Elbow, Wrist, Hand
Specialist Rehabilitation and Therapy
An effective and targeted rehabilitation program after an orthopedic injury is crucial in regaining optimum function after your surgery or period of rest.
Our team of Hand & Upper Limb Therapists are specialized in orthopedic conditions of the Elbow, Wrist and Hand. Working closely with you and your referring Surgeon/Orthopaedic Doctor, we tailor a program that effectively targets the restoration of your Mobility, Strength and Function to enable you to return to your best life and sporting activities that you love.
Post Surgical Rehabilitation of the Elbow, Wrist & Hand is an area of clinical specialty that our Hand & Upper Limb therapists treat. Working closely with your Surgeon, we manage surgical scars, swelling, range of movement and strength issues on a post operative time line closely according to your fracture/ligament recovery.
Non Surgical Rehabilitation of injuries arising from a wide variety of sport are also a clinical specialty of treatment. In these cases, effective diagnosis and treatment of the root cause, coupled with appropriate manual techniques along with movement analysis and resistive training has helped so many of our patients regain a pain-free return to sport again!
Specialized Custom Splinting and Orthoses for a wide variety of conditions from repititive stress injuries, to supporting orthoses for a recovering fracture or ligament tear also form part of our specialized clinical services. Our custom splints and orthoses are fabricated from premium light weight thermoplastic materials and moulded to your hand to ensure a comfortable fit, making it a wearable companion in your daily activities.
Fractures
Finger Fractures
Finger fractures occur when one or more of the bones in the fingers, known as phalanges, are broken. The fingers are made up of 14 phalanges: three in each finger (proximal, middle, and distal phalanges) and two in the thumb. Fractures can occur in any of these bones due to trauma, such as a fall, a direct blow, or a twisting injury. Depending on the severity, a finger fracture can cause pain, swelling, bruising, and difficulty in moving the finger. It’s crucial to treat finger fractures promptly to prevent long-term issues such as stiffness, deformity, or loss of function.
Treatment Options:
Splinting: For simple fractures, a splint or cast may be used to keep the finger immobilized and in the correct position as it heals. This helps prevent further injury and promotes proper alignment of the bones.
Reduction: If the bones are misaligned (displaced), a procedure called reduction may be necessary. This involves realigning the bones manually, often followed by immobilization to maintain proper positioning.
Surgery: In cases of severe fractures, especially those that are displaced, open, or involve multiple fragments, surgical intervention may be required. This could involve the use of pins, screws, or plates to stabilize the bones during healing.
Physical Therapy and Rehabilitation: After the initial treatment, rehabilitation is crucial to restore movement, strength, and function. Occupational therapy focuses on exercises and techniques to improve flexibility, reduce stiffness, and regain dexterity in the finger.
Wrist Fractures
The wrist joint is a complex structure comprising multiple small bones, ligaments, tendons, and muscles. The two major forearm bones, the radius and ulna, connect to a group of eight small bones known as the carpal bones. These carpal bones, along with the radius and ulna, form the wrist joint. A wrist fracture refers to a break in one or more of the bones in the wrist joint, such as the radius or ulna. It is often accompanied by pain, swelling, bruising, and difficulty moving the hand and wrist.
Treatment Options:
Splinting: We fabricate a custom wrist splint to immobilize your fracture and support healing during the initial recovery period until you are cleared to begin movement exercises.
Swelling Management: We employ strategies to manage and reduce swelling, ensuring optimal healing conditions for your wrist.
Exercises: We design targeted exercises to restore flexibility and strength, helping you regain full function in your wrist.
Manual Therapy: We use manual therapy techniques to alleviate pain, improve mobility, and support the healing process.
Functional Training: We provide functional training to help you return to your daily activities with confidence and ease.
Scar Management: For post-surgery cases, we offer scar management to minimize scarring and improve the cosmetic and functional outcomes of your recovery.
Elbow Fractures
The elbow joint is a hinge joint that connects the upper arm bone to the two bones in the forearm An elbow fracture can refer to a break in any of the 3 bones, or a combination of them as well. There are many muscular attachments around the elbow that help you move your arm, wrist, and hand. The bones of the elbow are connected by ligaments on the inner and outer part of your arm. These may be affected due to the injury as well.
Treatment Options:
Splinting: We may fabricate an elbow splint to immobilize your fracture for the first 4-6 weeks to support healing before you are cleared to start range-of-motion exercises.
Swelling Management: We use methods to manage and reduce swelling, facilitating optimal healing of your elbow.
Exercises: We provide targeted exercises to restore flexibility and strength in your elbow, aiding in functional recovery.
Manual Therapy: We apply manual therapy techniques to alleviate pain, enhance mobility, and support the healing process.
Functional Training: We offer functional training to help you resume your daily activities with confidence and ease.
