What Is Hand Physical Therapy?
Hand therapy is a specialized area of physical and occupational therapy focused on conditions affecting the hand, wrist, forearm, and elbow. It encompasses both rehabilitation — post-injury and post-surgical recovery — and conservative management of chronic conditions like arthritis, nerve compression, and tendon dysfunction. The hand is one of the most anatomically complex and functionally demanding regions of the body, and the rehabilitation it requires reflects that complexity.
Practitioners who specialize in this area may hold the CHT (Certified Hand Therapist) credential, a nationally recognized certification awarded to clinicians who have completed significant post-graduate hand therapy practice hours and passed a rigorous examination. Hand therapy at Joint Ventures PT is provided by clinicians with focused experience in upper extremity conditions, applying both the technical skills of hand rehabilitation — including custom orthosis fabrication — and the progressive exercise protocols that drive functional recovery.
Conditions Hand Therapy Treats
Post-surgical rehabilitation is one of the largest categories in hand therapy practice. Flexor and extensor tendon repairs require carefully timed mobilization protocols — too early and the repair ruptures, too late and scar tissue restricts motion permanently. TFCC repair, carpal tunnel release, Dupuytren’s contracture release, and fracture fixation all require structured post-surgical PT to restore full function. The timing and progression of these protocols is specific to the surgical approach and the individual patient, which is why communication between the hand surgeon and the therapist is essential.
Beyond surgical rehab, hand therapy addresses tendon injuries including mallet finger (extensor tendon disruption at the fingertip), jersey finger (flexor tendon avulsion), and boutonniere deformity. Nerve conditions — carpal tunnel syndrome, cubital tunnel syndrome, and trigger finger — respond well to hand therapy with the right combination of nerve mobilization, splinting, and activity modification. Arthritis of the CMC joint (the thumb base, one of the most commonly arthritic joints in the hand), rheumatoid arthritis affecting the hand joints, sports injuries including UCL tears of the thumb (skier’s thumb) and boxer’s fractures, and work-related repetitive strain injuries like de Quervain’s tenosynovitis are all within the scope of what hand therapy addresses.
What Makes Hand Therapy Different From General PT?
The hand has 27 bones, 29 joints, and over 30 muscles controlling it — it is anatomically complex in a way that demands specialization. General orthopedic PT does not typically include the specialized skills that hand rehabilitation requires. The most significant differentiator is custom orthosis fabrication. Hand therapists design and fabricate thermoplastic splints custom-fitted to the individual patient — static splints that protect healing structures, dynamic splints that apply low-load prolonged stretch to restore motion, and functional splints that allow patients to continue working while protecting an injury. This is a skill that requires training and equipment specific to hand therapy, and it’s not available at most general outpatient PT clinics.
Scar management is another area where hand therapy stands apart. Post-surgical scar tissue in the hand can restrict tendon gliding, reduce joint motion, and create hypersensitivity that limits function. Hand therapists use scar massage, silicone gel and sheeting, compression, and specific mobilization techniques to manage scar maturation and maintain tissue extensibility during the healing process. Edema management is equally specialized — the hand is particularly prone to significant swelling after injury or surgery, and unmanaged edema creates its own cycle of stiffness and dysfunction. Retrograde massage, compression wrapping, and elevation protocols are standard components of hand therapy care. Desensitization, for patients with hypersensitive scars or nerve injuries where even light touch is painful, requires graded stimulus protocols that general PT typically doesn’t employ.
What to Expect at Your First Hand Therapy Visit at JVPT
The initial evaluation is comprehensive. Your therapist will assess active and passive range of motion of all involved joints, grip and pinch strength (using a dynamometer for objective measurement), sensory function, and a functional assessment based on the tasks and activities most important to you. If custom splinting is indicated — for post-surgical protection, joint positioning, or nerve or tendon management — your therapist may fabricate the orthosis at the first visit, customizing it to fit your specific anatomy and healing requirements.
A robust home exercise program is a central feature of hand therapy, more so than in some other PT specialties. The hand is accessible for self-treatment, and the small, targeted exercises that drive tendon gliding, joint mobility, and grip strength are things patients can and should do multiple times per day between sessions. Adherence to the home program is consistently one of the strongest predictors of outcome in hand therapy. Frequency of visits is typically two times per week, with the duration of care depending on the specific condition, whether surgery was involved, and how quickly the patient is progressing toward their functional goals.
Hand injuries require specialized care — not a general approach. Joint Ventures PT offers hand physical therapy at locations across the Boston area. If you’ve had hand surgery, a tendon injury, or are dealing with carpal tunnel or arthritis, book a hand therapy evaluation today.
Dr. Kelly Robinson is a physical therapist at Joint Ventures Physical Therapy. She specializes in upper extremity and hand rehabilitation, including carpal tunnel syndrome, post-surgical hand and wrist recovery, and conservative management of hand and wrist conditions.
