Hand Therapy in Occupational Therapy: Restoring Function Through Purposeful Rehabilitation

For Vanessa Duran, OTD, hand therapy is a focused, problem-solving discipline that blends anatomy, clinical reasoning and functional rehabilitation.

As an occupational therapist at All Star Physical Therapy in Southern California, she treats upper-extremity injuries that affect daily movement, helping patients regain strength, coordination and confidence in the process.

"I'm only here for maybe two hours of your time a week," she said. "I want to see you go off and come back and tell me what's changing."

Her caseload includes postoperative wrist and finger fractures, tendon injuries, elbow sprains, soft-tissue conditions and functional limitations caused by pain or overuse. Each plan of care is tailored to the patient's goals, whether that's lifting a coffee mug, fastening clothing, returning to work or restoring fine motor control.

Developing an Interest in Upper-Extremity Rehabilitation

Duran discovered occupational therapy through shadowing. As a student athlete, she experienced sports injuries and rehabilitation firsthand. But it wasn't until a mentor suggested she explore OT that she understood its scope.

"Shadowing was what clarified it for me," she said. "I saw hand injuries, cognitive rehab, pediatrics, all completely different but still part of OT."

Her early experiences in pediatric emotional regulation, rural outpatient therapy and acute care broadened her clinical perspective. Observing how OTs used purposeful, task-specific interventions to rebuild everyday function made the profession a strong fit for her interests.

Earning an OTD and Building Professional Versatility

Duran completed her Doctor of Occupational Therapy (OTD) at the University of St. Augustine. As a first-generation college graduate, pursuing the OTD was both a personal milestone and a strategic professional decision.

"I thought, it's two more terms. Why not?" she said. "It opened opportunities in teaching and gave me a broader foundation for clinical practice."

Her capstone focused on hospice care and family caregivers, reinforcing her interest in aging, caregiver support and community health. Today, she also serves as a lab instructor, helping students develop clinical readiness for the demands of outpatient and upper-extremity care.

Practicing Hand Therapy in an Outpatient OT Setting

In her current practice, Duran evaluates and treats conditions involving the hand, wrist, elbow and forearm. Her approach integrates several key components of occupational therapy hand rehabilitation:

Task-specific training, joint and soft tissue mobilization, scar management, fine motor and dexterity exercises, activity modification, patient education and independent carryover, and progressive strengthening and movement retraining.

Many of her patients arrive shortly after surgery or injury, unsure what to expect. Early sessions often focus on addressing swelling, restoring protected motion and introducing functional tasks that the patient can safely practice at home.

When patients return with measurable changes (reduced pain, more coordinated movement, improved grip or simply the ability to manage daily tasks more effectively), Duran sees that as a direct indicator of clinical progress.

"Patients come in saying, 'My scar doesn't hurt as much,' or 'I could carry my coffee again,' and those details matter," she said.

Supporting Spanish-Speaking Patients Through Clear Communication

As a bilingual OT, Duran frequently works with Spanish-speaking patients who may not have received comprehensive explanations elsewhere.

"They don't always get told everything about their condition," she said. "Seeing their understanding grow and seeing them manage their rehab more independently is meaningful."

By explaining diagnoses, expected recovery timelines and home exercise strategies in the patient's preferred language, she removes barriers to participation and improves functional outcomes.

Clarifying the Role of OT in Hand Rehabilitation

Because hand therapy often resembles physical therapy from the outside, patients sometimes mistake Duran's profession. She addresses the difference directly:

"I care about what you do outside of here, your routines and the tasks you need to perform," she said. "That's where OT makes a distinct impact."

OT's emphasis on meaningful activity, fine motor coordination and real-world function helps patients make practical progress that aligns with their daily roles and responsibilities.

Guidance for Students Considering Hand Therapy or OT

For future OTs, Duran recommends exploring multiple practice areas before choosing a specialty.

"Shadow as many areas as you can," she said. "Hand therapy, pediatrics, mental health, aging in place. It's important to see the range of what OT can do."

When evaluating programs, she suggests considering board exam preparation, student support and how well the curriculum prepares graduates for clinical decision-making.