What We Do

Our therapists are here to help you overcome any hand, wrist or arm injury or condition, and any scarring on the body. This could be from an accident, sporting incident, surgery, or just a recurring pain that is starting to impact on your way of life. We are trained to assess your injury or condition, provide you personalised treatment plan to see you back to good health, or to manage your pain. Treatment could include rehabilitation exercises to build strength and support, or a custom made splint or cast to help repair any damage, or we may need to refer you onto surgical advice or for x-rays or ultrasounds should we need to have a clearer picture of your situation.

We are always working with a variety of health professionals such as local doctors, orthopaedic surgeons, hand surgeons, physiotherapists and other local allied health professionals, and rehabilitation providers. This allows us to either understand your specific situation, help devise the best course of action for your injury or condition, and to ensure you are receiving the best possible care and up-to-date information about treatments.

Whatever your upper limb condition, our team will go out on a limb to put in place a suitable treatment or pain management plan just for you.

Common hand, wrist and arm conditions and injuries that we see include:

  • Carpal tunnel

    At the wrist level, we have a tunnel in which the tendons operating our fingers run. The median nerve also runs through the tunnel, and not being as robust as the tendons, it can become squashed if there are changes to the shape of the tunnel, or increases in inflammation. When this occurs, symptoms include tingling in the thumb, index and middle fingers, sometimes associated with pain, and dropping items due to lack of sensation.
  • Trigger finger

    This can occur when the tendons pulling your fingers into a fist, enlarge and have difficulty moving through a pulley. Over time, a nodule can develop and the finger can get stuck when the nodule clicks through the pulley, but doesn't want to then come back through again. The condition can be painful. Splinting can help to relieve the symptoms.
  • Thumb arthritis and pain

    Arthritis can affect all of us at some stage. Osteoarthritis is a wear and tear condition and a common spot for this to occur is at the base of our thumbs. Over time, pain can develop from damage to the joint itself, from weakness that occurs, or an imbalance of muscles that are working to try and support the joint. We can help to strengthen, re-balance muscle power in the thumb, and learn about how to protect the joint from ongoing damage.
  • Dupuytren's disease

    This is an interesting condition where the fascia or tissue around the tendons in your palm, thickens and as a result, it produces contraction of the tendons, pulling the fingers in towards the palm. This can be a quick progression, or it can take years. The fingers most commonly affected are the pinkies, ring fingers, and thumbs. Conservative management has historically been unsuccessful in preventing the contractures from developing because the disease process is so strong. Therefore, it is recommended that a review with a hand surgeon be the best starting point. We help to manage people post operative to ensure the surgery gains are maintained.
  • Broken bones

    Fractures are breaks in the bones. Yes, a broken bone is a fracture! The most common are fractures the distal radius (largest forearm bone) and the finger bones. Fractures can be treated with immobolisation to allow them to heal, or they can be treated with surgery, often called an ORIF (Open Reduction and Internal Fixation) whereby surgeons secure the bone with screws or plates. Whichever option you are undergoing, it is important to get to therapy early so ensure your fracture is supported in the correct position for healing, and to prevent other joints and fingers from getting stiff unnecessarily.

  • Finger joint injuries

    These are common! They can involve a dislocation, a break in the bone, or disrupt the tendon and joint ligaments. Swelling is often present and this persistent swelling can cause stiffness and limit recovery. In therapy we work on supporting the healing of the finger joint with a splint and work with you to keep the swelling down and move the joint in a way that is safe and prevents stiffness.
  • Scar tissue

    People are affected by scar tissue in individual ways. Scar tissue can stick to other tissues in the body, such as nerves, tendons, skin and ligaments, which the affects those structures abilities to move and work effectively. Softening scar tissues has a great impact of reducing this issue, as well as improving the cosmesis (how the scar looks). Scar management is easy once you know how, and we can help teach you.
  • Post op hands and wrists

