The Fort Worth Hand Therapy Center at the Orthopedic & Sports Medicine Institute (OSMI) offers comprehensive hand and upper extremity rehabilitation services provided by physical and occupational therapists, including a Certified Hand Therapist.
Our mission at the Fort Worth Hand Therapy Center is to provide an encouraging, patient-focused environment that achieves the goals of our patients and referring physicians.
As stated by the American Society of Hand Therapists, “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). Hand therapy uses a number of therapeutic interventions to help return a person to their highest level of function.”
Hand Therapy Center for Hand Injuries and Conditions
The Fort Worth Hand Therapy Center therapists work directly with their patients and referring physicians to treat the following injuries and conditions:
- Repetitive motion disorders
- Tendon injuries
- Peripheral nerve injuries
- Crush injuries
- Arthritic conditions
Hand Therapy Services:
- Customized home exercise programs
- Post op management
- Custom orthosis fabrication
- Wound and scar management
- Manual therapy
- Joint mobilization
- Edema management
- Taping techniques
Outcomes of Hand Therapy Services
The duration of upper extremity rehabilitation varies depending on the patient’s goals and severity of their condition. Most patients can expect:
- Decreased pain
- Improved range of motion
- Improved strength
- Improved coordination
- Improved sensation
- Return to regular activity
- Patrick C. Kimball, PT, CHT – Physical Therapist
- Tiffany C. Montgomery, MOT, OTR – Occupational Therapist
- Lindsey D. Snow, MOT, OTR, ATC, LAT – Occupational Therapist
OSMI Therapy Clinics Location Information
Hand therapy and rehabilitation is a sophisticated science due to the intricate design of the fingers, thumb, hand, wrist and elbow, which makes it an extremely complex organ. Even minor hand injuries can lead to potential problems in hand function if not evaluated and treated promptly.
The hand and wrist are made up of 27 bones, muscles, tendons, ligaments, nerves, arteries, veins, and joint cartilage.
With constant use, the potential for injury to the fingers, thumb, hand, wrist, and elbow can be great. The Hand Therapy Center at the Orthopedic & Sports Medicine Institute (OSMI) in Fort Worth offers comprehensive hand and upper extremity rehabilitation services provided by physical and occupational therapists, including a Certified Hand Therapist.
Surgery of the Fingers, Thumb, Hand, Wrist and Elbow
Hand & Wrist Disorders
- Boutonnière Deformity
- Carpal Tunnel Syndrome
- Compartment Syndrome
- Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy)
- Cubital Tunnel Syndrome
- De Quervain’s Tenosynovitis
- Dupuytren’s Contracture
- Ganglion Cyst of the Wrist and Hand
- Kienböck's Disease
- Mallet Finger
- Mucous Cyst
- Trigger Finger
- Ulnar Tunnel Syndrome of the Wrist
- Volar Retinacular Cyst
- Arthritis of the Hand, Thumb and Wrist
Postsurgical Rehabilitation of the Hand, Wrist and Elbow
Postsurgical rehabilitation of the hand, wrist and elbow will involve occupational therapy to regain the fine-motor skills in your fingers, thumb, hand, wrist, or elbow. An individualized therapy plan will be designed to restore functional use in the affected area as soon as possible.
Rehabilitative goals after hand, wrist or elbow surgery include:
- Restoration of functionality
- Prevention of further disability
- Improvement in daily task performance
- Closely following your personal occupational therapy plan will greatly assist in recovering strength and motion.
Sports Injuries and Other Trauma
Sports injuries to the hand, wrist and elbow often involve a crushing blow which affects soft tissues, as well as the bony skeleton. Traumatic hand injuries sustained during sports are common, and typically a result of falling onto an outstretched hand or a forced twisting of the hand or arm. Trauma, in general, is usually due to an accidental injury such as:
- Deep cut
- Piercing wound
Fractures of the Wrist, Hand or Fingers
Fractures of the wrist, hand or fingers are some of the most common types of hand injuries. Fractures usually heal well with rehabilitation and casting to immobilize the bone, but depending on the location and severity of the fracture, can require a surgical procedure. Fractures typically present as:
- Restricted movement of the area
- Severe fractures can cause a deformity, while more minor fractures may have minimal symptoms. An x-ray is the best way to determine whether a bone is fractured.
