April’s blog post discussed Occupational Therapy as a whole and how our profession is able to improve a person’s life across all ages. This month we will be highlighting the Hand Therapy specialty to celebrate the upcoming Hand Therapy Week in June.
What is Hand Therapy?
Hand therapy is a highly specialized area of clinical practice. Hand therapy providers are dedicated to understanding detailed anatomy and kinesiology related to injuries and disability of the hand and upper extremity. Any occupational therapist (OT) can work in hand therapy, but for those that have advanced understanding of treatment of the upper extremity there is an additional specialty certification called Certified Hand Therapist (CHT). Hand therapy is a special area of practice where both OTs and physical therapists (PT) can treat patients. Hand therapy specializes in the evaluation, assessment, and treatment of upper extremity injuries, spanning from the shoulder to the fingers. This includes providing patient education, and utilizing current research and clinical standards. Common therapeutic interventions within hand therapy include individualized therapeutic exercises and targeted manual therapy, which ultimately improve performance of desired daily activities.
Certified Hand Therapist
The field of hand therapy is highly specialized and as such, is a very developed area of practice. In fact, a CHT has an additional credential that practitioners can pursue once pre-requisite criteria are met. These criteria include practicing as an OT or PT for a minimum of three years, completing and logging at least four thousand hours specifically treating the upper extremity, and passing the certification exam. The CHT exam includes questioning including: upper extremity anatomy, injuries and diseases, splinting, and clinical application all pertaining to skilled treatment. Furthermore, this exam holds a very low passing percentage, reinforcing the prestige of the credential. Specializing and going beyond to obtain additional credentialing in this field express the provider’s knowledge and skills in treating the upper extremity. To put this into perspective, there are less than seven thousand CHTs around the world.
• Number of CHTs via HTCC: 6,967
• The American Society of Hand Therapists (ASHT) was founded in 1977. The first official meeting of the ASHT was in 1978 and was held in Dallas, Texas. In 1987, the ASHT agreed upon an official hand therapy certification process and the first Certified Hand Therapy Exam was administered in 1991.
• In 1989, The Hand Therapy Certification Commission (HTCC) incorporated and separated from the ASHT to form its own distinct organization that sponsors the voluntary credentialing of OTs/PTs who specialize in upper extremity rehabilitation.
Why Adrian chose Hand Therapy:
The first time I heard of hand therapy was from a childhood friend. During college, she had an accident with a can opener, resulting in an involved laceration to her pinky. During her recovery, she was referred to a Certified Hand Therapist that was also an OT. Knowing that I was in the process of applying to OT school, my friend reached out to me to let me know that she was really enjoying her experience in hand therapy and encouraged me to explore this area of practice. Being a self-proclaimed crafty gal and playing several instruments, I already had a deep appreciation of my hands and their capabilities. However, confused as to what hand therapy might entail, I reached out to a local sports clinic with the intent of observing. Instantly, I was fascinated with splinting and appreciated the science behind the “toys”. Around this same time, I enrolled in a prerequisite course to apply to OT school. On the first day of the course our instructor stated, “There are 9 muscles in your thumb alone”, and I was hooked. I knew this was a field where I would stay amazed by the intricacy of the upper extremity. I also appreciate that this specialty encourages development and advancement via credentialing, courses, and working with other healthcare providers. My interest in hand therapy was solidified when I completed a FW-II rotation with David at the close of my graduate schooling. Currently, I am anticipating sitting for the CHT exam in November of 2020.
Why David chose Hand Therapy:
I did a FW-II clinical rotation in hand therapy while in OT school. At that time, I fell in love with hand therapy and knew that I was going to be a CHT someday. Our hands are our primary avenues to independence. I enjoy being able to make a big difference in a person’s life in a relatively short amount of time. I also enjoy the science and technical nature of hand therapy. Having a B.A. in philosophy, I enjoy problem solving and critical thinking. Hand therapy requires a lot of clinical reasoning and problem solving to achieve the maximal outcome. We also get to allow our creative side to come out in the form of custom splinting. As a clinic, we take pride in fabricating excellent custom splints and is another enjoyable part of being a hand therapist. In summary, hand therapy incorporates my desire to help people in a significant way while challenging my critical thinking skills and allows my creative side to come out as well.
Why Kristen chose Hand Therapy:
Starting from a young age as an athlete I spent time with several athletic trainers and physical therapists where I starting learning about how the body functions from an orthopedic perspective. Specifically, in volleyball I had a few hand and shoulder injuries resulting in trips to the training room, where I understood first-hand how daily function is affected by injuries. I was very fortunate that I met David and Oliver at Covenant Hand Therapy in Plano, TX and was guided by them from the beginning of my occupational therapy journey. I ended up working with them as a therapy technician while in college to get more experience in preparation for graduate school and developed a love for hand therapy. I enjoy how critical thinking, knowledge of anatomy, and creativity are married to create a person-centered approach to healing. I also like the level of specialization required to treat hand to shoulder injuries including custom splinting, manual techniques and implementation of skilled treatments. We are working on peoples’ hands, which are used every day and is very personal. We are all people first, getting to know each patient I work with brightens my day and using my skills to help them recover reaffirms that I am in the right field.
Why Oliver chose Hand Therapy:
I chose the hand therapy specialty after completing my clinical internship in an outpatient orthopedic clinic at Charity Hospital in New Orleans under the mentorship of my clinical instructor, Rennie Jacobs. During my time there, I was exposed to several hand and upper extremity injuries, including fractures, carpal tunnel syndrome, tendonitis, and even more medically complex traumas, including gunshot wounds and knife injuries. I thoroughly enjoy several aspects of hand therapy, including the relatively fast and progressive improvement of patients as a direct result of the specialized therapy provided, as well as the skill, precision, and creativity required for custom splinting.