What Are You Doing to Protect Your Hands As An Occupational Therapist?
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[00:00:00] Hey there, it's Hoang. One very common question I get as an occupational therapist and certified hand therapist is, Hoang, how are you protecting your hands as an occupational therapist? Um, I had one person send me a message that says, I've been working as an occupational therapist for three years and my hands are always in pain.
Like, what are you doing? Well, my name is Hoang. Like I said, I'm an occupational therapist and certified hand therapist, and I've been in practice and clinical practice for over 20 years. Now, how did I do that by Um, and not have any hand pain. Well, I'm going to share those secrets with me so that you too can save your hands.
I think one thing that I hear often of, um, therapists who want to move away from their current setting, moving into hand therapy is like, it's easier, right? It's easier for your back. I've done skilled nursing. I've done home health. I've done acute care. Majority of my experience is in acute care. And I was recently reminded of a how heavy that really [00:01:00] is.
Um, you are getting people in and out of bed who. you know, can't get up, who are sick and you're managing lines, you're managing all sorts of stuff and it can be really tough on your back. When you're in hand therapy, majority of the time you're working with people who are really stiff, right? You're working with stiff hands and the smaller their finger is, Like if you're working with a thumb, it's almost better than if you're working with like a small finger.
It can be so straining onto your hands because you have to work like it's trying to, trying to move them and it's like patient after patient after patient and you go home at the end of the day, With hand pain, with thumb pain, with tingling, with numbness in your hands, with fatigue. I mean all sorts of stuff.
I've heard it time and time again from so many occupational therapists. I hear from physical therapists, too, who are doing a lot of manual therapy and then having pain. So I'm gonna share with you, these are three things that I do. [00:02:00] These are my main three things and I go back to them time and time again Alright.
If I ever, I'm like, why, why do I feel this? This is exactly what I do. Number one, I'm always making sure that. I don't have pain. As soon as I feel it, I really work to take care of it, right? Number one, you've got to take care of your body. So your hands will be stronger if your shoulders are stronger, right?
If your, if your biceps, your triceps, your elbow muscles, your forearm muscles, if all those muscles are stronger, then your hands will be stronger. So number one is that I do a certain amount of exercises. I don't do like a ton. I'm not like a gym buff. You know, I mean, I am going to the gym now more just because I'm getting older and I'm thinking about longevity in my career.
And I'm like, okay, I don't want, I, I, I don't want to get to a point in my [00:03:00] career where I'm, You know, I want to retire and like everything hurts, right? Like that's just not how, how I want to live my life. So I do things to protect my hands. First and foremost, I make sure I exercise. If I am giving my patients an exercise, I need to know how it feels on me.
So I get my exercise in when I'm demonstrating for them When they're doing an exercise, I will do it with them so that I'm like, oh if I'm working on internal external rotation you know for sure I'm doing some of those if They are working on shoulder extension, you know, I'm working on shoulder extension to things like that.
I will work on Um, my hips and my back while they're doing stuff. So it looks like we're exercising together. So I get it in when I can. That's number one. Protect my own body first. Number two is I'm a really big fan of managing [00:04:00] my body mechanics, right? And I this is so embedded in my manual therapy workshops and I show people how to work with patients.
in different positions. So now, generally speaking, and I'm going to say generally speaking, you'll see a hand therapist on one side of the table and you'll see the patient on the other side of the table. I don't think that that works that well. First of all, I'm not a very tall person, kind of short. I'm 5'1 and that's stretching it.
I have good length arms, like I'm proportional, but, you know, you know, my arms can only go so long and your patients come at different heights, different sizes, and your hands are, your hands are different size from my hands. And so, you know, when I teach within my manual therapy workshop, I go over those body mechanics, like things [00:05:00] like fundamental things that you have to take into consideration.
I'll give you an example. I don't always like to work in front of a person. If I have to work their whole arm, I will sit next to them instead. I will put them on a mat and sit. Now, I know some people are like, Well, I don't have the space, you know? One, you should ask for the space, because in most therapy clinics, there's and other people don't need to hoard them off.
