Commonwealth Hand & Physical Therapy

Mary Reilly stated, “man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.” A pioneer in the field of occupational therapy, Reilly captured the complexity of upper extremity dysfunction in her powerful 1961 Eleanor Clarke Slagle lecture. At Commonwealth Hand and Physical Therapy, we understand the message that Mary Reilly passionately conveyed. Staffed with a team of highly skilled individuals, Commonwealth Hand Therapy treats a wide variety of diagnoses. As a teaching facility, we strive to provide gold-standard quality of care by constantly evolving with the addition of cutting edge technology and research. CUMULATIVE TRAUMA DISORDERS Cumulative trauma disorders are occurrences in which body structures have been stressed and loaded over time causing problematic dysfunction during activities of daily living. Commonly referred to as repetitive injury from “wear and tear,” cumulative trauma disorders are often ergonomically related. Proximal nerve compressions Median nerve compression Pronator Teres Syndrome Carpal Tunnel Ulnar Nerve Compression Cubital Tunnel Guyons Canal Chronic tendon conditions Lateral Epicondylitis Medial Epicondylitis Radial Tunnel Syndrome DeQuervain’s Disease Ganglion Cysts Numbness/tingling in arms and/or hands ACUTE TRAUMA DISORDERS Acute trauma occurs when body structures are damaged by sudden injury. Complex nerve injuries Fractures/Dislocations Humeral fractures Elbow fractures Distal radius fractures Complex Regional Pain Syndrome (I / II) Burns Crush Amputations Tendon Injuries Flexor tendons Extensor tendons Tendon transfers Complex Wrist Disorders TFCC SLACK SNAC Sports injuries Finger Conditions Mallet Finger Nail Bed Injuries Game keeper’s Thumb Trigger Finger Boutonniere deformity Swan neck deformity Fractures/dislocations​ Elbow DEGENERATIVE / CHRONIC CONDITIONS Dupuytren’s Disease Post Surgical Post Injection Osteoarthritis CMC Thumb arthritis Wrist arthritis Rheumatoid arthritis Presurgical inflammatory management SPECIAL SERVICES Upper Extremity Custom Orthotics Dynamic Flexion Extension Static Gauntlet Forearm Spica Hand Based Spica Long Arm Munster Industrial Programs​​ Ergonomics Tool design Activity modification Joint Protection Techniques DME Products Edema Glove Elastomer Silicone/Silipos Electrodes Theraputty Big Gripper/Hand Exerciser Vibrating Scar Massager Mac Blocker Buddy Strap/Soft Elbow Pad Comfort Cool Tube Splint Knuckle Bender Pain neuroscience education

At Commonwealth Hand and Physical Therapy, our mission is to provide a comprehensive and global approach to treat individuals recovering from upper extremity amputations including finger or partial hand, wrist, at or below the elbow, above the elbow and at the shoulder. We use a collaborative team of Occupation, Physical and Certified Hand Therapist to provide wholistic care to meet patient goals. We also work collaboratively with Kenny Orthopedics for prosthetic services and Agrability to help individual in agriculture continue their work following injury. TREATMENT Treatment is customized and designed to empower patients to reach individual goals and increase ability to participate in daily life, work, and their community. Treatment includes: Wound care including debridement and dressings Scar management and desensitization using thermal, mechanical, and electrical techniques: Paraffin to soften adhesions Vibration TENS unit Silicone and elastomer for reshaping and flatten scar Phantom limb pain interventions: Graded motor imagery Recognize app Imagined Movements Mirror Therapy Motor Control inventions: Biofeedback Functional Activities Core Stability to enhance functional endurance and control of prosthetics: Scapular stability prevent compensatory movements that lead to inefficient movement patterns and increase risk of injury Adaptive equipment to increase independence and safety with daily activities. Prosthetic training with ADL and IADL training ORTHOTICS Our therapists are trained to evaluate and fit patients with prefabricated and custom-made orthotics to maintain muscle length and maximize range of motion, prevent joint contracture or deformity, protect healing tissue, desensitization, and increase functional use of the upper extremity. FUNCTIONAL OUTCOMES Each patient is evaluated using standardized assessments to identify individual goals and track progress throughout treatment: Functional outcome measures: Canadian Occupational Performance Measures (COPM) Quick Disability of Arm, Shoulder, Hand (Quick DASH) A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees Fine and Gross motor assessments: Purdue Peg Board Box and Blocks, Minnesota Rate of Manipulation Test Bennett Tool Dexterity Test Pain using Visual Analog Scale

