As an outpatient physical therapist, depending on your setting, you likely perform quite a bit of manual treatment. In a typical orthopedic sports setting for example, if you see an average of 12 patients a day and incorporate manual techniques for 10-15 min of your treatment time, you may be using those helping hands for a solid 2-3 hours a day.
This is an extended workout for your hands. It’s important to be mindful of potential overuse and implement strategies or techniques to help preserve one of your most valuable assets as a physical therapist. Darragh, et al conducted a cross-sectional survey of 1,158 physical therapists in 2012 and concluded: “Manual therapy should be considered, along with patient lifting as one of the most substantial risk factors for injury (among physical therapists) and methods and devices to improve manual therapy safety should be developed and tested.”
The following methods have not been researched or tested to determine the overall benefit. These are simple suggestions and resources to help decrease strain at your hands in order to endure a long and successful career.
1. Get strong
As physical therapists, we all know the role that strength can play in preventing injuries. We use these strategies everyday with our patients to make them more resilient. We can apply the same principles to ourselves. You need to have good endurance in the muscles of your hands to tolerate long work days, while at the same time having good overall strength through the grip, fingers, and wrists.
This kit has a few different resistances as well as bands for training finger extension, and would be a great option for beginners and building endurance. You can always use the low tech, economical, and ever classic, rubber band for finger extension as well.
If you want to work on more pure strength you should seek out a grip trainer with more tension. Something like Captains of Crush would work well and has been popular in the strength and conditioning world for years.
Don’t forget wrist strength, either! Throwing a dumbbell in the car would be another multi-tasking way to get wrist extension and flexion in, but only at stop lights because, well, safety first!
2. Get assistance
Many manual therapy purists will say that there is no replacement for using your hands to feel motion, tissue changes and other subtleties during treatment. I completely agree, but if you can’t use your hands due to pain or injury then they aren’t much good to you anyway. I say take a little help whenever you can.
If you’ve evaluated the patient and the tissue with your hands and you feel you can use a tool to perform the treatment, it could be a great way to decrease the stress on your hands a little bit. There are many tools out there on the market nowadays.
I recently got this one from Erson Religioso, and it has been a lifesaver for me. I love the grip in the middle that makes it easy to hold and the fact that I don’t have to switch tools if a want a different effect.
3. Get educated
I don’t know about you, but we didn’t spend a lot of time in school during labs going over alternative soft tissue mobilization techniques. There are too many important things to cover during the whirlwind of PT school to spend additional time discussing the endless variations of every single technique out there. Typically it takes a bit of time practicing in the real world to understand which techniques cause discomfort for you when performed repeatedly. This is the time to tap into the resources around you.
Talk with your coworkers. Chat with all of them, and see if they have other techniques they’ve found successful. While it’s great to have one strong mentor to learn from, there is also value in asking around.
Another source that I’ve found valuable is drawing from the massage therapy world. These folks rely on their hands for income and are great at reducing overuse injuries or aches and pains. I had the benefit of having a massage therapist on staff at my first job and would often pick his brain on different techniques.
Doing a quick google search can also turn up new-to-you techniques that massage therapists have been using for ages. This You-tube channel is one of my favorites. He hooked me with a great video on thumb-free massage techniques. Getting advice from within and outside of the PT world can provide you with some effective, alternative techniques.
Take care of those helping hands!
As physical therapists, we care for people all day. We need to remember to take care of ourselves, as well. Not only for our health, but for the longevity of our careers. If you plan to work in a manual therapy focused outpatient clinic for the foreseeable future, keep these suggestions in mind.
If you have tips, tricks, or resources of your own, please share them in the comments. I’m always looking for ways to avoid my achy Friday hands and I’m sure I am not alone.
- Darragh AR, Campo M, King P. Work-Related Activities Associated with Injury in Occupational and Physical Therapists. Work (Reading, Mass). 2012;42(3):10.3233/WOR-2012-1430. doi:10.3233/WOR-2012-1430.