Occupational Therapy & Hand Therapy

Occupational & Hand Therapy Program

Occupational Therapy is a branch of rehabilitative medicine that addresses functional limitations and develops a rehabilitation program to improve the dysfunction.  OT’s design exercise programs specific to maximizing return to functional activities of daily living.  Manual techniques, splinting, adaptive equipment and energy conservation techniques may be used in your rehabilitation. In addition to dealing with an individual’s physical well-being, OT practitioners address psychological, social, and environmental factors that may hinder an individual’s functioning in different ways. This unique approach makes occupational therapy a vital part of health care team.

Hand Therapy is a branch of rehabilitative medicine that has combined the skills of Occupational Therapy and Physical Therapy to provide a specialized approach to treating disorders of the Upper Extremities.  Physical Therapists and Occupational Therapists can become Certified Hand Therapists, working side-by-side with use of treatment approaches from both disciplines to enhance the recovery from an Upper Extremity injury.  At Harmony Hand & Physical Therapy Center, we have 4 Occupational Therapists, 3 of which are Certified Hand Therapists.

A typical treatment from our Occupational therapist/Hand Therapists will consist of an evaluation of your condition, hands-on treatment, splinting if necessary, recommendations for adaptive equipment as necessary, education regarding your condition, instruction in a home program, possibly some use of modalities for pain control,  and recommendations for continued progress following the therapy program.

Common injuries & conditions helped by our occupational/hand therapists: 

Sprains & Strains in the shoulder, elbow, wrist and fingers - Fractures of the Upper extremity - Tendinitis - Trigger Finger - DeQuervain’s syndrome - Carpal Tunnel Syndrome - Arthritis - Traumatic injuries - Open wounds - Tendon repairs - Rotator cuff tears - Shoulder adhesive capsulitis - Fine Motor Coordination deficits - Repetitive trauma injuries.

> Treatment Techniques
> Modalities

 

Treatment Techniques

Custom Splinting - Upper Extremity injuries often require splinting for resting, positioning, and/or mobilizing tissues.  Our skilled therapists have experience in customized fabrication and fitting of thermoplastic splints.  In addition, we fabricate removable casts for maximum protection of an injury while allowing continued participation in sports or work activities.  The splints and removable casts are fabricated during your appointment.  You will be instructed in proper wearing schedule with respect to your specific injury.  Most custom splinting is covered by insurance.

Manual Therapy Techniques - Various soft tissue mobilization techniques are utilized to gain motion and reduce pain in the upper extremities.  Some of the manual therapy techniques utilized in our clinic include:  Sound assisted soft tissue mobilization (SASTYM) tools, muscle energy techniques, strain-counterstrain, active release techniques, myofascial release techniques, joint mobilization,  and manual stretching techniques.  Your therapist will explain the specific approach and benefits to the techniques being used in your rehabilitation.

Therapeutic Exercises - Our therapists are experienced with developing exercise programs to achieve greater strength, range of motion, and function.  We provide verbal and written instruction for exercises that will help facilitate recovery from injuries and various disorders affecting functional use of the upper extremities.  We feel it is important to know how to continue your recovery through proper exercise.  Our written exercise instructions have pictures and text, and can be printed in English or Spanish.

Neuromuscular Retraining - Neuromuscular retraining (NMR) is a very specific type of rehabilitation that seeks to identify and treat the underlying neuromuscular firing abnormalities. With NMR we look not just at how strong you are, but also the sequence in which your muscles are contracting. This critical piece of rehabilitation is often overlooked.  NMR therapy involves very subtle—but critically important—movement retraining exercises to teach and train your body to begin using its muscles more effectively and efficiently.

Activities of Daily Living (ADL’s) Retraining – This service is an integral part of all the treatments provided for people adjusting to an injury or condition that limits/alters the ability to perform everyday activities.  The use of adaptive equipment, activity modification, energy conservation training & joint protection education can greatly enhance independence when dealing with functional limitations.

Sports Injury Rehabilitation - Sports injury rehabilitation covers a wide range of treatments for various injuries.  Injuries may vary from overuse injuries to traumatic injuries.  A few examples of common sports related injuries that we treat are:  Rotator Cuff tears/repairs,  shoulder instability, shoulder impingement, elbow pain, lateral epicondylitis, medial epicondylitis, wrist instability/strain, finger fractures and dislocations.  We realize the importance for an athlete to return to their sport as soon as possible.  Our treatment focuses on function and education to return an athlete to their pre-injury state.