Right. I remember moving from, um, my outpatient setting to another clinics outpatient setting and they literally were putting baby in the corner. You know what I mean? Like I had this like little hallway and it had a long table where all my patients could sit. I'm like, thank you. But no, thank you. I need a mat.
And I was not going to manage three patients. Four patients at a time on one mat and then run across the room to get to a mat. [00:06:00] I was like, you guys need to rearrange this and I need that mat right next to me. The PT who can only see so many patients at a time had like five mats for him. I was like, yeah, people can move the equipment and give me a mat right next to me.
to me. Um, and I think part of it is like, you just have to ask. If they say no, they say no, but then you have to ask. And I mean, I didn't ask in that way. I'm like, obviously I'm telling the story, but I asked very nicely. I was like, I really, in order for me to do what you want me to do and get results for patients and have them keep coming back because they're really happy with how I'm treating them.
I need this mat next to me. You know, like you can say it in a nice way. You can say it in a way. That can get you what you want. And so telling a story, but I'm not that I'm not not that harsh So body mechanics is really, you know, it's really huge for me. Yes. It's extremely important. We should celebrate it So I think of not [00:07:00] only Um, you know, working in front, I'll think of patients different positions.
And then the other, uh, example of good body mechanics is, um, managing, you know, managing my own body based on what I need to do. So for example. For example, if I am working on a really stiff elbow, I'm not working at the table. I need them on a mat because it's going to be so much easier for me. And I want to use my whole body.
Like I'm going to use my whole arm versus just, um, you know, using my hands. Let me know if that makes sense. You can leave a comment below of if any of this helps or if this really makes sense to you. Um, because I think that for us therapists, like we really do have to think about our own [00:08:00] bodies and longevity.
And so body mechanics is a really important aspect. You know, any follow up questions from it? Just just leave me a comment below. Um, but yeah, I want to use my whole body and you know, your leg muscles and your body weight can be really helpful when you're working with someone who's really stiff and that way you protect your hands, right?
Um, so number one is I exercise and keep my body pain free. Number two is I manage and focus on, um, I focus on body mechanics when I'm working with someone. And then number three, I think one of the most important things that you could do to protect your hands as a, as an occupational therapist or a hand therapist is that you have to use proper manual techniques.
So the way I see it is manual techniques is paired up very closely with body mechanics. One thing that I noticed quite a bit when I'm teaching my manual [00:09:00] therapy workshops is people have a tendency to use their thumbs very specifically like, um, where they pinch like this. So they pinch like this, then you'll see their muscles are really strained.
Um, but I think that there are ways in which you can pinch and either use different aspects. Um, and it depends, of course, on on your own mobility. Um, but I like to, I always say, like, you actually need to have the tips of your fingers much softer than you think, right? So the technique itself, if you're overworking, like if your hands are squeezing the hell out of somebody and you have pain later, you are, you are not demonstrating good manual techniques because it, it, at the end of the day, shouldn't hurt you.
Right. And then in terms of manual techniques, [00:10:00] knowing how and when to take breaks by switching your techniques is a really important concept to protect your hands. So for example, um, one of the, uh,
One of the easiest example that I could share with you is when you're working with a stiff finger, right? One of the most important exercises we could do is blocking, right? But what happens is we tend to squeeze so much. That, uh, to, to, to stop the blocking, right, to stop the blocking. Um, so from a manual perspective, right, from a manual perspective, and I'm gonna exaggerate this just so you can see it, right?
If you're blocking them from MP, PIP, and you want them DIP, but they're so strong, they're, they're, You know, we're doing it because they don't have the full motion. Let's say they're stuck like this, right? And you're trying to get them to block and [00:11:00] you're trying to go in an extension, but also allow them to block.
Right? What I've noticed people tend to do is squeeze the whole time. So when the person blocks, they're squeezing and they're constantly squeezing. Right? One thing you can do is work with them very rhythmically and say, I'm going to hold you like this. Right. And you're going to squeeze to get the extension.
