Hand therapists will use a variety of physical methods depending on the condition being treated, including:

• Exercise (active, passive and resisted)

• Joint movement and stretching 

• Tendon glide and function

• Strengthening (including resistance training)

• Grip optimisation 

• Bracing or splinting (including over the counter or bespoke)

• Massage therapy

• Scar care

• Swelling or oedema management

• Proprioception retraining

• Sensory re-education (e.g. following nerve injury)

• Desensitisation techniques 

• Mirror therapy

• Functional assessment

• Aids for work or home (e.g. desk, kitchen or garden aids)

• Education and advice regarding activities of daily living

• Wound care

Not all hand and wrist conditions will require hand therapy. If recommended, Matthew will advise on the expected benefits and limitations of hand therapy.

Some of the conditions that may benefit from treatment by a hand therapist are listed below.

• De Quervain’s syndrome (tendonitis)

• Extensor carpi ulnaris (ECU) tendonitis

• Thumb base arthritis

• Mallet finger

• Finger sprains or stiffness (e.g. following injury)

• Finger arthritis

• Wrist sprains or stiffness (e.g. following injury)

• Wrist arthritis

• Extensor tendon injury

• Flexor tendon injury

• Trigger finger

• Triangular fibrocartilage complex (TFCC) tears

Some milder forms of carpal tunnel syndrome and cubital tunnel syndrome may also benefit from hand therapy (such as for splint advice and nerve gliding exercises).

Many operations, including those for carpal tunnel syndrome or trigger finger, will not routinely require hand therapy. However, Matthew will often recommend simple exercises that will help to provide a speedy recovery and avoid stiffness. 

Matthew will advise of the need for routine post-operative hand therapy in advance of your surgery if it is likely to be required.

Operations that will commonly require post-operative hand therapy include the following:

• Dupuytren’s disease surgery (e.g. fasciectomy)

• Tendon surgery (e.g. repair, reconstruction or transfer)

• Ligament repair or reconstruction surgery (e.g. scapholunate ligament, Skier’s thumb)

• Bone surgery (e.g. fracture fixation)

• Joint replacement surgery (e.g. joint replacement for finger arthritis or thumb base arthritis).

• Wrist surgery requiring an initial period of immobilisation (e.g. fixation for scaphoid fracture non-union, fusion for wrist arthritis)

• Hand or finger surgery requiring an initial period of immobilisation (e.g. fusion for finger arthritis)

Matthew will sometimes recommend hand therapy before an operation in an effort to optimise your joint movement and strength, and to facilitate a discussion regarding the likely therapy requirements following surgery. Pre-surgical hand therapy is sometimes called ‘prehab’ or pre-rehabilitation.

Further information about hand therapy - including a list of Accredited Hand Therapists - is available at the British Association of Hand Therapists (BAHT) website.