KinesioTaping - KinesioTaping is a non-restrictive taping technique which allows for full range of motion used for preventative maintenance, edema and pain control.  The technique is based on the body’s own natural healing process, being applied over muscles to reduce pain and inflammation, relax overused tired muscles, and to support muscles in movement on a 24hr/day basis.  It can be used for a variety of injuries from headaches to foot problems.  Some examples include:  carpal tunnel syndrome, tennis elbow, finger pain, thumb sprains, wrist instability,  low back strain, knee pain, shoulder issues, plantar fasciitis or as injury prevention.  KinesioTape is widely used by professional athletes around the world.  The taping techniques can be taught to the patient or family member and thus used independent of the physical therapy treatment.

Wound Care - Traumatic injuries are often associated with open wounds which require attentive care to facilitate proper wound healing.  Our team of Certified Hand Therapists have experience in treating wounds and burns with research based treatment protocols.  Wound care will consist of debridement when necessary, dressing changes, wound cleansing, and instruction in self-management at home. Wound care is always provided with the guidance and supervision of your physician.  Depending on the location of the wound, splinting may be necessary to assist with positioning the hand during the wound healing phase.  This is especially true when treating burns.

Job Analysis/Ergonomic Assessments - This service is performed at the work-site to assess the ergonomics of the work-station.  The goal is to create a work environment that fits the worker.  This is often accomplished without the purchase of additional equipment.  Modifying the work-station to the employee will reduce the occurrence of repetitive strain and musculoskeletal injuries.
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Modalities

Ultrasound - Ultrasound is a treatment modality used by physical and occupational therapists that utilizes high or low frequency sound waves. These sound waves are transmitted to the surrounding tissue via a round headed probe. The sound waves penetrate the muscles to cause deep tissue/muscle warming. This promotes tissue relaxation and is useful in treating muscle tightness and spasms. The warming effect of the sound waves also cause vessel vasodilatation and increases circulation to the area which assists in healing. The frequency can be adjusted to assist with decreasing inflammation.  Medication can be mixed with the ultrasound gel and applied to the area which is referred to as Phonophoresis. The ultrasonic sound waves force the medication to migrate into the tissues reducing inflammation.

Electric Stimulation - Electrical stimulation uses an electrical current to cause a muscle or a group of muscles to contract. Your therapist can change the settings to allow for a forceful or gentle muscle contraction depending on your condition or what the goal of your therapy might be.  Along with increasing muscle strength, the contraction of the muscle also promotes blood supply to the area that assists in healing as well as calming and relaxing the targeted muscle upon conclusion of the treatment.  There are many various types of electrical stimulation that have differing treatment benefits including TENS (Transcutaneous Electrical Stimulator) which is used in pain therapy, our therapists are able to teach you how to use the TENS unit as a home device.

Low Level Laser - Laser therapy, also known as low-level laser therapy (LLLT), is a light source that generates pure light of a single wavelength. The effect produced by laser therapy is not thermal (heat)—instead, it has to do with photochemical reactions in cells.  LLLT reduces musculoskeletal pain and inflammation as well as promoting tissue repair wherever the laser beam is applied.  One of the primary actions is on mitochondrial production of ATP, therefore potentially affecting any eukaryotic cell in the body.

Fluidotherapy - Fluidotherapy is a high intensity heat modality consisting of a dry whirlpool of finely divided solid particles suspended in a heated air stream.  Studies comparing its effective heating with that of a paraffin bath and whirlpool have found them to be similar. Use of fluidotherapy’s dry heat and fine particles is an excellent alternative to other heat therapy modalities especially when the goal involves desensitizing an area.

Paraffin Bath - Paraffin wax is a mineral wax derived from petroleum.  Unlike normal candle waxes, which is viscous and sticky to bond to hair and skin, paraffin wax is a soft wax with a low melting point.  This means that it melts at a temperature cool enough to safely immerse your skin.  Paraffin therapy is one of the most effective methods of applying deep heat to relieve pain and stiffness. The warm paraffin also moisturizes for healthier looking, softer skin.
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