Category : Hand Therapy

Hand Hand Therapy Pencil Grip

Advice from a Certified Hand Therapist: Modifications to Pencil Grip for Handwriting

As a pediatric hand therapist, I see clients who hold their pens and pencils a little bit differently than most. Typically, these clients are using a different grip to compensate for weakness or loose joints. An altered grasp is not in itself a bad thing until it creates a problem.

The problem is usually a complaint of pain with handwriting. An individual with loose joints develops an altered grasp pattern in order to increase stability when writing, thus allowing them to write clearly. An example of a modified grip is excessive extension of the tip of the fingers or thumb along with excessive flexion of the second joint of the thumb.

Another example involves holding the pencil tight in the first web space while using all four fingers and thumb to stabilize the pencil.

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Arthritis Hand Hand Therapy Thumb Thumb Arthritis

Ask a Therapist: Thumb Arthritis

Certified Hand Therapist Michelle McMurray, MOT, OTR/L, CHT discusses thumb arthritis, also known as basal joint arthritis.


Basal joint arthritis, or thumb arthritis, is the most common site of arthritis in the hand.  This may also be referred to as the CMC (carpometacarpal) joint.  Pain typically occurs at the base of the thumb where the hand meets the wrist.  People typically report pain and weakness with grasping or pinching activities. Most people do not realize how important this particular joint is to the function of the hand until it hurts.  The amount of force transmitted through the CMC joint holding a 1-pound object at the tip is amplified to over 13 pounds at the CMC joint.  Basic activities of daily living can require between 6 and 8 pounds of pinch at the tip of the thumb, which would be amplified more than 10 times that at the base of the thumb!  Over time, this can cause break-down of the joint with loss of cartilage (the smooth part of the joint) and inflammation.  This is sometimes a painful process.

When this occurs in the body, what options do we have to feel better?  Most people do not choose surgery as their first option, and it is often not recommended as the first option.  Initial options may include injections, splinting, medications and/or rest.  Additionally, there are modifications that can be made to our daily activities which may also help to decrease the pain.

Here are a few examples of some easy and inexpensive ways to protect your hands to decrease the stress and inflammation at your thumb:

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Hand Hand Surgery Hand Therapy

What is a Hand Therapist?

I have been told to see a hand therapist, but am unsure what that means. Who provides “hand therapy”?

A hand therapist is an occupational therapist (OT) or physical therapist (PT) who has specific training and expertise in treating hand and arm conditions. Typically, this person has spent many additional years gaining expertise with hand and arm injuries and treatment. When an OT or PT has reached this higher level of experience, they often become a Certified Hand Therapist (CHT).

So I can see anyone that is a PT, OT or CHT to take care of my problem?

You will want to ensure that the therapist you see, whether it is an OT or a PT, is qualified to treat your condition. If they are a CHT, it means they have had extra training and passed a rigorous exam to demonstrate their skill. If they are an OT or a PT, they may still treat hand and arm conditions, but you should ask questions to ensure they have spent extra time after their formal education learning about the hand and arm. To find a hand therapist near you, click here.

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Hand Hand Therapy Mirror Therapy Pain

Advice from a Certified Hand Therapist: Mirror Therapy for Chronic Pain

Chronic pain that does not respond to conventional treatment can be frustrating for both the person with the pain and the team of people trying to help alleviate the pain. You may have heard of mirror therapy, but are unsure of what it is or who can benefit. To answer these questions, I consulted Susan Stralka, PT, DPT, MS. Susan has many years of experience treating patients with chronic pain and has lectured around the world on this topic.

What is mirror therapy?

Mirror therapy is a rehabilitation technique that uses the mirror image of a non-painful limb to retrain the brain about its perception of a painful limb. The non-painful limb (such as a hand or foot) is placed in front of a mirror and the painful limb is placed behind the mirror out of sight.

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Hand Therapy Joint Pain Joints

Advice from a Certified Hand Therapist: Techniques to Reduce Joint Pain

For this post, we are sharing a video that demonstrates many techniques you can use on a daily basis to protect your joints. In past posts, we’ve discussed joint protection and gave some examples and illustrations of this. (See Protecting Your Joints and Living With(out) Thumb Pain.)

The video below shows some of those examples in action. The video has no sound, so don’t worry about turning up the volume. As you watch, you will be given some practical pointers. There are some questions in the video, so put on your thinking cap and see what ideas you come up with to take care of your joints.

After watching the video, you may have questions about specific activities and how to make changes to decrease your joint pain. Talking to a certified hand therapist can help you apply these principles to your specific activities, which can help you to keep doing what you want in life.

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Hand Hand Safety Hand Therapy

Advice from a Certified Hand Therapist: Safety Tips to Avoid Common Holiday Injuries

christmas-lights-cropped

Many of us start our holiday preparations by “making a list and checking it twice!” Suddenly, we are overwhelmed by its length. The fact that baking, decorating, shopping, wrapping and travel all come before December 25 can be dismaying. If this describes your current quandary, please continue to read about how you can have a safe and enjoyable holiday season!

The most commonly reported decorating injuries are lacerations, back strains and falls. Luggage-related injuries increased to approximately 75,500 annually, according to the Consumer Product Safety Commission. The American Society for Surgery of the Hand (ASSH) reports that holiday hand injuries are caused by carving a turkey, ham or roast and that tendon and nerve injuries are caused during meal cleanup (contact with a sharp knife or a broken glass).

Here are simple holiday tips for ladder safety, luggage transport and meat carving:

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Hand Hand Therapy Posture Stretching

Advice from a Certified Hand Therapist – Desk Posture Part II

Rear view of young businesswoman sitting at desk stretching. Copy space

Spending extended periods of time at a workstation places high levels of stress on our body, especially our arms and hands. The more time we spend at our work station, the more our muscles fatigue and gravity pulls our body forward. The result is rounded shoulders and a forward head position. Standing or sitting in a static desk posture throughout the day places a lot of stress on our tendons, nerves and muscles. The nerves in our shoulders and arms can become compressed and irritable, which can result in numbness and tingling in our hands. The muscles at the front of our chest (our pectoralis muscles) become tight and the muscles between our shoulder blades become overstretched. As a result, we can develop painful trigger points in these muscles. Over, time these issues become more difficult to correct.

Here are some simple exercises to help prevent these issues:

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Hand Hand Safety Hand Therapy Pumpkin Carving

Advice from a Certified Hand Therapist: Pumpkin fun without knives!

pumpkins-cropped

My children love carving pumpkins at Halloween. I worry about them cutting their fingers. How can we keep everyone’s hands safe?

Take a look at the safety tips published last year by the American Society for Surgery of the Hand (ASSH). The pumpkin carving tools in the kits at your grocery or pharmacy are safer to use than knives. There is a blog article from last year on just this topic!

There are tons of fun decorating ideas that don’t involve young folks using knives. Here are just a few:

  • Use push pins or adhesive jewels to script a word such as “EEK!” or “BOO!” or to draw the outline of a ghost or bat.
  • Push small picture-hanging nails into the pumpkin and use brightly colored yarn wound around the nails for an abstract pattern.
  • After an adult scoops out the pulp and seeds, use a hand drill or spin a screwdriver to punch out the dotted outline of your favorite scary pumpkin face or the outline of a haunted house. A light source inside will shine through the holes and illuminate your scene. A string of Christmas lights can be pushed through the holes for a sparkly effect.
  • Coat your pumpkin with chalkboard spray paint. Use a white chalk marker to create a spooky design.
  • Use a hairdryer to melt crayons over your pumpkin.
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