Injured Tendons or Nerves of the Fingers, Hands or Arms
Hand and arm lacerations often result in injury to tendons or nerves. The inability to extend or fully flex a thumb or finger is an indication of soft tissue damage. Tendon and nerve repair has become state-of-the-art with modern microsurgical techniques. Tendon strengthening after repair can take 3-5 months and nerve regeneration can take 6-18 months.
Amputations of the Fingers, Hands or Arms
Amputations of the fingers, hands and arms are unfortunately not uncommon, and always require immediate emergency treatment to achieve optimal recovery. Replantation (the reattachment of the amputated part) is a highly technical surgery in which multiple structures (bones, nerves, muscles, arteries, tendons, and veins) must be reconnected. An intense rehabilitation program is usually necessary following replantation. On a smaller fingertip amputation, reconstruction may be obtained through the use of skin flaps transferred from another part of the body.
Elbow Injury or Dislocation
Elbow injuries can range from minor aches and pains, which can be treated at home, to more serious problems including:
- Ruptured or torn muscles
Elbow dislocation occurs when the joint surfaces of the elbow become separated, either partially or completely. Dislocation of the elbow is often the result of a fall or car accident in which the patient’s outstretched hand hits a surface and the force travels to the elbow. Realignment can typically be done in the emergency room, unless the dislocation is complex and requires surgery. Recovery will include immobilization and physical therapy.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common hand disorder in which the median nerve in the wrist becomes compressed due to swelling in the tunnel that contains the nerve. Carpal tunnel syndrome can cause tingling, numbness, and pain in the fingers and hand, especially at night or during a grasping activity. Carpal tunnel syndrome is often a result of repetitive motion, but can be associated with diabetes, rheumatoid arthritis, some thyroid disorders, and other medical conditions.
Arthritis of the Fingers, Hand, Wrist or Elbow
Arthritis is a common inflammatory disorder that can affect the joints of the fingers, hands, and wrists causing swelling, stiffness and pain. Osteoarthritis (wear and tear arthritis) involves the deterioration of joint cartilage resulting in direct contact of the bones. Rheumatoid arthritis is a disease that begins as inflammation in the joint lining and can eventually cause tendon ruptures and joint destruction if left untreated.
Repetitive Stress Injuries of the Fingers, Hand, Wrist or Elbow
Repetitive stress hand injuries are caused by repetitive motion of the fingers or wrists oftentimes in a work setting or during a sports activity. Repetitive stress injury symptoms can include pain, tingling, or numbness in the hand, wrist, or forearm which develops gradually as the area is overused. Common types of repetitive stress injuries are:
Tennis elbow, also known as lateral epicondylitis, is an inflammation of the tendons that attach the muscles on the outside of the elbow. Small tears create scar tissue under the tendons which leads to inflammation, tenderness, and pain in the elbow and surrounding area. Bending the wrist, gripping and lifting heavy objects may be especially painful, as these muscles extend from the elbow to the wrist.
Tendonitis of the hand is an inflammation of the cords which attach the muscles in the hands to the bone. Tendonitis is often a result of repetitive motion, and presents as pain and stiffness. Tendonitis can become chronic if not treated properly.
Bicipital tendonitis, or biceps tendonitis, is an inflammation of the biceps tendon which connects the muscle to the shoulder bone. Bicipital tendonitis is typically caused by daily wear and tear, but can be worsened with repetitive activities and overuse. Bicipital tendonitis usually causes pain in the shoulder, and often accompanies additional shoulder problems such as:
- Rotator cuff damage
- Instability or dislocation
- Glenoid labrum tears
Dupuytren’s disease, also known as Dupuytren’s contracture, is a hand condition in which nodules develop in the palmer fascia (the tissue in the palm of the hand). Dupuytren’s disease is a hereditary disorder affecting 20 times more men than women, and often those of Northern European descent. Dupuytren’s nodules are typically painless, but over time, can develop into rope-like cords which may cause finger flexion and require surgery.
