Terry Streetman (Host): Hello and welcome back to the Well Within Reach podcast. I'm Terry Streetman, Riverside Marketing and Communications Representative. I'm joined today by Elizabeth Finn, Occupational Therapist and Certified Hand Therapist, here to discuss hand therapy, a treatment offered by Riverside's Rehabilitation and Therapy Department.

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Host: Thank you for being here today, Elizabeth. Could you tell us a little bit more about yourself, your background, and your role here at Riverside?

Elizabeth Finn, CHT: Yes, I have been working at Riverside for four years and have been working as an occupational therapist, since 2007 and more specifically in hand therapy since 2012.

I live in New Lenox with my husband, my two children, and my dog. I received my master's in occupational therapy at the University of Illinois at Chicago and started my career treating in acute care at Christ Hospital in Oak Lawn. After discovering I wanted to specialize in treating hand and upper extremity injuries, I moved to a private hand clinic in Joliet for five years, and now I currently work at Riverside's Outpatient Rehabilitation and Therapy Department evaluating and treating the upper extremity.

Host: Awesome. Well, we're so grateful to have you here to share your knowledge. To start our discussion, can you educate our listeners on some common conditions that might bring someone into the clinic for this type of therapy?

Elizabeth Finn, CHT: Yeah, we see cumulative type trauma injuries including carpal tunnel syndrome, cubital tunnel syndrome, tennis elbow, trigger finger, tendinitis, and osteoarthritis. And we also see acute traumas including fractures and amputations, soft tissue injuries, which include ligament tears, wounds, tendon lacerations, crush injuries and sprains, just to name a few, and treat these conditions, both conservatively and often post operatively.

Host: Wow. Okay. That's a lot of things that we cover. Um, so can you tell me how many other therapists are there within your clinic and what do you feel makes the clinic special?

Elizabeth Finn, CHT: Yeah. So in our clinic, we currently have a group of five very skilled occupational therapists, two of us who are certified hand therapists, one who is a lymphedema certified therapist. We have an awesome technician who is the heart of our program, and awesome front desk staff and nurses that are part of our team.

 We work very closely as a clinic collaborating and assisting each other, sharing our knowledge and often exchanging treatment techniques and ideas. We also have two newly hired occupational therapists joining our team. Our team is very passionate about helping our patients and using effective treatments and custom orthotics to give our patients the best treatment.

We have a small enough clinic that we can all kind of assist each other and get to really know our patients. We also get the opportunity to work very closely and learn from Dr. Crawford, our Riverside orthopedic surgeon who specializes in hand therapy, and her physician assistant Carly who provide us with the majority of our referrals.

Host: Excellent. Well, thanks for that look into the department. So you recently received a hand therapy certification, I understand, from the Hand Therapy Certification Commission. Can you tell us more about that certification and why you chose to pursue it?

Elizabeth Finn, CHT: Sure. Getting your hand therapy certification recognizes a therapist's knowledge of the intricate anatomy, surgical procedures, postoperative protocols, and it recognizes the OT's clinical expertise to effectively manage injuries of the upper extremity. The certification requires at least 3 years of clinical experience with 4,000 hours or more of experience in hand therapy and successfully passing a comprehensive 4 hour 200 question test that's offered twice a year.

Host: Wow. Okay. That's really impressive. And can you tell us a little bit more about like why you chose to pursue that certification?

Elizabeth Finn, CHT: Yeah. So at the beginning of my career, I enjoyed really working with like a variety of different diagnoses, working on the medical floors at a level one trauma hospital. It gave me a really broad knowledge of a spectrum of diagnoses and an understanding like of different conditions that affect more than just the physical aspect of a patient's rehab.

But over time I wanted to specialize, knowing as much as I could about a specific area to help my patients using my occupational therapy degree. I was interested in hand therapy because the many awesome mentors I have had who excited me about hands and actually made it very interesting. I also felt it was important to challenge myself and demonstrate what my mentors have taught me. It was also important to me to show my kids you are always learning and hard work is all worth it if you find a profession that you enjoy and want to succeed at.