    We work closely with the local surgeons to look after your hand and wrists following surgery. We are trained in knowing the healing time frames for wounds and for the recovery of bones, tendons and tissues in the body. In therapy we will often remove your post op dressings, look after your wound, and start therapy under the guidance of your surgeon. It is a team effort.
    A moist woundbed is the most effective way to heal wounds. Applying the correct dressings is important to prevent the wound from dying out. A dry wound is at risk of developing a scab. Wounds heal from the outside in, and can’t do this well if there is a scab in the way. As wounds normally heal, they often contract and tighten. The longer a wound takes to heal, the more scar tissue that is laid down. This can effect movement of the upper limb or hand.
    Nerve injuries and compressions
    Our nerves travel from our neck through our shoulder and armpit region and down the arm into the hand. There are three main nerves supplying sensation and instructing our muscles. These are the radial, median and ulnar nerves. Nerves are sensitive to change. They can become stretched, caught between muscles, compressed in tunnels within the arm, or sensitive to swelling or pressure. When nerves are injured, they take a long time to recover and this effects your sensation and how well your muscles work. Nerves are very important to our normal daily function. If you have altered sensation (either lack of feeling, or increased sensitivity when touching things), muscles weakness or pain, it is most likely from a nerve injury or compression. It is best to sort these out as soon as possible to avoid permanent damage to the nerve and muscles it supplies.
    Tendon injuries and inflammatory conditions
    We have all heard of RSI before. Repetitive Strain Injury. Over time, this term has been replaced, because the word RSI did not describe well the nature of tendon and soft tissue injuries. Tendons can become very painful when they are over loaded (doing too much work that was out of normal), or when they are compressed over time. There is often associated swelling. Splinting, kinesiology taping and activity modification are just four methods to help settle the tendons down and alleviate the pain. Tendons respond to exercise that increases their capacity or ability to take on more work, and we can help design an exercise program to help your tendons recover, and to prevent re-occurrence.
    Tennis Elbow and Golfer's Elbow
    These are also known as Lateral Epicondylitis, or Medial Epicondylitis. If you find the two bony lumps on either side of your elbow, these are your epicondyles. The muscles that operate the wrist and the fingers attach onto these points. Sometimes, people can get pain at these attachment points and the muscles can become painful, often during gripping activities.
    DeQuervain's Syndrome
    When you have DeQuervain’s, you commonly have pain and swelling on the thumb side of the wrist. Pain is increased with gripping, and pinching or holding a saucepan, for example. In this region of the wrist, friction is caused when two tendons that move the thumb, rub together or are compressed in a tunnel at the level of the wrist. Splinting, and taping work well to settle the condition, and a strengthening program once the pain settles helps to return people to normal activity.
    Complex surgical reconstructions
    Unfortunately we see many large injuries to hands and arms often the result of a farm equipment accident or crush injury. Traumatic injuries result in large amounts of trauma to the soft tissues in our arms and hands, and produce large amounts of swelling. In turn, this causes scarring of our tissues to one another, which as a huge impact on movement. There is a balance between creating movement in the injured limb to prevent tissues sticking together, while also resting the injured part to allow structures to heal well.
    Joint instabilities
    Our joints are supported by ligaments and muscles. Ligaments are short thick structures at the joint, which communicate with our brain about the location of our hands and limbs so we know what our hands are doing even we are not looking at them (proprioception). Muscles cross the joints and provide strength. If either ligament or muscles become damaged, or are known to be lax, the stability of the joint becomes affected, which can cause pain. If you are getting joint pain, it could be from an instability and this is not uncommon in the wrist. We can help you retrain the muscles and ligaments to overcome the instability.
    Finger dislocations
    These are common in sporting injuries often from blows to the ends of the fingers. The most common joint to dislocate in the fingers is the PIP joint (proximal interphalangeal joint), which is the second joint down from the tip of the finger. Joints are supported by ligaments and tendons. When a joint dislocates, often the structures around it are damaged, including these ligaments or tendons. Depending on which ones are injured, the treatment can be different. Custom made splinting is applied to the joint for protection whilst the surrounding structures are healing, with a balance of specific exercises to prevent stiffness from occurring.
    Any body part that has been through an amputation is at risk of developing sensitivity at the stump, which can cause pain, and make things like reading a newspaper, feel like razorblades. It is important to start the process of desensitisating the area early so the nerves are relaxed and start to get used to the part of the body being altered. It is common to also experience phantom pain, where you may have an itchy finger, but that part of the finger is not longer there.
    Complex Regional Pain Syndrome
    Also known as CRPS for short (and previously known as RSD), this syndrome can be devastating if not assessed and treated early. CRPS can occur in anyone, and is most common after an injury. The main symptoms is the development of pain outside the normal parameters for the injury. Other symptoms can include increased swelling, sensitivity when touching things, sweating or dryness or the skin, mottled or blotchy skin compared to the other hand or arm, and changes to the way the nails grow. Once of the biggest effects of CRPS is stiffness in the affected part, but also surrounding parts. When people have CRPS, things hurt! We are here to help and get you back on the road to regaining function in the hand.
    Stiffness and lack of strength
    After any injury or condition, stiffness can occur and strength can plummet due to disuse of the muscles, prolonged periods of being held still in a cast, or persistent swelling that blocks movement. Joints are prone to getting stiff very quickly. We use a variety of techniques to ensure we get your hand and wrist moving first and then we work on regaining your strength.
    Pins and needles and numbness in hand or wrist
    This is nerve related. We help identify which nerve is being affected and why it is being compressed or irritated, and provide solutions for overcoming this. A compressed nerve left for a long time, can become damaged, so best to get onto these things early.
    Wrist pain
    We love wrists! We see many painful wrists coming through our doors. There are many joints in the wrist. We have two forearm bones that form part of the wrist, but we also have eight small carpal bones that all join together. Wrist pain can be caused by many factors, such as tendon inflammation, instability or laxity of ligaments that support the joints, fractures, or injured ligaments that then don't hold the bones in the correct places. Whichever one is affecting you, we can help.
    Upper limb limitations from neurological injuries
    The upper limb can be greatly affected by neurological injuries, such as stroke, brain injury or spinal cord injury. In particular, the damage to the nervous system can impact on the communications between the arm and the brain. It is not uncommon to develop tight muscles resulting in wrist and finger contractures, tremors, weakness, and some muscles that just don't work anymore. Anyone with a neurological injury is different and therefore goals and strategies need to be individualised for best outcomes.
    This can occur following surgery where lymph nodes are removed, or from damage to the lymphatic system from trauma or radiation therapy. During lymphoedema, swelling occurs in the lymphatic channels of the arms, chest or legs, as the body is not able to regulate the lymphatic drainage well. Over time, the swelling can harden and become fibrotic, so early diagnosis and treatment is paramount to a good outcome.