Scar Management: For post-surgery cases, we implement scar management techniques to minimize scarring and enhance cosmetic and functional outcomes.
Forearm Fractures
The forearm consists of two long bones: the radius and the ulna. The radius is located on the thumb side of the forearm, while the ulna is on the pinky side. Fractures can occur in either or both of these bones due to trauma, such as falls, direct impacts, or accidents. Symptoms of a forearm fracture may include pain, swelling, bruising, and difficulty moving the wrist or elbow. Proper diagnosis and treatment are essential to ensure correct healing and restore full function.
Treatment Options:
Splinting: For many forearm fractures, immobilization with a cast or splint is used to keep the bones in place during the healing process. This approach is typically recommended for non-displaced or stable fractures.
Reduction: If the bones are misaligned, a procedure called reduction may be necessary. This involves realigning the bones manually or surgically to ensure proper healing.
Surgery: Severe or complex fractures, especially those involving multiple fragments or significant displacement, may require surgical intervention. This can include the use of plates, screws, or pins to stabilize the bones.
Physical Therapy: Once the fracture begins to heal, physical therapy is important to restore movement, strength, and flexibility. Therapy includes exercises designed to improve range of motion, strengthen the forearm, and facilitate a return to normal activities.
Pain and Swelling Management: Throughout the healing process, pain and swelling management techniques, such as ice, elevation, and medications, are used to alleviate discomfort and support recovery.
Functional Rehabilitation: After the initial healing phase, functional rehabilitation focuses on regaining full use of the forearm. This includes exercises and activities to help you resume your daily routines with improved strength and coordination.
Ligaments Tears/Strains
Wrist Ligament Tears
The scapholunate ligament is a band of tissue that connects two important bones in the wrist, the scaphoid and lunate. It plays a crucial role in maintaining stability and proper alignment of the wrist joint. The injury occurs when this ligament is stretched, torn, or otherwise damaged. It is often caused by a fall onto an outstretched hand, repetitive stress, or a sudden forceful impact. Common symptoms include pain, swelling, tenderness, weakness, and difficulty gripping or moving the hand and wrist. The wrist may feel unstable, and activities requiring fine motor skills, like writing or using utensils, can become challenging.
Treatment Options:
Immobilization and Protection: Initially, therapy may involve immobilizing the wrist with a splint or brace to protect the injured ligament and promote healing.
Range of Motion and Strengthening Exercises: We provide exercises to restore range of motion and strengthen the wrist, aiding in recovery and function.
Joint Stabilization Exercises: We incorporate joint stabilization exercises to enhance wrist stability and support the healing of the ligament.
Pain and Swelling Management: We use techniques to manage pain and reduce swelling, facilitating a more comfortable recovery process.
Functional Training: We offer functional training to help you resume your daily activities with improved wrist strength and coordination
Elbow Ligament Tears
The elbow joint is a complex joint that is stabilized by several ligaments. The ligaments of the elbow include the ulnar collateral ligament (UCL) on the inner side of the elbow, the radial collateral ligament (RCL) on the outer side of the elbow, and the annular ligament that wraps around the head of the radius. Injuries to any or a combination of these ligaments can occur due to repetitive stress, trauma, or overuse.
Treatment Options:
Splinting: We may create an elbow splint to immobilize the joint, allowing the ligaments to heal during the first few weeks of recovery.
Swelling Management: We implement techniques to reduce swelling, aiding in the healing process and improving comfort.
Exercises: We provide targeted exercises designed to restore flexibility and strength in the elbow.
Manual Therapy: We use manual therapy to alleviate pain, improve mobility, and support the recovery of the elbow ligaments.
Functional Training: We offer functional training to help you resume daily activities with improved elbow strength and stability.
Scar Management: For post-surgery cases, we focus on scar management to enhance healing and minimize scarring.
Repetitive Strain Injuries
De Quervain’s
De Quervain’s tenosynovitis is a condition that affects the tendons on the thumb side of the wrist, specifically the abductor pollicis longus and extensor pollicis brevis tendons. These tendons are responsible for thumb movement and, when inflamed, can cause pain and tenderness at the base of the thumb. This condition often results from repetitive thumb motions or overuse, leading to difficulties in gripping, pinching, and overall thumb function.
Treatment Options:
Immobilization: We may provide a splint or brace to immobilize the thumb and wrist, allowing the inflamed tendons to rest and heal.
Swelling and Pain Management: Our therapists use techniques to manage swelling and reduce pain, ensuring a more comfortable recovery process.
Manual Therapy: We employ manual therapy to relieve pain, improve tendon function, and enhance overall wrist mobility.
Targeted Exercises: We design specific exercises to restore flexibility and strength to the thumb and wrist, promoting long-term healing.
Activity Modification and Functional Training: We offer guidance on modifying activities that exacerbate symptoms, along with functional training to help you safely return to your daily tasks.
