What is Occupational Therapy?

What is Occupational Therapy?

By Chanon Vallas MS, OTR/L, CHT for ATI Physical Therapy

Occupational therapy is a profession that helps people do the things that they want and need to do across their lifespan. The word “occupation” encompasses a wide range of daily activities. Occupational therapy interventions assist individuals with psychological and/or physical barriers that interfere with their ability to carry out their occupations independently. This could be working with a person with cognition deficits impacting their ability to problem-solve, a child with developmental delays impacting their ability to perform school work, an individual who has sustained a neurologic event impacting their ability to perform self-care, or an individual that sustained a traumatic injury to their hand and is unable to work. 

Occupational therapy practitioners have a holistic perspective, in which the focus is on adapting the environment and/or tasks to fit the person, and the person is an integral part of the therapy team. They perform individualized evaluations and develop customized interventions that are client centered with the client’s goals as the priority. They incorporate outcome evaluations to ensure that the goals are being met. Occupational therapy is an evidence-based practice deeply rooted in science.

Hand therapy is just one specialty area, out of many, in which occupational therapists can specialize and become experts. Occupational therapists can advanced their specialty by becoming certified hand therapists (CHTs). To qualify to be a CHT and sit for a board exam, one has to be an occupational therapist or physical therapist for three years and obtain hours in the field of hand therapy. CHTs partner with individuals that have sustained an injury to the upper extremity that is impacting their ability to carry out their occupations independently. Through a commitment between the therapist and client, they work together to meet the clients individual goals to achieve independence with the function of their arm.

To learn more about occupational therapy and how it might help you, visit the American Occupational Therapy Association’s website.

Featured Body Part: Wrist

Featured Body Part: Wrist

By Kristy Loose, DPT, OTR/L, CHT, Angela Bender and Cori Cameron for ATI Physical Therapy

As stated by Mary Reilly, “Man through the use of his hands as they are energized by mind and will, can influence the state of his own health.” The wrist is a crucial joint for our hands to be able to explore our environment and injuries can lead to serious functional impairments.

The wrist joint is comprised of three main joints: radiocarpal, midcarpal, and intercarpal joints. The main motion at the wrist joint is flexion/extension (movement of the wrist up and down) and radial deviation/ulnar deviation (movement of the wrist from side to side) which are accomplished via five primary movers and three peripheral nerves. Being aware of common conditions and causes of pain, how to treat them, and how to generally keep our wrists healthy, can be a key factor in preventing an acute injury from progressing to chronic, life-long pain.

Common Causes
While we may not think about how much use our wrist typically gets in a day, when we start to experience pain we definitely take notice of the importance of this joint. Injuries, arthritis, and other ailments can all cause pain.

  • Carpal Tunnel Syndrome – CTS is caused when the median nerve becomes compressed, or pinched. This compression is caused by swelling in the wrist; the wrist pain associated with this is due to the excess pressure on the nerve.
  • Sudden (Acute) Injuries – Sprains, broken bones, and tendonitis can all cause pain in the wrist. Symptoms of an injury can include swelling, bruising, or disfigured joints near the wrist.
  • Arthritis – Pain, stiffness, and swelling of the wrist may be caused by various forms of arthritis. Arthritis can be caused by many things, including overuse, aging, and normal wear and tear.
  • Gout – When your body breaks down foods containing purines, uric acid is produced. A buildup of uric acid may cause gout, which can result in pain and swelling in the wrists, knees, ankles and feet.

Common Conditions
While there are multiple conditions associated with wrist pain, some of the common conditions include:

  • Carpal Tunnel Syndrome – CTS is a condition that causes numbness and tingling in the hand and arm. The syndrome is caused by a compressed nerve in the carpal tunnel, the narrow passageway on the palm side of your wrist.
  • Strains – A wrist strain can occur when there is a simple overstretching of the tendon or the ligaments of the wrist bone, or it can occur when there is a partial or complete tear in the tendon or the ligaments.
  • Sprains – A sprained wrist is an injury to any of the numerous ligaments which connect bone to bone in the wrist.
  • Tendonitis – Tendonitis is an irritation and inflammation of one or more of the many tendons surrounding the wrist joint.
  • Arthritis – Inflammation in any of the small joints in the wrist can be a sign of arthritis. Arthritis attacks your bones by destroying the cartilage, causing your bones to rub against one another.

Injury Prevention
Kristy Loose, DPT, OTR/L, CHT, gives us some tips to help prevent and rehabilitate wrist injuries:

  • Watch Your Positioning – Keep your wrists straight or only slightly bent while performing activities. Avoid activities that bend or twist the wrists for long periods of time.
  • Take Breaks – Take frequent breaks from typing or other repetitive activities to stretch your hands and wrists.
  • Watch Your Grip – Whenever possible, use your whole hand to grasp an object. There may be less pain with gripping in a supinated (palms-up) position rather than a pronated (palms-down) position.
  • Wear the Right Protective Equipment during Activities – When working with tools that vibrate (drills, sanders), use specially designed gloves that support the wrist and have vibration-absorbing padding. Take frequent breaks, and switch hands often.
  • Pay Attention – Stop any activities that you think may be causing numbness and pain.

