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Hand Therapy Conditions

Island Hand Therapy Clinic treats clients with a wide variety of conditions of the upper extremity. We have compiled a list of common conditions along with a brief description of each one. Click the name of a condition to learn more about it. For more information about hand therapy conditions and treatment options, please visit our links page or contact us.

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The information on this website, and the links provided, is not a substitute for a consultation with your physician or hand therapist. It is designed for information only. Be sure to see a doctor and/or hand therapist if you think you have a hand problem.

We treat clients with a wide variety of conditions of the upper extremity. Some of the conditions treated include:

    Traumatic Conditions

  • Crush Injuries
    Crush injuries can involve all structures in the area of the injury: muscles, tendons, joints, blood vessels, nerves, etc. causing pain, swelling and stiffness. Initial treatment focuses on pain and swelling control, progressive movement and strengthening are gradually incorporated into the program.

  • Dislocations
    This is defined as a temporary disruption of a joint, and usually involves damage to ligaments, tendons, muscles, and sometimes bones and nerves. Movement is usually started early, to prevent adherence and scarring of the tissues involved in the injury.

  • Fractures
    Injuries to bones - these include cracks, chips and complete breaks. Treatment includes splinting, mobilizing and strengthening.

  • Mallet Finger
    A droop of the tip of the finger caused by bumping, catching or forcing the finger. This is a tendon and/or bone injury, and can be successfully treated by splinting, then a graduated program of movement exercises.

  • Sprains and Strains
    Injuries to ligaments and muscles/tendons can be a result of a fall, twist, pull, etc. Treatment may include rest to allow for healing, then reactivation through exercises, ultrasound, massage, etc.

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    Post surgical Conditions

  • Amputations
    Amputations are usually a result of a laceration, crush injury, or disease. Treatment will focus on reshaping the tip of the finger, restoring function and desensitization.

  • Carpal Tunnel Release
    A release of the membrane in the front of the wrist to release the pressure on the median nerve, which causes numbness and tingling in the fingers. If therapy is required, the goals will be restoration of movement and strength, and management of scar tissue.

  • Dupuytren's Surgery
    The fascia of the hand, the layer between the skin and the muscles, shortens and causes the finger joints to bend. The surgery releases and/or removes the contracted tissue. Hand therapy, following surgery, may include night splinting to maintain the finger in the straightened position, exercises to restore movement, and scar management.

  • Fracture Fixation
    Some arm, wrist and hand fractures require internal fixation in the form of pins, plates, or screws to ensure stability. Treatment will depend on the area, type and severity of the fracture as well as the type of fixation. Often splinting for protection with early movement is requested by the surgeon. As healing progresses, strengthening will be incorporated.

  • Ganglionectomy
    A ganglion is a benign cyst that develops most commonly on the back and the front of the wrist or on the inside of the fingers. If function decreases or pain increases, surgical removal is an option. Treatment will focus on restoration of function.

  • Joint Replacements and Reconstructions
    A number of joints in the hand can be successfully replaced or reconstructed if there is significant damage due to arthritis or an injury. The timing will depend on the specific joint, but once movement is allowed, treatment consists of a combination of splinting and exercises.

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  • Nerve Repairs
    If a laceration has damaged a nerve, the surgeon may repair it by reconnecting the severed ends. Hand therapy may include splinting for protection while the nerve is healing, restoration of function, and activities to help normalize the sensation and restore strength once the nerve has regrown.

  • Tendon Repairs
    Tendons are the rope like structures on both sides of the hand which allow movement by way of their attachment to muscles and bones. Injuries are caused by lacerations or ruptures, and require surgical repair. After surgery, the tendon a cast and/or splint will be applied, with a very specific series of exercises to allow joint movement while protecting the repair.

  • Tenolysis
    Sometimes after an initial injury, scar tissue or adhesions prevent free gliding of the tendons. This surgery frees up the tendon, so improved movement is possible. Therapy generally starts within the first few days of the surgery to prevent adhesions from forming again.