Host: Excellent. Well, we're really proud to have certified providers like you here. And I think that really reflects Riverside's commitment to providing quality care close to home. So obviously we love that you have this certification, and that you can help folks, but what are some things that people can do to help avoid some of these conditions that might bring them in for treatment.

Elizabeth Finn, CHT: So specifically for like cumulative trauma type injuries like arthritis and tendonitis, we recommend joint protection strategies in our clinic. For example, like using your larger joints like your elbow or your shoulder versus your smaller joints in your hand which can't withstand as much to lift and hold items like grocery bags, a heavy bag, or a purse. We recommend built up handles on everyday tools and utensils to reduce stress on the joints in your hands, including larger handles on gardening tools, forks, knives, hairbrushes, and pens and pencils, and then just something as simple as an electric can opener versus like a manual opener, a padded steering wheel or an ergonomic work setup.

Host: Okay. Those are all really helpful tips. Thank you for that. So for someone who is experiencing some of these issues, let's say carpal tunnel or tennis elbow, at what point should they consider coming in for treatment?

Elizabeth Finn, CHT: So if a patient has been experiencing pain that like limits their day to day performance with activities of daily living, work, leisure activities, or it hinders a person's ability to complete more complex functions necessary for caring for themselves and their participation in day to day activities, then I do recommend they see a doctor sooner than later.

A doctor will perform an evaluation and order the necessary, like, diagnostic tests and, if appropriate, can give a referral, with a diagnosis for an evaluation and treatment by an occupational therapist. As occupational therapists then, we can educate the patient on their condition, appropriately evaluate the patient for their deficits, treat the condition, and issue an individualized home exercise program, and custom fabricate orthoses as needed.

But if someone is experiencing more of an acute trauma, for example, from a fall, a car accident, machine or blade such as a knife or chainsaw, then we'll see them after the doctor has evaluated them and if necessary, even, has performed surgery. In that case, we might fabricate custom orthoses for the upper extremity to protect,immobilize and support the healing structures.

 We also use modalities in our clinics such as heat and electrical stimulation and ultrasound to facilitate healing, as well as stretching and therapeutic exercises with weights and TheraBand, if appropriate.

Host: Shifting a little bit to some of those more leisurely activities that people might experience issues with, like tennis or golf elbow. Does that mean they have to completely avoid these activities?

Elizabeth Finn, CHT: No, not necessarily. Resting the involved structures, improving posture and positioning, perhaps like adjusting the grip size on handles, stretching, conditioning, and potentially supporting or inhibiting muscle activity with something like therapeutic tape, maybe kinesio tape or a supportive strap, like a counterforce strap can also support return to these leisure type activities.

Host: Awesome. Well, I know a lot of people will be glad to hear that.

Elizabeth Finn, CHT: Yeah.

Host: Um, so where would somebody start? I know you talked a little bit about this before, if they need treatment for this, is it call the clinic or referral from their doctor or their provider?

Elizabeth Finn, CHT: A referral from their primary doctor for occupational therapy or even preferably a referral from a doctor that specializes in the treatment of the upper extremity like a hand surgeon will provide us with a more specific diagnosis, the appropriate diagnostic tests and orders for evaluating and treating the patient.

Host: Awesome. Well, thank you for all this great information, Elizabeth. To remind our listeners, if you're interested in learning more about hand therapy or other rehabilitation and therapy services, you can visit the department's page on the Riverside website or you can call 815-802-7090. Thanks again for being here, Elizabeth.

 Thank you to our audience for tuning into Well Within Reach, presented by Riverside Healthcare. Please take a moment to rate and leave a review for Well Within Reach on Apple, Spotify, or wherever you get your podcasts. And to learn more about Riverside, visit riversidehealthcare.org.