Trigger Finger
Trigger finger, also known as stenosing tenosynovitis, occurs when one of your fingers or thumbs gets stuck in a bent position and then suddenly snaps straight. This condition involves the inflammation of the flexor tendon and its sheath, which can cause the tendon to catch or lock when bending or straightening the finger. The affected area may become painful, and a noticeable bump or nodule may develop at the base of the finger. Repeated gripping motions or chronic overuse are common causes of trigger finger, and the condition can significantly impact hand function.
Treatment Options:
Immobilization: We may recommend a splint to keep the affected finger or thumb in a straight position, allowing the inflamed tendon to rest and reduce irritation.
Swelling and Pain Management: Our therapists use techniques to manage swelling and alleviate pain, making the healing process more comfortable.
Manual Therapy: We offer manual therapy to help reduce the inflammation, release the tendon, and restore smooth movement to the affected finger or thumb.
Targeted Exercises: Specific exercises are provided to improve flexibility and strengthen the tendons, helping to prevent future occurrences.
Activity Modification and Functional Training: We guide you on modifying activities that could aggravate the condition and provide functional training to help you safely return to your regular tasks.
Tennis Elbow
Tennis elbow, medically known as lateral epicondylitis, is a condition characterized by pain and inflammation on the outer part of the elbow. It occurs when the tendons that connect the forearm muscles to the elbow become overloaded, usually due to repetitive wrist and arm motions. Despite its name, tennis elbow isn’t limited to tennis players; it can affect anyone who engages in activities that strain the forearm muscles, such as gardening, painting, or repetitive computer use. Symptoms often include pain and tenderness on the outside of the elbow, which may radiate down the forearm and worsen with gripping or lifting.
Treatment Options:
Immobilization: We may recommend a brace or strap to reduce strain on the affected tendons, allowing them to rest and heal.
Swelling and Pain Management: Our therapists employ techniques to manage swelling and alleviate pain, helping you stay comfortable during the healing process.
Manual Therapy: We provide manual therapy to relieve tension in the forearm muscles, enhance blood flow, and promote tendon healing.
Targeted Exercises: We offer exercises specifically designed to strengthen the forearm muscles, improve flexibility, and reduce the strain on the elbow.
Activity Modification and Functional Training: We guide you in modifying activities that may aggravate the condition and provide functional training to help you safely resume your regular tasks.
Golfer’s Elbow
Golfer’s elbow, also known as medial epicondylitis, is a condition characterized by pain and inflammation on the inner side of the elbow, where the tendons of the forearm muscles attach to the bony bump on the inside of the elbow. This condition results from overuse or repetitive stress on these tendons, often due to activities that involve gripping, lifting, or repetitive wrist flexion. Despite its name, golfer’s elbow can affect anyone who engages in activities that strain the forearm muscles, such as throwing sports, weightlifting, or manual labor. Symptoms include pain and tenderness on the inside of the elbow, which may radiate down the forearm, as well as stiffness and weakness in the affected arm.
Treatment Options:
Immobilization: We may suggest using a brace or strap to reduce strain on the affected tendons, providing support and allowing them to heal.
Swelling and Pain Management: Our therapists use techniques to manage swelling and alleviate pain, ensuring a more comfortable recovery process.
Manual Therapy: We offer manual therapy to release tension in the forearm muscles, improve blood circulation, and support tendon healing.
Targeted Exercises: We design exercises that focus on strengthening the forearm muscles, improving flexibility, and reducing strain on the elbow.
Activity Modification and Functional Training: We provide guidance on modifying activities that may worsen the condition and offer functional training to help you safely return to your daily activities.
Intersection Syndrome
Intersection syndrome is a painful condition affecting the forearm, where the tendons of the wrist extensors (responsible for wrist and finger movements) intersect with the tendons of the thumb. This intersection occurs in the area where the first and second dorsal compartments of the wrist meet, typically about 4-6 cm above the wrist joint. The condition is often caused by repetitive or excessive wrist movements, particularly those involving forceful gripping or twisting. Common among rowers, weightlifters, and individuals performing repetitive tasks, intersection syndrome can lead to pain, swelling, and a distinct creaking sensation (crepitus) in the affected area.
Treatment Options:
Immobilization: We may recommend using a splint or brace to immobilize the wrist and forearm, reducing strain on the affected tendons and allowing them to heal.
Swelling and Pain Management: Our therapists employ techniques to manage swelling and alleviate pain, ensuring a more comfortable recovery process.
Manual Therapy: We provide manual therapy to relieve tension in the tendons, reduce inflammation, and improve mobility in the wrist and forearm.
Targeted Exercises: We design specific exercises to restore flexibility and strength in the wrist and forearm, promoting long-term healing and preventing recurrence.
Activity Modification and Functional Training: We guide you in modifying activities that may aggravate the condition and offer functional training to help you safely resume your regular tasks.