Our Physical Therapy service provides a customize treatment plan to alleviate problems in upper extremity, cervical, and lower extremity. All treatments are delivered in an individualized, one-one-one care approach. Our goal is to optimize each client's return to normal activity following injury. CUMULATIVE TRAUMA DISORDERS Cumulative trauma disorders are occurrences in which body structures have been stressed and loaded over time causing problematic dysfunction during activities of daily living. Commonly referred to as repetitive injury from “wear and tear,” cumulative trauma disorders are often ergonomically related. ​Generalized low back pain Nerve-related pain of the lower extremities Femoral-acetabular impingement (hip pain) Gluteal tendinopathy (hip pain) Patellar tendinopathy (knee pain) Achilles tendinopathy (ankle pain) Neck related tension type headaches Numbness/tingling in arms and/or hands ACUTE TRAUMA DISORDERS Acute trauma occurs when body structures are damaged by sudden injury. Shoulder Instability (ie. dislocations;pre/post surgery) General and complex post-surgical shoulder rehabilitation Fracture repair Rotator cuff repair Tendon/nerve transfer Sports injuries Fractures/dislocations Spinal fractures Neck​​​ Hip Knee Ankle DEGENERATIVE / CHRONIC CONDITIONS Glenohumeral (shoulder) osteoarthritis Hip osteoarthritis Knee osteoarthritis DRY NEEDLING Dry needling treats muscle tissue, and its goal is to reduce pain, inactivate trigger points and restore function. Myofascial Pain Sports Injuries Chronic Pain PELVIC FLOOR DYSFUCTION Physical therapy can assist in treating muscle tightness and dysfunction secondary to several pelvic health issues including: Urinary and fecal incontinence Postpartum care Dyspareunia and vulvodynia Chronic pelvic pain Tailbone pain/coccydynia PARKINSON'S REHABILITATION LSVT BIG is a program designed specifically to treat patients with Parkinson's disease or Parkinson-like symptoms. The program trains patients to move their body more normally, as they typically develop smaller, slower movements. This can affect their ability to walk and perform daily activities, such as getting up from a chair or buttoning a shirt. Treatment is focused on retraining how patients perceive their movements, using extra effort to perform bigger movements, in order to perform activities more safely and efficiently.

Mary Reilly stated, “man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.” A pioneer in the field of occupational therapy, Reilly captured the complexity of upper extremity dysfunction in her powerful 1961 Eleanor Clarke Slagle lecture.​ At Commonwealth Hand Therapy, we understand the message that Mary Reilly passionately conveyed. Staffed with a team of highly skilled individuals, Commonwealth Hand Therapy treats a wide variety of diagnoses. As a teaching facility, we strive to provide gold standard quality of care by constantly evolving with the addition of cutting edge technology and research. Stroke Joint Protection Ergonomics Adaptation Activity Modification FUNCTIONAL CAPACITY EVALUATIONS Functional Capacity Evaluations (FCE’S) are a collection of tests that are used to identify a person’s current safe work capacity. Patients will be asked to perform a range of physical activities that will include sitting, standing, walking, climbing, lifting, carrying, pushing, pulling, handling, reaching, squatting, crouching, kneeling, turning, crawling and work simulation. Commonwealth Hand Therapy FCE’s are a comprehensive, systemic and objective process of assessing a worker’s ability to perform essential job functions. ​Results may be used to determine: return to work capabilities, possible job accommodations, the need for further treatment, residual functional capacity, and impairment ratings. ​Based on the Matheson System of Biopsychosocial Evaluation. Residency trained “Thinking Evaluators” combine standardized testing with the expertise of an experienced clinician. ​Administers functional testing protocols based on the most recent published, peer reviewed and court tested literature. ​Report includes a short summary attached to a full-length report for quick and easy review of results. Results are objective, reliable and always include statements regarding client physical effort and reliability. ​Customized to each physician’s referral questions Work restrictions/accommodations Recommendations for further treatment ETC Full report available in less than 2 business days of test administration.