Assessments (initial and ongoing)
Objective measures are recorded in order to create a baseline against which to measure progress. These may include range of motion, strength, sensation and function.
Mobilization of joints and soft tissues
Progressive exercises designed to increase movement of joints, tendons, and nerves will be an important part of any program. Massage, joint mobilizations, stretches, continuous passive motion machine, muscle stimulation are adjuncts that may be used to help increase range of motion.
Development and monitoring of a strengthening program
Once soft tissues are stretched out and joints are mobile, strengthening will be started. Specific hand strengthening equipment, pulleys, weights are available in the clinic. A home exercise program will be designed to assist in reaching functional goals.
Custom splints will be selected and fabricated, as required, for support, protection, pain relief, function, and mobilization.
Management of scar tissue
A comprehensive program will be developed for management of scar tissue to prevent contractures and thickened painful scars. It may include the use of scar massage, exercises, pressure garments, gel products, splinting.
Management of swelling
Retrograde massage, compression pump, pressure garments, elevation, ice, and exercise work together to help decrease swelling. Other modalities such as contrast baths, ultrasound, TENS, HVGS, muscle stimulation may also be part of the program.
Development of techniques to reduce neural tension
Nerves, like muscles and joints can become tight, so require special exercises, known as nerve glides, to decrease symptoms. Massage, muscle stretches can be useful adjuncts.
Normalization of sensation by desensitization or re-sensitization
Often after surgery or an injury, there is hypersensitivity or numbness around the scar. A program of desensitization helps minimize the uncomfortable sensations. Re-sensitization helps re-organize the perception of touch as the nerve recovers.