Laura Lee Smith, OTR/L, CHT
Laura Lee Smith, OTR/L, CHT, says that the most rewarding aspect of being a Certified Hand Therapist is trying to pinpoint the cause of dysfunction through understanding the underlying anatomy of the structure.
“I enjoy the understanding of anatomy to figure out what soft tissue, nerve, muscle, etc., is causing the pain or dysfunction. Hand therapy is both an art form and a science. You have to be very specific with the science, but you can be creative in the way you address the therapy.
A certified hand therapist treats injuries from the shoulder down to the fingers and can be either a physical therapist or an occupational therapist.
What Conditions Does a Certified Hand Therapist Treat?
Laura Lee sees patients for upper extremity injuries, after surgery, or when inflammation and scarring interfere with normal function.
“I often treat trauma such as crush injuries and or lacerations. Those are tricky because there is bruising and swelling, which translate into scarring. Scar tissue creates more problems and needs to be addressed to minimize adhesion and soft tissue restriction.
“In the case of tendon lacerations, the new advanced surgical techniques to repair the tendons and or nerve allow patients to move sooner after surgery and there is less scarring, but you have to balance the resting and healing with the mobilization.”
“I also treat patients who have fallen or have work injuries. They can have multiple trauma and they usually require multiple surgeries. The goal is to allow healing while restoring motion, strength, and function to get the individual back to work.”
Many conditions are “positional” – they are caused by poor body posture or improper ergonomics. Carpal tunnel syndrome is the result of holding the wrist improperly which puts pressure on the median nerve going through the wrist.
“When a person sustains an improper position for a long time, that can cause the damage to a nerve. On the other hand, some conditions are caused by repetitive motion, particularly the “itises” like DeQuervain’s Tenosynovitis, lateral epicondylitis (tennis elbow), and stenosing tenosynovitis (Trigger finger).”
COVID-19 Related Ailments
Since the COVID-19 pandemic, Laura Lee has seen and treated people with new ailments related to quarantine.
“I saw a health care provider that was having a lot of shoulder pain. She was treating her patients via telehealth for hours, not moving, with poor posture. I did a telehealth visit with her and could recommend a better chair and set up and exercises for her shoulder.”
“I also saw a high-school student who was home for COVID. He had an injury in the fall, and the pain had returned. I pinpointed it to the use of video games and keyboard and told him that it would improve by modifying or restricting the use of the games.”
“A third patient, a young man in his 20’s, had tingling and numbness in his fingers. He was an author, so he was sitting and writing and typing all day. I looked at his set up and could recommend a pad to protect and support his wrists, a better set-up for his keypad, a new chair and exercises.”