DRAFT: This module has unpublished changes.

11 November 2010

1:30-3:30pm   2 hours

Accumulated Hours: 42.5

  Ultra sound is used commonly within hand therapy to deep massage and heat areas within the hand. Ultra sound primarily serves to break up scar tissue and swelling and loosen up the injured area. The ultra sound machine requires “ultra sound gel” applied generously to the area as the machine should not come in direct contact with the skin; a thick layer of gel should be between the skin and tool at all times. Patients should not (and never have) feel heat from the tool on the surface of their skin whatsoever. The therapist then massages the area with the rod shaped tool in small circular motions for a specific time period. Ultra sound is usually used in the beginning or middle of the session.

  Another common tool used in therapy is a machine called stem which triggers and fires the muscles/tendons based on where it is applied. Here the therapists places two to four sticky circular pads to the hand different distances apart to reach different intensities. These are wired to a machine and begin to vibrate at timed intervals based on the intensity the patient is able to tolerate. Stem is often used while icing the hand as to reduce swelling after therapy and acts as a cool down after a session of exercise.  

  A lady came in today that had broken her finger in June and had six screws placed between the middle joint and bottom joint to hold the shattered bone in place in July. The tendon became completely caught in scar tissue and became immovable. A week ago the doctor went back in and removed the screws and freed the tendon in the top of the finger then had to make a large incision and then free the finger from the bottom of the finger. She was sent to ph6sical therapy immediately after the6 s7rgery and was at first put in a splint that  held the finger at a 90 degree angle. Her finger does not straighten and is sore and swollen from the surgery. It is very important to keep the finger sterilized at this point because infection is easy to get so soon after surgery. Nicole wears gloves, uses rubbing alcohol to sterilize tools and pours sterilizing solution and saline on the finger after and during a warming bath. The patient is told to passively stretch the finger straight and then try to do the same voluntarily. It is too soon to use heat, stem, or ultra sound on the finger. Her exercises include squeezing pencils, rolling a ball to straighten the finger, and doing fist exercises.

  Another sliced the two tendons in his pinky and ring finger completely in half while carving pumpkins in the end of October. The surgeon sewed the tendons back together and the patient is currently in a splint restricting all motion. For now he s told not to make any sudden movement or a sharp fist as it may rip the stitching inside the finger. He is told to passively stretch the finger into a lose uncurled fist to start movement of the tendons through scar tissue.

  To become a hand therapist you first get a degree in Occupational or Physical therapy then become a certified hand therapist. Anne is a physical therapist while Nicole and Tracy are occupational therapists and all three are certified hand therapists. I am leaning towards occupational therapy however would like to research the difference between the two more in depth.

DRAFT: This module has unpublished changes.