Hand Therapy Secrets | Helping Occupational Therapist Become Experts

You don’t need to be scared of treating flexor tendons. It’s easy to worry about moving too much, causing a rupture, or doing something wrong—especially when you’ve heard all the horror stories. But that fear can also make you too conservative with your treatment.

Flexor tendon rehab can feel complicated—but it doesn’t have to be. Instead of getting overwhelmed by every protocol, start by simplifying the process.

Too many therapists think treating a finger fracture means following the prescription exactly as it's written. The prescription tells you what's allowed—it doesn't tell you how to treat the patient. As hand therapists, our job is to use clinical reasoning, educate our patients with confidence, and apply the right techniques—not just follow a script.

Persistent ulnar-sided wrist pain after a distal radius fracture isn't always a TFCC problem. In this episode, let's break down the anatomy and clinical reasoning that helps you identify the true source of pain and choose more effective treatment strategies.

Anatomy doesn’t change—but protocols do. Flexor tendons are one area where what you’re doing in the clinic may not always match what you’re expected to know for the CHT exam. If you’re studying based only on the protocols you use at work, you could be missing an important part of the picture.

I recently consulted with a patient who had a nondisplaced radial styloid fracture—but as she told me how she had been immobilized, I immediately started asking questions.

What if the MRI isn't telling the whole story? Let's talk about a real patient case as we break down the critical thinking behind persistent wrist pain and why looking beyond the wrist can change your treatment approach.

Distal radius fracture rehab isn't just about waiting for the bone to heal. It's about knowing when to progress motion, how to teach exercises correctly, and recognizing that the elbow and shoulder can limit wrist recovery.

What do you do when a patient comes in just days after surgery for a finger fracture? I take you through my entire thought process—from deciding what orthosis to fabricate to determining when it's appropriate to begin gentle range of motion. Understanding why you're making each decision is just as important as knowing what to do.

What are the first things you should assess after a Dupuytren's release? Let's walk through the 3 things every therapist should address when it comes to evaluating and treating patients after a Dupuytren's release.

A patient came in with a distal radius fracture and an ulna styloid fracture. One of the first questions they asked was: "Why did they only fix one of the bones?" Questions like these come up all the time in hand therapy, and when you understand the anatomy and the reasoning behind the injury, you're able to educate your patients, build trust, and make better treatment decisions.

If I had to start over and break into hand therapy today, here's exactly what I'd do. Learn the three steps that can help you stand out to employers and build confidence faster.

If distal radius fractures overwhelm you, you're not alone. In this episode, I’ll tell you how to break wrist fractures into manageable concepts so you can think critically, make better clinical decisions, and feel more confident on the CHT exam.

Memorizing protocols might help you pass a test, but it won't help you think through real patient cases. I'll explain why true confidence in hand therapy comes from understanding principles and developing strong clinical reasoning—not just following a protocol.

What do you do when a patient case doesn't make sense? Let's walk through a real distal radius fracture case and show you the framework I use to think critically, gather the right information, and make confident clinical decisions.

Never heard of hand therapy? You're not alone. Let's discuss why so many OT students miss exposure to this specialty and how you can start exploring it for yourself.

Not all carpal tunnel cases are actually wrist problems. Let's talk about how to find the true source of the symptom so you can stop chasing symptoms and start getting better results.

You know you want to become a Certified Hand Therapist... Now what? Let's talk about how to decide between diving head first into your journey or taking a slower approach that builds confidence along the way.

Nerve injuries sound intimidating, but they don't have to be. Let's go through the framework that can help you treat them.

Hand therapy can feel overwhelming. There's so much to memorize, so many protocols, and every patient is a little different. I've been there. That’s why I created 2 frameworks that can help you get through your patient cases.

When a finger amputation patient comes in with severe pain and guarding, don't just focus on the wound, focus on the nerve. Let's discuss.

I had an COTA ask me recently, "Can I really work in hand therapy?" My answer was yes. But I also told her the truth: you have to be willing to learn. If you're a COTA, here's what you need to do.

You don't have to just follow the doctor's orders when you know a different approach will better serve your patient. Here's how you handle pushback with confidence.

Becoming a certified hand therapist might feel out of reach if you don't treat hand patients every day, but the path is more accessible than you think. Your current experience qualifies, you don't need a formal program, and adding hand therapy knowledge will only make you more effective with the patients you already love to treat. Let's go through the full breakdown on where to start and how to prepare.

You have the tools and you know the mechanics, but your shoulder patients still aren't getting better. In this episode, I break down how to analyze your own treatment approach, manage patient expectations, and finally get unstuck with stubborn shoulder cases.

School didn't teach you hand therapy, and that's fine — I graduated from a top program and we barely touched on it. Your degree is a ticket, not a finish line; you don't need to know everything to start treating.

You don't need to know everything about shoulders to start treating them. I share my framework using modalities, manual therapy, and basic exercises that work — no matter what setting you're in.

If you’re wondering if you should learn how to treat the spine, here are a couple questions you should ask yourself as a practicing therapist.

Shoulder injuries don't have to be intimidating. I share a simple framework to help you treat bone, tendon, and ligament problems — plus why understanding protocols makes surgical cases easier than you think.

Most therapists fail the CHT exam not because they don't know enough, but because they never spend time on what they don't know. Let's break down exactly how to organize your studying so you actually cover everything.

You can't treat lateral epicondylitis with a one-size-fits-all approach. Phase, body type, and the order of your exercises all matter — and if you're still doing wrist curls for a patient who's 80% better, you might be the reason they're stuck. Let's talk about it.

Hospital systems, clinics, or acute care — which is right for you? I break down the best places to start your hand therapy career and where you should think twice.

Stop overcomplicating elbow fractures. The CHT exam doesn't care if you can name every crevice. It cares if you can integrate anatomy, protocols, and treatment. Let's discuss.

You can be so excited to finally get your foot in the door that you forget to ask the important questions. Don't let that be you — here are the questions you need to ask before you accept that hand therapy job.

If your patient isn't progressing, check yourself before you check them. You can't control what they do, but you can control what YOU do.

Your first year in hand therapy will feel hard — but that's normal. Let's break down what you should expect and what you should be doing.

Your textbook doesn't teach you everything. Oftentimes, you'll end up learning on the job. That's why I decided to break down exactly what school didn't teach you about lateral epicondylitis.

You don't need to wait for an offer to get started on learning hand therapy, let me tell you how you can get started.

Splinting doesn't need to be hard all the time... so how can you get it to be easier? Here are some tips.

How do you know if you're studying for the CHT exam correctly? I'll break down how you should be studying so you can make sure you pass.