Common Conditions and Management Techniques

HAND CONDITIONS

Finger Fractures and Dislocations
  • Finger orthosis
  • Edema management
  • Range of motion exercises
Arthritis
  • Paraffin and moist heat
  • Edema management
  • Range of motion exercises
  • Isometric strengthening exercises
  • Joint protection techniques
  • Adaptive equipment
Thumb Basal Joint Arthritis
  • Hand-based thumb spica
  • Deep tissue massage and thenar eminence
  • Range of motion exercises
  • Education regarding join protection principles
  • Adaptive equipment
Flexor Tendon Laceration
  • Dorsal blocking orthosis
  • Range of motion exercises
  • Edema and scar management
Extensor Tendon Laceration
  • Paraffin and moist heat
  • Edema management
  • Range of motion exercises
  • Isometric strengthening exercises
  • Joint protection techniques
  • Adaptive equipment
Mallet Finger
  • Finger extension orthosis
  • Edema management
  • Update every 2-4 weeks
Trigger Thumb / Finger
  • Finger / thumb orthosis
  • Edema management
  • Activity modification
Skier’s Thumb

(Ulnar collateral ligament injury)

  • Hand-based thumb spica
  • Range of motion exercises
  • Edema management
Amputations
  • Whirlpool and wound care
  • Dressing changes
  • Protective orthosis if needed
  • Range of motion exercises
  • Desensitization
Burns and Frostbite
  • Whirlpool and wound care
  • Dressing changes
  • Orthotic fabrication (if needed)
  • Range of motion exercises

WRIST DISORDERS

Carpal Tunnel Syndrome
  • Wrist orthosis or splint
  • Tendon and median nerve glides
  • Education regarding avoidance of aggravating activities
Extensor Tendon Laceration
  • Forearm-based thumb spica
  • Edema management
  • Range of motion and strengthening exercises
  • Activity modification
Wrist Tendonitis
  • Wrist immobilization orthosis or splint (custom splinting)
  • Edema management
  • Activity modification and symptom management
Scaphoid Fractures
  • Forearm-based thumb spica with ulnar clamshell
  • Edema management
  • Range of motion and strengthening following bone healing
Intersection Syndrome

(Inflamation at the intersection of the thumb extensors and radial wrist extensors approx. 4-6 cm proximal to dorsal wrist crease)

  • Forearm-based thumb spica
  • Edema management
  • Activity modification and symptom management
Wrist Sprain
  • Wrist immobilization orthosis or splint
  • Edema management
  • Range of motion exercises / strengthening
  • Activity modification and symptom management
Wrist Fractures
  • Wrist orthosis
  • Edema management
  • Range of motion exercises
  • Strengthening exercises following bone healing
Degenerative Joint
Disease of the Wrist
  • Wrist immobilization orthosis or splint
  • Paraffin and moist heat
  • Activity modifications, adaptive equipment, and joint protection principles
  • Range of motion exercises
  •  
Midcarpal Instability
  • Forearm-based ulnar gutter | Radial clamshell orthosis
  • Edema management
  • Education regarding avoidance of aggravating activities
Thoracic Outlet Syndrome
  • Brachial plexus nerve glides
  • Postural stretches and exercises
  • Strengthening exercises
  • Education regarding proper posture

(Compression of the brachial plexus through area bordered by first rib, clavicle, and neck muscles. Symptoms include numbness and tingling in the arm or hands, pain radiating up or down the arm, hand, or neck, and occasional muscular weakness.)

Elbow DISORDERS

Tennis and Golfer’s Elbow
  • Wrist immobilization splint / aircast
  • Modalities as needed
  • Deep tissue massage
  • Forearm stretches
  • Strengthening
  • Activity modification and symptom management
Cubital Tunnel Syndrome
  • Elbow gel pad
  • Elbow extension orthosis or splint
  • Ulnar nerve glides
  • Education regarding avoidance of aggravating activities
Radial Nerve Palsy
  • Dorsal extension outrigger orthosis
  • Passive range of motion exercises
  • Monitor monthly for regeneration / update exercises