Advanced Physical Therapy



In deQuervain’s tenosynovitis, the tendons of the thumb become inflamed at the level of the wrist and do not glide correctly in the tunnel they pass through. This condition occurs somewhat frequently in new mothers or grandmothers from frequently picking up the newborn. It can also occur from overuse in work or hobby activities. Symptoms include pain and tenderness over the thumb side of the wrist and can extend up the forearm. The pain is usually worse with use of the hand and thumb, especially when forcefully gripping things or twisting of the wrist.

Lateral Epicondylitis "Tennis Elbow" - is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities can also put you at risk.

Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

Medial Epicondylitis "Golfer's Elbow" - is a condition that develops when the tendons on the inside of the forearm become irritated, inflamed, and painful due to repetitive use of the hand, wrist, forearm and elbow. It is often diagnosed in people who perform repetitive motions, such as swinging a golf club or tennis racket, or activities requiring gripping, twisting, or throwing. Even using a computer or performing yard work can cause the condition. It is most common in men over the age of 35.

Duputytren's Contracture - is an abnormal thickening of the tissue just beneath the skin. This thickening occurs in the palm and can extend into the fingers. Firm pits, bumps and cords (thick lines) can develop and cause the fingers to bend into the palm (Figures 1 and 2). This condition may also be known as Dupuytren’s Disease. Occasionally, the disease will cause thickening on top of the knuckles or cause lumps and cords on the soles of the feet (plantar fibromatosis).

Certified Hand Therapy Treatment Plan: After careful evaluation by the physical or occupational therapist, the first step in treating this condition is to reduce pain and inflammation in the tendons at the wrist. Treatments may include ultrasound, heat/cold therapy, iontophoresiselectrical stimulus, activity modification, and use of a thumb brace. Your physician may prescribe anti-inflammatory medications, or you may receive a local steroid injection. In physical therapy, gentle stretching and functional restorative exercises will be added as they are tolerated.


After your initial prescription for therapy is completed, your physician and therapist will decide if you need to continue therapy or if you will be discharged to a home exercise program.


This information is provided as a learning resource for the benefit of our patients. It is NOT INTENDED to replace personal consultation with your medical professionals.

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