgery is always an elective option and only performed with your total consent.
Dislocations
Any of the joints of the hand may dislocate due to unexpected forces pulling the joint beyond what would be considered normal movement. If the joint has dislocated, it will need to be put back into position by a medical doctor. Sometimes the joint may be pulled out of position but then fall back into place immediately. Either way, the joint may need to be protected against further injury while the ligament and surrounding soft tissues are healing. An orthosis (splint) can be custom made to protect that joint until the tissues have healed. Specific exercises will be provided to hasten your return to normal function.
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Dupuytren's Disease
Dupuytren's disease is a condition that results in thickened tissue in the palm or palmar surface of the fingers that contracts and pulls the fingers into a flexed (bent) position. It can affect one or more fingers including the thumb. It is generally not painful but can reach a point where functional use of the hand is compromised due to lack of straightening of the fingers. Many men become embarrassed when shaking hands as the curled little finger gets in the way.
It is unlikely that the use of orthoses (splints) will help resolve the contracture and surgery is recommended before the fingers become too contracted.
There are several surgical options include fasciectomy or needle aponeurotomy. You will need to obtain a referral to a Plastic or Orthopaedic Hand Surgeon to discuss the options.
Post operatively it will be important to see a Hand Therapist to make up an orthosis (splint) that keeps the fingers extended at night, and to provide you with exercises and advice regarding managing the wound/scar and advice on how to regain normal use of the hand.
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Elective Surgery
There are many surgeries that can be performed to reduce pain in the hand/wrist or to improve functional use of the hand. You may be referred to a Hand Surgeon who will provide you with available options.
The surgeon may refer onto a Hand Therapist before any surgical procedure is confirmed. This is to evaluate your condition and assess the functional issues you may be experiencing, and to help determine whether the procedure is likely to improve your function.
Some procedures are more straightforward and do not require this assessment.
Post operatively, it is likely you will need to see a Hand Therapist for hand rehabilitation. This may include the making of an orthosis (splint) to support or protect the operated site, and subsequently a progression of specific exercises to improve range of movement, strength and return to normal function.
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Fractures
Fractures (broken bones) may occur in any bone in the hand or wrist, usually due to a forceful knock to the bone. The fracture is usually uncomfortable, although not always. Many times the bone will remain in position and you might need to have an orthosis (splint) made to protect this bone from further knocks and bumps for a number of weeks.
If the bone is displaced (shifted position) you will likely need to see a doctor for advice regarding putting it back into place. Surgery may be required to internally fix the fracture.
Usually an orthosis will be required to ensure the fracture heals.
A Hand Therapist can also provide you with quite specific exercises and advice to ensure you achieve the maximum potential.
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Ligament Injury
Ligaments are very important stabilising structures that keep the skeleton or bony structure in place. Undue forces, either sudden traumatic or longstanding repetitive in nature, can make some joints in the hand and wrist unstable. This may lead to pain over time and, ultimately, arthritic joints.
Hand therapists are able to fabricate customised hand orthoses (splints) to stabilise the affected joint and also provide you with specific exercises aimed to strengthen muscles crossing over the joint.
Sporting Injuries
The hand is always at risk of injury when playing sport. Injuries are often very minor and may only require short term use of cold packs and buddy taping. Other injuries quite obviously require medical attention (with or without surgery), and subsequent Hand Therapy. These may include fractures / dislocations / tendonitis to name a few.
Often a Hand Therapist can advise regarding returning to sport. Customised orthoses (splints) can be fabricated to be worn while playing to protect the injury and reduce the likelihood of further injury.
Tendonitis
Tendons are extensions of the muscle which contract and move one or more joints. They may become inflamed for a number of reasons, but particularly with repetitive use. Often new mothers will develop pain on the side of the wrist and forearm when handling their growing babies. Office workers can develop pain in the hand, or manual workers may experience tendonitis in the wrist due to repetitive heavy lifting or use of hand tools.
Hand Therapists are able to advise in ways of managing the tendonitis. This may include the use of various orthoses (splints) but also important advice in how to manage the hand in your daily life.
Trauma
Unfortunately the hand is at times at risk of significant injury due to the use of the hand in performing all manner of tasks in our daily routine. Use of power tools or operating machinery can sometimes result in accidents that require multiple surgeries to regain movement, sensation (feeling), strength and, ultimately functional use of the hand. Often these injuries involve multiple structures such as bone, tendon and nerve. The Hand Therapist plays an important role in rehabilitating these challenging injuries.
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