CMU Hand Therapy

In May of 2016, I observed an Occupational Therapist for 14 hours. Mike, went to Saginaw Valley to be an OT after injuring his back & not being able to return to the Air Force. The first day I shadowed him was something extraordinary. I have never learned so much in one day & connected with so many patients. He saw maybe 10 patients that day & each had a different story & a different therapy exercise to do. The age range was anywhere from 8-88 & from a joint in the finger injury to an arm injury to just inflammatory responses. Each patient loved and showed improvement from working with Mike.

Most start out by doing this therapy with corn stalks crushed up, heated, and massaging the arm called fluidotherapy to help with circulation and to help manipulate the arm more afterwards. He usually then stretched the arm, ligaments, or whatever the problem was to farther stretch to new lengths than the time before. Next, some would move to the steroid electrical treatment or some to the splint making stage. Some moved on to the active therapy part where he would have them work on an arm bike for a couple of minutes and move on to various exercises. Some were moving the yoga ball up and down the wall to improve strength and ROM. Some went to the treadmill and walked with a weight in the hand. Some dug out marbles and dimes out of a box of rice. Some clipped and unclipped increasing intensity clips to a pole.  Some picked up a box and lowered it multiple times. Some did a downward facing dog. And some dug marbles out of this play-doh to work the fingers and joints. No matter who it was, he catered the activity to fit their needs and wants.

The second day of shadowing Mike, I learned SO much. One man in particular recently had surgery on his hand after a hand saw accident and losing his pinky finger and getting his ring finger re-sewn on. 2 weeks after this surgery, he came to Mike as he is obviously having trouble moving his fingers in proper range of motion. Seeing this amputation and his story of the phantom pain and troubles with adjustments, was very interesting. To hear how much Mike educated him on everything from nerve damage to how to properly move forward effectively like how to smoke properly for effective healing since he refuses to quit and to exercise the fingers in a certain way.

Another man I really got to learn about is this 60 year old who has worked in a factory for the past 30 years manufacturing restaurant machinery. He is having many problems with his right arm and shoulder that would even wake him up with pain. So from the constant repetition of moving just the upper extremities for long periods of the day, almost 7 days a week, and with force could definitely cause it over the 30 years. Mike gave him stretches and exercises to work on elongating and depressing his shoulders through 3 different stretches 5 times a day for 10 minutes.

And most patients ranged from having rheumatoid arthritis, or falling on their hand/finger wrong, or just rushing something that shouldn’t be rushed. The most important lessons from working in this clinic that I learned from Mike is when it comes to being an OT are:

  1. Be personable but also knowing the difference between having a conversation and pulling out important information about how they got there and their everyday afterwards. This is a vital balancing act as connecting with them is important and any conversation involves questions about the other person but when it comes to treatment, there needs to be redirection to their life.
  2. Getting rid of any nervous laugh. It is instilled in myself and others to laugh at inappropriate or unnecessary times because of nervousness or awkwardness. When it comes to being a clinician, it is important to lose that though as the patient may take it the wrong way or just find it unprofessional. This will be the hardest thing for me to lose as I am known for laughing and giggling at even the smallest things because I do find most things funny.
  3. Knowing that it may be easy to just work on their hand or do exercises to them but to EDUCATE the patient, is the most vital thing to being a successful clinician. If you are not educating them on what they did, or the knowledge behind that ligament/muscle/bone, and how to improve it overall for their greatest pleasure; they are walking away with just the mechanical piece improvement. To know prevention in the future or how to work the issue at home will significantly help the patient more than just doing it for them.