  • Trigger Finger/Thumb Release
    Locking or clicking of the finger or thumb that does not resolve with conservative treatment may require a surgical release of the pulley in the palm, restoring free gliding of the tendon. Following the surgery, gentle movement will help restore the full function.

  • Wrist Surgery
    Arthroscopic or open surgery can be performed to debride or repair damaged structures. Casting or splinting for a few weeks allows for initial healing, then movement will be started. When movement is full, strengthening will be initiated.

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    Repetitive Strain Injuries

  • Carpal Tunnel Syndrome
    Compression of the median nerve through the carpal tunnel, at the base of the hand, causes numbness and tingling of the fingers, weakness, and in some cases, pain. Night splinting and hand therapy can be effective in reducing symptoms and increasing function.
  • DeQuervain's Tenosynovitis
    This is a form of repetitive strain injury that is localized to the tendons of the thumb at the level of the wrist. The most common cause is sideways movement of the wrist with the thumb stabilized in a gripping position. Changing the causative activities combined with hand therapy are key to resolution.
  • Epicondylitis
    This is an overuse syndrome involving strain, resulting in an inflammatory response of the tendon on the inside (golfer's elbow) or the outside (tennis elbow) of the elbow. Repetitive forearm use while gripping is a common cause. Restoration of muscle length and strength are important to recovery.
  • Tendonitis/Tenosynovitis
    Tendonitis or tenosynovitis can occur in the hand, wrist, forearm or shoulder. It is an inflammation of the tendon or of the sheath surrounding the tendon. Discussion of causative factors and activity modification is an important part of recovery in conjunction with splinting and hand therapy.
  • Trigger Finger/Thumb
    If the tendon or tendon sheath in the palm becomes thickened, the finger will lock or click when bent or straightened. Decreased irritation of the tendon by splinting, avoiding of locking or clicking, and minimizing pressure in the palm may decrease the problem.

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    Other Upper Extremity Conditions

  • Arthritis
    Both osteoarthritis and inflammatory forms of arthritis are treated by addressing joint protection issues, splinting, and maintenance exercise programs. Specific problems are addressed with appropriate treatment modalities to decrease pain and swelling and to increase movement and function.
  • Ganglion
    A benign cyst that forms on the back or front of the wrist or on the insides of the fingers. Conservative treatment is aimed to decrease discomfort.
  • Elbow Problems
    Includes fractures, sprains/strains, tennis elbow, golfer's elbow, ulnar nerve transposition surgery.
  • Shoulder Problems
    Includes sprains and strains, tendonitis, rotator cuff injuries, fractures, shoulder dislocations, etc.
  • Neurological Conditions
    Clients who have various chronic neurological conditions, who want to upgrade their hand functioning are assessed for suitability for hand therapy to address their specific goals and concerns.
  • Ergonomic Problems
    The era of specialization has created the potential . for "repetitive strain injuries" in many areas of the work force, including computer use, and assembly lines. Part of the recovery includes looking at the work station, task scheduling, and stretching.
  • Sports Injuries
    This covers a wide range of injuries associated with sports activities, including fractures, dislocations, sprains, and strains. Therapy helps to return the client to regular activities as quickly as possible in a safe fashion.
  • Performing Artist Problems
    Musicians are particularly at risk for repetitive strain injuries because of the nature of practising and performing,. An assessment will help focus treatment on the areas of concern and the underlying problems. Discussion of technique and positioning is key to changing symptoms.
  • Complex Regional Pain Syndrome (CRPS)
    This was previously known as reflex sympathetic dystrophy (RSD). It is an over-reaction to an injury or surgery. Please seek your physician's or hand therapist's advice if you are concerned.

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The information on this website, and the links provided, is not a substitute for a consultation with your physician or hand therapist. It is designed for information only. Be sure to see a doctor and/or hand therapist if you think you have a hand problem.

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