Entrapment syndromes, or entrapment neuropathies, are disorders in which peripheral nerves are compressed causing numbing, weakness, and pain. Common entrapment syndromes include carpal tunnel syndrome, affecting the median nerve in the hand, and ulnar nerve entrapment (Cubital Tunnel Syndrome), which involves the nerve across the elbow within the cubital tunnel. Treatment can include hand therapy and possibly a surgical decompression of the affected nerve.
Overuse syndromes of the hand, wrist, and elbow are common due to daily activities that we routinely perform. Overuse injuries are often a result of a repetitive motion related to sports, work, or hobbies. Common overuse syndromes include:
- Carpal tunnel syndrome
- Golfer’s or tennis elbow
- De Quervain’s disease
- Cubital tunnel syndrome (ulnar nerve entrapmen)
- Flexor tendonitis
Myofascial Pain Syndrome (MPS)
Myofascial pain syndrome (MPS) is a condition characterized by chronic muscle pain, often resulting from strain, repetitive motion, or stress on the skeletal muscles. Myofascial pain is usually localized and can involve trigger points and muscle knots which can limit range of motion. Heavy lifting, fatigue, and muscle weakness can contribute to MPS. Anti-inflammatories, muscle relaxants, and massage therapy are effective treatments.
Epicondylitis is the inflammation of the tissue and muscle surrounding the elbow. Epicondylitis is usually caused by repetitive forearm strain, such as that associated with tennis, golf, painting, or using certain tools. Treatment for epicondylitis can involve physical therapy, rest, pain relievers, ice therapy, and the use of a brace.
Cubital Tunnel Syndrome
Cubital tunnel syndrome, or ulnar nerve entrapment of the elbow, is a compression of the ulnar nerve, which runs through the cubital tunnel at the inside of the elbow. Ulnar nerve compression causes numbness and tingling in the ring and little fingers of the affected arm, usually when the elbow is bent.
Contributing factors include:
- Cysts or swelling at the elbow joint
- Bone spurs or arthritis of the elbow
- Previous elbow fracture or dislocation
- Repetitive bending of the elbow
Complex Regional Pain Syndrome (CRPS)
Complex regional pain syndrome (CRPS) is an uncommon systemic disease which involves chronic pain, generally in the arm or leg. CRPS affects approximately 3 times more women than men, and is characterized by severe pain, sensitivity to touch, and changes in the skin. Most cases of CRPS present after an illness, injury, surgery, or trauma to the affected limb. Early treatment of CRPS is usually effective, but if left untreated, the limb can atrophy, become cold and pale, and develop muscle contracture which may be irreversible.
Bone Spurs at the Elbow (Osteophytes)
Bone spurs at the elbow are bony projections at the edge of the elbow joint where the ligaments, tendons, and muscles attach. Bone spurs can be caused by osteoarthritis or injury. While bone spurs are often asymptomatic, they can cause swelling, tearing, and pain in the surrounding tissue. Bone spurs at the elbow can be treated with anti-inflammatories and ice application, but surgery may be necessary if the bone spur interferes with functionality.
Joint Replacements of the Hand, Wrist and Elbow
Joint replacement of the hand, wrist, or elbow may be necessary in severe cases of osteoarthritis, rheumatoid arthritis, or any other joint degenerating condition. Joint replacement involves replacing the damaged joint with an artificial metal joint (in the case of wrist or elbow replacement) or a metallic pyrocarbon or silicone implant (in the case of a finger joint replacement). Joint replacement surgery on the wrist, hand and elbow is typically an outpatient procedure. Several months of rehabilitation therapy will be necessary after joint replacement surgery of the hand, wrist or elbow.
If you are ready to choose a team of hand, wrist and elbow orthopedic and sports medicine specialists that offer state-of-the-art treatment and highly personalized care, contact the OSMI office or call 817-529-1900 today!