Expert, Specialized Care: Certified Hand Therapists at South Shore Health
Our hands play a key role in how we interact with the world around us, from opening doors and jars to shaking hands with a new acquaintance.
We use our hands so often that it can be easy to take for granted the complexity of the human hand, with each hand containing a near-countless collection of bones, tendons, joints, and nerves.
With such complex anatomy, it’s no surprise that injuries to the hand, wrist, or other parts of the upper extremity require specialized treatment to ensure proper healing.
At South Shore Health, patients can receive that specialized treatment from the expert caregivers in our Hand Therapy Program.
Our Hand Therapy Team is among the largest in the region – all four of our outpatient occupational therapists (OTs) are also certified hand therapists:
- Brooke Belden, MS, OTR/L, CHT
- Roger Cufaude, OTR/L, CHT
- Kathy Kowalski, OTR/L, CHT
- Peggy Leung, OTR/L, CHT
“We have a comprehensive program here at South Shore Health,” Kowalski said. “We really focus on each patient’s goal and what they want their outcome to be: it might be going back to work or getting back to a hobby that they love to do.”
What is a certified hand therapist?
A certified hand therapist (CHT) is a licensed therapist who has completed a rigorous certification process and earned their CHT credential from the Hand Therapy Certification Commission (HTCC).
At South Shore Health, all four of our outpatient OTs are certified hand therapists, meaning any OT you see can offer specialized treatment for the hand, wrist, and elbow.
To receive their CHT credential, certified hand therapists must complete a demanding set of requirements, including:
- 4,000 hours of direct practice in a hand therapy setting
- Three years of clinical experience
- Successfully passing a test of clinical skills and theory administered by the HTCC
In addition, certified hand therapists must complete continuing education courses and recertify with the HTCC every five years.
While the process of becoming a certified hand therapist is challenging, it leaves certified hand therapists well prepared to meet the demands of the role.
“After going through the certification process, you have that confidence in yourself,” Belden said. “There are certain surgeries that are very complex, and doctors will only refer to a CHT because they want their patient to be working with an experienced therapist.”
What conditions does a certified hand therapist treat?
Certified hand therapists treat patients with a variety of both orthopedic and neurologic diagnoses affecting the fingers, hands, wrists, or elbows.
Common orthopedic conditions treated by certified hand therapists include:
- Elbow, finger, and wrist fractures
- Lacerations
- Snow blower and table saw injuries
- Crush injuries
- Tendon and joint injuries
- Carpal tunnel syndrome
- Tennis elbow (lateral epicondylitis)
In addition to the conditions above, certified hand therapists at the South Shore Health Physical Therapy and Wellness Clinic located at South Shore Hospital also provide therapy services to patients with a number of neurologic conditions, including:
- Stroke
- Traumatic brain injury
- Cerebral palsy
- Multiple sclerosis (MS)
- Amyotrophic lateral sclerosis (ALS)
While certified hand therapists are trained to treat both orthopedic and neurologic diagnoses, their approach will vary depending on the condition.
“Neurologic cases often aren’t as straightforward as something like a wrist fracture,” Leung explained. “If a patient has a stroke or TBI, the way they present can be so different from person to person.”
“For patients who fractured their distal radius, for example, their goals tend to be more biomechanical: range of motion, strength, and those kinds of things,” Cufaude added. “For neurologic patients, we often focus more on assessing daily activity and building independence.”
Why should I see a certified hand therapist instead of a different type of therapist?
Due to the complex anatomy involved, injuries to the hand, wrist, or elbow require highly specialized treatment to ensure proper healing and prevent further injury.
While other therapists may be familiar with some aspects of upper extremity care, certified hand therapists have the anatomical knowledge and clinical experience required to treat these injuries and conditions appropriately.
“We work with these injuries all day, every day,” Belden said. “We have extensive knowledge of the anatomy of the hand, wrist, and elbow. We know the exercises patients need to do to get back whatever it is they’re lacking.”
Additionally, many upper extremity injuries require extremely targeted therapy in order to heal the injury without collateral damage.
Certified hand therapists train and study for years to provide that kind of therapy.
“We have to be very skilled in our knowledge of what you can do with tendon repairs, nerve repairs, and similar injuries,” Belden explained. “With tendon lacerations, for example, there’s a strict protocol on how to rehab those injuries: you don’t want the patient to do too much, because they can rupture the tendon.”
Certified hand therapists also have experience with many related aspects of medicine, including wound care.
This experience enables certified hand therapists to spot potential infections or wounds that aren’t healing properly during treatment and refer patients for further follow-up care as needed.
How do patients benefit from seeing a certified hand therapist?
While specific goals will vary from patient to patient, our certified hand therapists focus on helping patients regain function and get back to doing the things they love.
Because our team has so much experience treating hand, wrist, and elbow conditions, patients often progress quickly.
“Sometimes, people are skeptical - ‘what are you going to be doing for me? It’s just a finger,’” Kowalski said. “But by the end, they’re usually pretty impressed by all of the different things we could do and the different techniques we have to get that finger moving.”
For patients who have suffered particularly serious injuries, there are often concerns about permanently losing the ability to do a cherished hobby or activity.
Fortunately, our hand therapists are often able to ensure this isn’t the case.
“With the OT background that we have meshed with our hand therapy background, we can teach patients how to modify behaviors, as needed, to get back to what they’d like to do,” said Kowalski. “For example, their injury may prevent them from full finger flexion or full grip, but we can teach them how to modify a pickleball racket so they can grip it.”
As patients move through hand therapy, many form bonds with their certified hand therapist and excitedly report their progress.
“You build so much rapport with patients because we see them during a hard time in their lives,” Belden said. “You know that you’re making a difference in these patients’ lives. They come in and say, ‘guess what I did this weekend? I played catch with my grandson.’ They’re so thankful.”
Certified hand therapists and custom splinting
Our Hand Therapy Team also features experts in custom splinting, a process that involves creating unique hand or wrist splints individually designed for a patient’s needs.
Custom splints can be used in a variety of different ways: some hand or wrist injuries can be treated almost exclusively by using a custom splint, while other patients may require a custom splint due to lifestyle factors.
“A patient may have an unstable thumb, but want to continue playing lacrosse,” Cufaude explained. “We’d explore what kind of splinting material could be worn under a lacrosse glove to give additional stability.”
Custom splinting is a skill that takes years to develop due to the complexity of the bones, joints, and tendons in the hand and wrist.
“If you had a tendon laceration, for example, you would need a splint that positions specific joints in a specific angle, while also keeping other joints free,” Cufaude said. “One of the things that distinguishes hand therapy is that you really have to have the skill to be able to do that.”
Where can I find a South Shore Health certified hand therapist near me?
Our certified hand therapists care for patients at two South Shore Health locations:
- Weymouth: The South Shore Health Physical Therapy & Wellness Clinic located on the first floor of South Shore Hospital.
- Hingham: The South Shore Health Physical Therapy & Wellness Clinic located at 2 Pond Park Drive.
If you’re dealing with hand, wrist, or shoulder pain and think you’d benefit from seeing a certified hand therapist, please speak to your primary care provider about a referral to South Shore Health. Our team is ready to help.
“If your pain is getting in the way of your daily function or preventing you from doing activities that you love, you should come see us,” Kowalski said.
“Hand therapy improves quality of life - patients are much happier once they’re better,” Belden added. “It really is limiting when you don’t have use of your hand.”