And then when they come up, you relax your hand a little bit. And then when they go into block, you hold it. And then when they go into extension, you let go of it. Now, obviously, I'm, I'm exaggerating that movement. You actually don't let go. You hold it, but you're not squeezing. Right. You can hold to maintain, but you're not really squeezing.
Right. So that there's like this ebb and flow to your technique so that you're not constantly contracting. Um, the other thing in terms of the, the technique [00:12:00] aspects is if we're asking someone to do something, we need to give proper direction so that they do it correctly. So it's not harmful to us. So when I'm telling someone to do a blocking exercise and I tell him I'm going to hold you straight at your big knuckle and at your middle knuckle, and all I want you to do is pull down at your little knuckle.
When people are injured, they try really hard and they engage really hard. all of the muscles. Let me know if that happens to you. Cause that's surely always happens to me, especially when they're stiff. Right? So in that example, I'm going to hold, and then I'm going to explain to them. Okay. So I just want you to pull gently.
So only this one. So one thing I'll do is I'll ask them to demonstrate. I'll demonstrate it with their other finger. And then I teach them how to gently pull. in that one specific tendon that I'm looking to [00:13:00] improve upon without them pulling on everything and pulling on the PIP as well because then you're working super hard to do this one manual stretch with exercise.
Let me know if that makes sense. Um, so your directionality around what you're doing paired with that manual technique needs to needs to work. You're right. Like it comes down to a little bit. Technical skills is just managing. Some of that will also help protect your hands. I've trained and So many therapists who have come through my clinic and one of them, my, my, my most important thing as I tell them is if your hands are hurting at the end of the week or so, like you're doing it wrong.
Right? And so I've had students come through and it's like, Oh, the first week they're like, Oh my God, my hands. I'm like, you're doing it wrong. Um, and by the end of the three months they should be much better and they shouldn't have that kind of hand pain because [00:14:00] then it's like, okay. It tells me that they're not, um, they're not demonstrating the proper manual techniques because they're doing, they're trying too hard, or I might have to encourage them to exercise a little bit so that they not only can feel what the patients are supposed to do, so they know how to better give the direction, but also it helps them.
over time to not get injured. And that's really important. I've trained students. I've had therapists come through my clinic. I've had therapists come through through my manual therapy classes and things like that. And really, one of the biggest questions is how do you protect your hands? And I think if I were to bundle it up into those three major concepts, that's it.
You've got to stay safe. healthy and strong for yourself. You've got to eat so that you can help other people. Cause you can't help anyone if you're broken, you can't help anyone. If you're broken and you think therapy doesn't work because you're going to admit that if you're like, Oh, nobody buys into therapy.
I'm like, do you buy into [00:15:00] therapy? All right. First question asked there is do you buy into therapy? Do you know that this works? Because if you have pain and you can't get rid of it There's no way you can tell other people that it's possible for them to get rid of it, right? Therapy freaking works It's just got to be done right, right?
So do therapy to yourself for yourself so you can be pain free. Two is really pay attention to your body mechanics It's huge. It's not just for heavy lifting. It's for anything that's heavy, repetitive That you do over and over again, right? Uh, when you do it and you demonstrate it, your patients also see it and they are like, Oh wow, like I got to pay attention to that too.
It's both for you and a teaching moment for them. And then number three is using proper manual therapy techniques will save your hands. Each and every single time, right? Each and every single time. I hope this video helps you because I do want to share it with more occupational therapists, physical therapists as well, who are working in hands because hands is a different type of toughness.
You [00:16:00] know, it might not be as heavy as like lifting a whole leg or lifting a whole body, but, but it's really, it can be really hard on your body. So I hope that this video helps you and if videos like this help you You know go ahead and like subscribe and share with another friend to see if you can help them as well Protect their hands.
All right. Now if you're looking to learn more manual Therapy if you're looking to learn more therapies manual therapy techniques. I've got some other videos on my channel as well. So Um, i'm gonna see if I can link it here and you go check it out. All right until next time. See ya
