Hand Therapy in Bend and Redmond

People value the use of their hands and any loss of function may have a devastating effect on their lives. Anyone with an injury wants the very best care. Rebound has been offering hand therapy since 1998, and in 2002 became the first physical therapy provider in Bend and Central Oregon to have a Certified Hand Therapist. To earn certification, our hand therapists had to have over 4,000 hours of direct hand therapy practice, at least 5 years of experience, and pass a rigorous exam. Rebound’s Certified Hand Therapists are experts in the intricate rehabilitation of the arm and hand. Tony Dao, OTR/L, CHT, Director of Hand Therapy, Joyce Stahly, OTR/L, CHT and Lisa Cena, MOTR/L/CHT all have extensive experience rehabilitating a broad range of hand injuries and surgical procedures using evidence-based hand therapy techniques. Hand therapy is available at our East Bend and Redmond 4th Street locations.

Why choose a Certified Hand Therapist?

– Simply put, they’re the most qualified, highly-trained specialists and are current on the latest rehabilitation techniques and protocols, surgical procedures and postoperative therapy programs.  Rebound works closely with Central Oregon’s physicians to maintain the most up-to-date rehabilitation standards for complex elbow, wrist, hand and finger surgery.  See the full list of CHT training at the Hand Therapy Certification Commission website.

Tony Dao, OTR/L, CHT

Joyce Stahly, OTR/L, CHT

Lisa Cena, OT, CHT

Lisa Cena, MOTR/L, CHT

Rebound’s Certified Hand therapists are specialists who treat conditions including:

Traumatic injuries / Fractures

A broken bone is commonly known as a fracture. Any bone in the arm can be broken, but common areas for fractures in the arm are:

  • Wrist, specifically the distal radius
  • Forearm bones (radius and ulna)
  • Elbow
  • Humerus
  • Shoulder

Sports injuries

Tennis elbow, golf elbow, snowboard, ski injuries – your hands are constantly at work during sports. We diagnose and treat all hand sports injuries.

Tennis elbow and other types of tendonitis

Lateral epicondylitis, commonly known as tennis elbow, is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. Tendons anchor the muscle to bone. The muscle involved in this condition, the extensor carpi radialis brevis, helps to extend and stabilize the wrist. With lateral epicondylitis, there is degeneration of the tendon’s attachment, weakening the anchor site and placing greater stress on the area. This can then lead to pain associated with activities in which this muscle is active, such as lifting, gripping, and/or grasping. Sports such as tennis are commonly associated with this, but the problem can occur with many different types of activities, athletic and otherwise.

Carpal tunnel, cubital tunnel, thoracic outlet syndrome, and other nerve entrapment disorders

Carpal tunnel syndrome is essentially a pinched nerve in the wrist. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when swelling in this tunnel puts pressure on the nerve.

Amputations

Amputation is the removal of an injured or diseased body part. It may be the result of a traumatic injury, or it may be a planned operation to prevent the spread of the disease in an infected finger or hand. Some traumatically amputated fingers may be replanted or reattached. In many cases, reattachment of the amputated finger is not possible or advisable because the patient will be more comfortable and have better function if the part is not reattached.

Burns and frostbite

When the skin comes in contact with something hot, it may be damaged, with death of cells in the skin. The severity of the injury depends on the intensity of the heat and the length of time that it is in contact with either heat or certain chemicals.

Degrees of burns
Burns are classified by the depth of injury, which helps determine the appropriate treatment.

  • 1st Degree: Superficial – redness of skin without blisters
  • 2nd Degree: Partial thickness skin damage – blisters present
  • 3rd Degree: Full thickness skin damage – skin is white and leathery
  • 4th Degree: Same as third degree but with damage to deeper structures such as tendons, joints and bone

Arthritis

Arthritis is the wearing away of the cartilage at a joint. Cartilage is the coating layer of tissue on the end of a bone that acts as a shock-absorber. Loss of cartilage can lead to joint destruction and a shift in the finger position towards the small finger side, which is called ulnar drift. When arthritis affects the MP joints, the condition is called MP joint arthritis.

Nerve injuries

Nerves are the “telephone wiring” system that carries messages from the brain to the rest of the body. A nerve is like a telephone cable wrapped in insulation. An outer layer of tissue forms a cover to protect the nerve, just like the insulation surrounding a telephone cable. A nerve contains millions of individual fibers grouped in bundles within the “insulated cable.” Nerves serve as the “wires” of the body that carry information to and from the brain. Motor nerves carry messages from the brain to muscles to make the body move. Sensory nerves carry messages to the brain from different parts of the body to signal pain, pressure, and temperature. While the individual axon (nerve fiber) carries only one type of message, either motor or sensory, most nerves in the body are made up of both.

Dupuytren’s contracture

Dupuytren’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. 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).

Complex regional pain syndrome / RSD

Formerly Known as Reflex Sympathetic Dystrophy (RSD) – Complex regional pain syndrome (CRPS) is a pain condition that is constant over a long period of time. It is believed to be the result of dysfunction in the central or peripheral nervous systems. It causes the nervous system to send frequent or constant pain signals to the brain. The nervous system becomes overactive, causing intense burning or aching pain, swelling, changes in skin color and moisture.

  • Source: American Society for Surgery of the Hand. www.handcare.org

    Successful hand rehabilitation

    Physical therapy should begin as early as possible to achieve the highest level of functional ability possible. Following a thorough evaluation, a customized treatment plan is developed for each patient. Your hand therapist will be in regular communication with your physicians for the best possible outcome. Meet our hand therapists: Tony Dao, OTR/L, CHT and Director of Hand Therapy, Lisa Cena, MOTR/L and Joyce Stahly, OTR/L, CHT