Occupational Therapy

Hand Therapy & Splinting


"Working with a knowledgeable hand therapist can make the difference between success and failure in complex hand surgical cases. The therapist extends the continuum of our care, as well as functioning as coach and trainer for our patients.” - Marybeth Ezaki, MD, Past President, American Society for Surgery of the Hand"

Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper extremity (shoulder, arm, elbow, forearm, wrist and hand). 

Our hand therapists (occupational therapists OT ) are proficient in treatment of pathological upper extremity conditions resulting from trauma, disease, congenital or acquired deformity.  They have advanced training through integration of knowledge in anatomy, physiology and kinesiology as well as clinical experience.

A hand therapist may achieve advanced certification as a certified hand therapist, referred to as a CHT. To obtain the CHT credential, a hand therapist must practice for a minimum of three years, accumulating at least 4,000 hours of treatment for hand and upper extremity disorders. Certified hand therapists must also pass a rigorous certification exam to demonstrate their competency in the practice. 

CHTs specialize in treating hand and upper extremity conditions. They work closely with orthopaedic and general surgeons who also specialize in the hand to ensure maximal outcomes for patients.

Hand therapists bridge the gap from medical management of upper extremity conditions to successful recovery, allowing individuals to function normally in their daily lives. Hand therapists provide non-operative interventions, preventative care and post-surgical rehabilitation for a wide variety of upper extremity disorders, from simple fingertip injuries to complex replanted extremities. Patients with chronic conditions, such as arthritis, or neurologic conditions, such as a stroke, can benefit from therapy through education on joint protection and energy conservation, and with recommendations for adaptive equipment or devices to improve function. A hand therapist employs a variety of techniques and tools, including activity and exercise programs, custom orthotic fabrication, management of pain and swelling and wound and scar care. A hand therapist can also be a consultant in the industrial world, training employees in healthy work habits.Fabricated splints/orthotics* may be static, dynamic or static progressive. Static orthotics are often used to put part or all of the elbow, wrist & hand at rest so that diseased or injured tissue can be supported and undergo uninterrupted healing. Dynamic or static progressive orthotics are used to add mobilizing tension to influence tissue healing and scar maturation, minimizing the development of restrictive scar tissue that is so detrimental to tendon excursion and normal joint motion. Whether the injured part is immobilized or mobilized depends on the current phase of tissue healing. Static orthoses are generally made to protect healing structures such as a fracture, a collateral ligament strain or repair, but are also used effectively to decrease pain during functional activity with a diagnosis such as CMC arthritis or tendonitis.

The advantages of custom fabricated orthotics are:

  • Removable for wound care, bathing, or gentle exercise if appropriate.
  • Easily adjusted if uncomfortable
  • Any position requested can be achieved with the low-temperature plastic
  • Able to clean as needed
  • Can get wet
  • Adjustable as swelling decreases or as able to get into a better position