Hand Therapy

Here at Rue & Primavera, we specialize in upper extremity injuries, or what is called Hand Therapy. Hand Therapy is a type of rehabilitation performed by an occupational or physical therapist with patients that suffer from conditions affecting the hands and upper extremities. This type of therapy enables patients to hasten their return to a productive lifestyle.

Patients who are good candidates for hand therapy may have been affected by an accident or trauma, leaving them with wounds, scars, burns, injured tendons or nerves, fractures, or even amputations of the fingers, hands or arms. Others include patients who suffer from conditions such as carpal tunnel syndrome and tennis elbow, as well as from chronic problems such as arthritis or a neurologic condition (i.e. stroke).

What Does Hand Therapy Provide?

  • Treatments without an operation
  • Help with recent or long-lasting pain
  • Help to reduce sensitivity from nerve problems
  • Learning to feel again after a nerve injury
  • Learning home exercise programs to help with movement and strength
  • How to make splints to help prevent or improve stiffness
  • Learning to complete everyday activities with special tools
  • Help getting back to work

If surgery is needed, hand therapists can also help with a patient’s recovery. This may include assistance with helping wounds heal, preventing infection, scar management and reducing swelling.

Getting Back to Work

Hand therapists are able to talk with employers about preventing problems for workers with hand or arm symptoms. They may recommend changes at your place of work or different ways of doing your job to help ensure a healthy style of work.

Common conditions and injuries that we treat:

  • Broken arms
  • Carpal tunnel syndrome
  • Cubital tunnel syndrome
  • Tennis elbow -lateral epicondylitis
  • Golfers elbow – medial epicondylitis
  • Elbow fractures
  • De Quervain’s syndrome
  • Dupuytren’s contracture
  • Ganglion cysts
  • Hand fractures
  • Mallet fingers
  • Jersey fingers
  • Rheumatoid arthritis
  • Thumb arthritis, trigger finger/thumb
  • Wrist and finger fractures
  • Shoulder arthritis/tendinitis
  • Shoulder fractures

These conditions are treated with a variety techniques. Some common techniques are:

  • Joint, Soft Tissue, and Neural Mobilization – We utilize different types of mobilization that help decrease stiffness and increase ROM, especially in patients who have had surgery or a fracture. These techniques also help to improve neural function and alleviate pain.
  • Pain Management – By using modalities, massages, and soft tissue technique, we are able to help control pain associated with many persistent injuries that our patients encounter.
  • Edema Control – We aim to decrease swelling through manual edema mobilization with  hands-on techniques or with modalities.
  • Dynamic and Static Splinting – We are adept at both Dynamic and Static splinting. These custom made splints, protect fractures, help soft tissue injuries, and improve range of motion and function by positioning the hand to provide a prolonged low load stretch or in a functional position safe position.
  • Sensory Re-Education and Desensitization – After injuries to small nerves in the hand, we will monitor sensation recovery or will use different textures to decrease hypersensitivity.
  • Joint Protection Techniques – We will educate patients on how to use their upper extremities in daily living to prevent stress to their joints and to help alleviate future injuries that are a result of persistent misuse.
  • Physical Agent Modalities – We use hot packs, cold packs, paraffin wax baths, electricalstimulation, ultrasound, game ready pneumatic compression cryotherapy and other modalities to decrease pain and prepare tissue for manual techniques. Our range of modalities offers advantages that you are unlikely to find at other therapy sites.
  • Work Simulation – In order to allow our patients to return to work in as quick a time as possible, we will review the patient’s job descriptions and develop a treatment plan that targets their injuries efficiently and effectively. It is in our best interest to see our patients healthy and functioning at their optimum level.

Why should I see a hand specialist?

The hand is very complicated and jam-packed with delicate nerves, muscles, and tendons. A small injury can translate into a huge loss of function, and when you consider the thousands of movements our hands make every day, it makes sense that one should invest in the therapist with the most knowledge and experience. Rue and Primavera proudly offers one of the finest teams of hand therapists in Washington State, combining decades of experience with a deep passion for helping people get back their functionality.

Our Hand Therapists

Thomas Primavera has specialized in hand therapy for over 20 years. His experience has been broad; working with severe injuries such as traumatic amputations to intricate tendon transfer surgeries.

Mel Velsher-Hurd graduated with a Bachelor of Science in human, and went on to complete a Master of Science in Occupational Therapy. It was during her time in university that she discovered her passion for hand therapy. Mel has experience working with pediatric patients and neurological insult survivors.

Tabby Brickley graduated with a Masters in Occupational Therapy.  After graduation, she spent 3 years working in outpatient/acute care with patients with neurological and orthopedic deficits.  With each patient, she focuses on person centered and patient directed care to facilitate regaining prior level of functional independence.

Nicki Boehm received her Master of Occupational Therapy. She has experience in both inpatient and outpatient settings, and enjoys working with orthopedic and neurological diagnoses. Nicki strives to make every patient feel welcome and feels blessed to assist them during their recovery.

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I can snap my fingers again!

Teresa Aracto

Oak Harbor, WA