Hand Therapy and Ageless Guide to Physical Rehabilitation of Hand Dysfunctions

What is Hand Therapy?

Whether it’s lifting a cup, moving a chair or scratching the back of your head, you use your hands in a different set of motions in a three-dimensional plane countless times per minute, yet they resolve in a unified motion to complete the tasks.
For example, if you want to pick up a cup, you think, “No problem.” You reach for it, grasp it, bring it up to your mouth, drink, then put it back down in what you think of as one continuous motion. But actually a series of many complex motions went into performing this simple task. You may not have been conscious of it, but part of your brain was constantly firing a series of commands like an air traffic controller: “Shoulder forward; elbow open; hand rotating, opening, closing; wrist lifting, no tipping, no spilling; bring it to the mouth; easy does it, now stop; check temperature before proceeding.”
Our brain is processing a million things at once, yet we’re barely conscious of it, if at all.
Ageless Physiotherapy Clinic hand therapy is the non-surgical management of hand disorders and injuries using physical methods such as exercise, splinting and wound care, functional simulations using specialized tools, toys, games and techniques. Our hand therapy is also used to treat other upper limb disorders that affect hand function by undertaking diagnosis and treatment of common hand disorders, including injections and requesting and interpretation of x-rays.
We bring together techniques of occupational therapy (scar management, retraining, splinting, and advice on activities of daily living) and physiotherapy (joint mobilizations, stretching, active and resisted exercises, and therapeutic ultrasound).
Our hand therapy has a crucial role in the recovery from injury of the hand or wrist, and in the recovery from hand surgical operations focusing on the acute needs of acquired deficits post surgery or trauma.
How much do you know about your hands?
Mankind’s greatest achievements are all thanks to the capabilities of our hands: gross and fine motor movements. Gross motor movements allow us to pick up large objects, and fine motor movements allow us to pick up much smaller things.
Hands are what raise buildings, paint masterpieces, compose symphonies, and hold newborn child. They are great works of art capable of creating great works of art.
The hand can be considered in four segments:
• Fingers: Digits that extend from the palm of the hand, the fingers make it possible for humans to grab the smallest of objects.
• Palm: This is the bottom of the body of the hand,
• Back (opisthenar): The spot that everyone knows so well, the back of the hand shows the dorsal venous network, a web of veins.
• Wrist: The connection point between the arm and the hand, the wrist facilitates hand motion.
Each hand consists of 27 bones. The palm includes five metacarpals, and each finger except the thumb contains one proximal phalanx, one middle phalanx, and one distal phalanx. The thumb doesn’t have a middle phalanx. Each bone is connected by a series of ligaments.
The hand has a very delicate and complex structure, which allows muscles and joints in the hand a great range of movement and precision. The different forces are also distributed in the hand in the best possible way. But the hand is also quite vulnerable: tendons, nerve fibers, blood vessels and very thin bones are all positioned right under the skin and are only protected by a thin layer of muscle and fat. Only the palm is protected by a strong pad of tendons (aponeurosis) for a powerful grip. Our hands are put through quite a lot day in and day out, and are often within range of dangerous tools. This makes hand injuries and problems due to wear and tear very common.
The right and left hand are each controlled by the opposite hemisphere of the brain. Usually one hand is preferred for fine and complex motion, leading us to speak of someone as being either right- or left-handed.
Each fingertip—distal phalanx and accompanying tissue—contains a fingernail. These structures are made of keratin, a tough protein. Similar types of keratin also make up human hair, the scales and claws of reptiles, and the feathers, claws, and beaks of birds.
The palm of the hand doesn’t contain melanin (skin pigment) or hair follicles. The only other place on the body that lacks both of these is the sole of the foot. These two surfaces also have thicker skin than other places of the body.
Although fully functional hands can accomplish great things, they are susceptible to a number of ailments, including:

• Arthritis
• Burns
• Cumulative trauma
• Finger/wrist joint replacement
• Fractures
• Lymphedema
• Neuromuscular weakness
• Peripheral nerve injuries/repairs
• Reflex sympathetic dystrophy (RSD)
• Skin grafts/flaps
• Sprains/strains
• Tendinitis
• Tendon and ligament injuries and repairs
• Tumors
• Brachial Plexus Injuries
How does the hand functions?
To grasp and move objects, the hand has two different ways of gripping things:
• power grip
• precision grip
The technique used depends on whether the object is very large and very heavy, and what sort of shape it has and how easy it is to handle. The power grip is better suited for large, heavy objects, and the precision grip is used for small, lighter objects.
Power grip
The power grip is used for carrying heavy bags or for holding on to a handle, for example. In the power grip, the object is held in the palm of the hand, the long flexor tendons pull the fingers and the thumb so that they can tightly close around the object. This grip is made possible by the four other fingers flexing and, more importantly, the ability of the thumb to be positioned opposite the fingers. With the hand in this position, larger objects such as a stone or a heavy bottle can be held and moved in a controlled way. The greater the weight and the smoother the surface is, the more strength is needed for holding and moving the object.
Precision grip
The precision grip is important for delicately handling and moving an object, for example when writing, sewing or drawing. When using the precision grip, the thumb and the index finger work like a forceps: The thumb is opposite one or more fingertips, allowing the hand a controlled grip of even very small objects like a pencil or fine instruments. Depending on the weight of the object and the direction and speed of the movement, the brain directs the use of force and coordinates the muscles of the hand.

Dumbbell Exercise_0

Our Hand Therapy Techniques
• Edema control
• Electrical stimulation
• Functional activities related to joint mobilization
• Manual lymph drainage
• Massage activities of daily living
• Myofascial release
• Neuro-developmental treatment
• Neuro-muscular re-education
• Patient education (e.g. energy conservation, work simplification, adaptation, joint protection principles)
• Scar release therapy
• Soft tissue mobilization
• Splinting
• Therapeutic exercise
• Thermal modalities (hot/cold therapy)
• Trigger point therapy
• Wound care
What we will be evaluating?
• Atrophy
• Deformities
• Dexterity
• Edema
• Endurance
• Home management
• Neurovascular status
• Pain
• Range of motion
• Scars
• Sensation
• Skin/nail conditions
• Stiffness
• Strength
• Vocational/avocational tasks
At Ageless Physiotherapy Clinic, our highly specialized physical rehabilitation programs for hand dysfunctions are geared towards restoring hand functions making it possible for the patient to use the hands again for work, lifestyles and other activities of daily living.
Our overriding objective is clear. Your physical rehabilitation is not yet complete until your hands functions are restored to an effective stage making you to perform functions you are used to either at work or at home or during recreation activities. Hand therapy is always a hard journey to undertake but we make your therapy exciting and rewarding by introducing techniques that are entertaining, imaginative and functional.
Why don’t you book a place today so we can help you restore that hand functions.


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