Customized Hand Therapy [Sara Lutz, OT]

My name is Sara Lutz, and I'm an occupational therapist at the Brookings Health System, and I specialize in hand therapy.

Why do you enjoy your work as an Occupational Therapist?

I love getting to help people get back to doing what they were doing prior to injury or illness. Especially in hand therapy, we use our hands so much throughout the day, and we take it for granted. I like being able to say, this is what you can't do now, but we're gonna get you back to that, whether it be post-injury, post-surgery, or just overuse type injuries. Getting you back to what you were doing previously is very rewarding.

What are the focus areas for an Occupational Therapist?

We can actually cover the entire lifespan, birth to the geriatric population. And we are lucky enough in this facility, there are four of us on staff, so we really do cover the whole lifespan. I, again, specialize in hand therapy, and so, I look more at anything that's related to the hand or upper extremity, anything that you need to do, whether it's cooking, cleaning, being able to do fine motor intricate, nuts and bolts types work, writing, penmanship, anything like that, getting you back to doing those things. But again, we can also cover kiddos up to adults, whatever they need to do.

Why do you love hand therapy?

I didn't know that I loved hand therapy until I really got to be in the thick of it. I'm a very organized and structured person, and so, hand therapy typically follows a general progress, or there's a protocol involved. And so, with that, you have these milestones that you're gonna be hitting, and it's so great for patients to be able to say like, this is where we're at, this is what you can expect is coming next, but this is where we're gonna get to, and an end range. Progress is fantastic to be able to see with patients. It's fun to see them hit those milestones and to be able to say like, typically this is how you heal, or typically this is how this evolves. And so, hand therapy definitely gives me the ability to be able to get you to where you need to be, but following these very organized structured steps.

What is hand therapy?

Hand therapy encompasses so much more than just the hand. It's really anything from fingertip to shoulder. I do dabble a little bit in the neck, but depending on if your neck is involved with back, we'd have to refer to a physical therapist. Hand therapy really could be trigger finger, carpal tunnel, nerve-related pain or tendonitis at the elbow, biceps ruptures, triceps, pain ruptures, and then anything shoulder, pain pre or post-op on any of the conditions. So, anything hand therapy, like I said, is more than just the hand. It's fingertip to shoulder.

What treatments do you use during hand therapy?

Depending on where you have pain and what's causing the pain, there are lots of modalities, or like feel-good things that we can do during hand therapy. So, we can use ultrasound or deep heat. I do cupping, I do different sorts of, I hate calling it scraping, but like soft tissue mobilization, just to get out some of the aches and pains, or the knots to try to reduce pain. After we've got your pain level under control, we then move on to gaining back range of motion. So, if things are stiff, whether it be your joints or the tissue, we work on getting those joints and the tissue to move like they're supposed to again. And then last but not least, we try to gain strength or function. So, we could be doing just some different exercises to strengthen the muscle, but if you're someone who is like, I need to be able to use this tool to do this specific job, I try then to actually practice some of those skills to get you back to that functional task as well.

How do you determine a treatment?

So, working with a physician, we develop a customized plan of care for the patient. From there, after we've got the physician's broad guidelines, I then get to use my clinical expertise to determine what modalities are gonna be appropriate, what exercises are we gonna use, what areas of the body are we focusing on to determine what we're doing in therapy.

How can hand therapy improve quality of life?

So, again, typically when people come to see me, it's because something hurts, something isn't working right, it's not moving right. And so, my job is to get the pain under control, or at least to a manageable level, or refer you to a specialist who can help with that, and then get you back to doing what you were doing, whatever it may be.

How can a patient get started with hand therapy?

If a patient was interested in hand therapy, you do have to seek a physician's referral. Sometimes that's as easy as just calling your doctor and saying, hey, I have pain in my hand. I'd like to try some hand therapy. Some physicians will take that and just write an order from there and fax it over. Some physicians are gonna wanna see you just to do an assessment as well, maybe take some X-rays or imaging, and then from there, they would send a referral to me.

Why is Brookings Health System a great place for outpatient care?

The Brookings Outpatient Clinic is actually the only clinic in town where we are a one-stop shop. We have occupational therapy, which includes hand therapy, physical therapy, and speech therapy, all on staff. I think we're a pretty friendly and great group to work for as well. And we've got a lot of different brains that we can pick. So, it's fun when we get a condition in and it's like, ooh, I maybe don't know the best answer. We have other staff members that we can pick their brain, and again, we're a one stop shop.