Rehabilitation
If you have pain in your wrist that isn’t going away, rehabilitation can help to improve functionality. During rehabilitation you will work on:

  • Avoiding Gripping – Gripping increases carpal load.
  • Considering Forearm Position to Minimize Carpal Load and Create a More Stable Wrist – In a neutral wrist position, 80% of the load is transmitted through the radiocarpal joint and 20% through the ulnocarpal joint. Pronation and ulnar deviation may increase ulnocarpal load up to nearly 40%, something to keep in mind when choosing your positioning for therapy exercises in those with ulnar sided wrist pain.
  • Maximizing Range of Motion Is Not the Goal – The goal is for functional range of motion with good stability and no pain.
  • Gradual Strengthening – Using isometrics, eccentrics, and concentrics.
  • Stabilization – Extensor carpi ulnaris, flexor carpi ulnaris, and hypothenar muscles will stabilize the ulnar wrist, while flexor carpi radialis will stabilize the radial wrist.

When weighing your treatment options for wrist pain and injuries, consider occupational therapy. ATI Physical Therapy offers a wide variety of treatment options including strengthening, stretching, and sustainable home exercise programs. Stop in or call any ATI location for a complimentary injury screen or to learn more about how we can help you overcome your elbow pain.

It’s all in the wrist!

Featured Body Part: Elbow

By Angela Bender and Cori Cameron for ATI Physical Therapy

Featured Body Part: Elbow

The elbow, a hinge joint that consists of the humerus, ulna and radius, is one of the most active parts of the body. It is used for virtually any activity which involves your hands. Because the elbow is often used as a contact point for trauma, it is the second most frequently dislocated joint in the body after the shoulders and can also be prone to oversue injuries. The more knowledge we have regarding prevention and common causes of injuries, the better our chances are to remain injury free.

Common Causes
Even though the elbow can take a lot of use, arthritis, injuries and other problems can all cause pain.

  • Overuse (Chronic) Injuries – When movements such as bending or twisting of the arm and throwing are repeated without proper rest, the tendons, ligaments, and muscles of the elbow can be damaged.
  • Sudden (Acute) Injuries  – During a fall or other injury, a person typically tries to use their hand to brace themselves; this can cause the arm to twist sharply and dislocate the elbow. A direct blow to the elbow can cause the bone(s) in the joint to fracture.
  • Arthritis – Pain, stiffness and swelling of the elbow may be caused by various forms of arthritis.

Common Conditions
Elbow pain can be caused by any one of these common conditions:

  • Tennis Elbow (Lateral Epicondylitis) – This is a condition in which the tendons that join the forearm muscles at the elbow become inflamed and painful due to overuse. Playing tennis is a common cause of the condition, however, other activities that involve repetitive use of the elbow also can lead to tennis elbow.
  • Olecranon Fractures – The most easily fractured bone of the elbow is the olecranon, the point that sticks out when you bend your elbow at a 90-degree angle.
  • Bursitis – The bursa, located at the tip of the elbow, is a small fluid-filled sac that allows the skin to move freely over the underlying bone. Inflammation of the bursa can cause swelling and stiffness of the elbow.
  • Biceps Tendon Tear – When the tendons that attach the biceps muscle at the front of the upper arm to the bones in the elbow are torn, it becomes difficult or impossible to rotating the arm to make the palms face upward.

Injury Prevention
Todd Cobler, OTR/L MOT, Occupational Therapist at our Carol Stream, IL clinic, gives us some tips to help prevent and rehabilitate elbow injuries:

  • Stay Flexible – Flexibility in the soft tissue on both sides of the forearm is just as important as strengthening because a tight muscle is an inefficient muscle. If there is an imbalance of strength and flexibility this can often make you more prone to injury.
  • Take Breaks – Take frequent breaks if you work a manual labor job to allow adequate recovery and not overusing muscle.
  • Strengthen Your Forearm Muscles – Don’t forget to strengthen your forearm muscles, these are the muscles that are most commonly injured from overuse.
  • Strengthen Large Muscle Groups – Working on the strength of larger muscle groups around the shoulder and mid ACL are important so you are not putting too much stress on the smaller forearm/elbow muscles.

Rehabilitation
If you have pain in your elbow that isn’t going away, rehabilitation can help to improve functionality. During rehabilitation you will work on:

  • Improving Joint Mobility – Improving joint mobility is a common treatment goal for a lot of elbow injuries due to it being one of the most congruent joints in the body.
  • Improving Range of Motion – Therapists will address range of motion losses in manual therapy to improve joint capsule mobility and soft tissue flexibility.
  • Strengthening and Support – Once optimal range of motion is achieved it is then important to focus on strengthening the supporting musculature around the elbow to increase functional independence.

When weighing your treatment options for elbow pain and injuries, consider physical or occupational therapy. ATI Physical Therapy offers a wide variety of treatment options including strengthening, stretching, and sustainable home exercise programs. Stop in or call any ATI location for a complimentary injury screen or to learn more about how we can help you overcome your elbow pain.

Putting the elbow grease into your recovery!

What is Sports Medicine?

By Matt Nohren, Outreach Athletic Trainer for ATI Physical Therapy

trainerAlthough the origins of sports medicine can be dated back to the Roman Colosseum and training gladiators of appropriate diet and exercise, sports therapy has vastly evolved over the past 100 years. The term “sports medicine” was coined in 1928, when various team physicians attending the Winter Olympics in St. Moritz, Switzerland, met to establish the International Assembly on Sports Medicine. From this point forward more research and education has been conducted to help protect, treat, and identify sports related health conditions.

A current day sports medicine definition can be described as a multifaceted approach to preventing, treating, and rehabilitating orthopedic and musculoskeletal injuries or conditions. This concept can be applied to every age group from our youth to our elderly and every skill level from recreational to professional. Sports medicine’s goal is to keep you in your sport or activity you love. If an injury is sustained, helping identify and treat, or refer the injury are all areas of sports medicine. Sports medicine care can also provide emergency response should a critical situation arise during a game, competition, or in the workplace.

With today’s active culture, sports medicine is a multidisciplinary field that is growing rapidly!