    Look after your precious people

    Children's injuries can cause the good old parent angst! Should you of brought them in earlier? You didn't think it was broken? Don't worry... you are not alone here. We help you undertsand the injury and how long things will take to heal.  

    Make waterproof casts

    Clunky, itchy, heavy plaster casts that start to unravel and come loose are not ideal! We safely remove these and provide waterproof casts so you can swim and shower without a plastic bag!! 

    Make splints to suit your injury

    We make these every day and we love them! Light weight and removable so you can do your exercises, check your wounds, and shower whilst still protecting your injury. There are night splints, day splints, soft splints, supportive splints, finger splints, thumb splints, wrist splints ..... all different kinds and sizesand we choose the right one for your needs. 


    We teach you the right execises to do for your injury - not what Dr Google says!! We help to rebuild your strength and movement in a way that does not make your pain worse. 

    Care for your wound

    We love helping you with your wounds.... we show you how to dress them well so they heal in the right time frame and we check your wounds to make sure they are healthy. 

    Advise about work

    Going back to work after an injury can seem a bit stressful.... especially if you have been away from work for some time. We help you to know which acitivites are good to start with and give advice on when and how to get back to your work duties. 

    19/325 Edward Street
    Wagga Wagga NSW 2650

    © Riverina Hand Therapy