Hand therapy in Carmel, Indiana

CHT stands for certified hand therapist, a credential awarded by the Hand Therapy Certification Commission to occupational therapists and physical therapists who meet three requirements. They must have held their license for at least three years, have at least 4,000 hours of direct practice experience in hand therapy, and pass the certification examination. Projected hours do not count, so the experience is already behind them when they sit the exam.

Plenty of physical therapists without the credential treat common wrist and elbow problems well, such as wrist tendinitis or tennis elbow, as part of general orthopedic care. The difference shows most after hand surgery, where small structures, tight protocols and custom splinting call for someone who does this work every day. A side-by-side comparison of the two roles is in hand therapist or physical therapist.

After a tendon repair or a fracture fixation, the hand has to move early enough to stop tendons sticking to surrounding tissue, yet gently enough not to pull a repair apart. Hand therapists manage that balance with a custom orthosis, a splint molded from heat-softened plastic directly on your hand, and a precise schedule of which joints may move, how far and how often.

Your surgeon’s protocol sets those limits, and they change week by week. A good hand therapist follows the protocol exactly, adjusts the splint as swelling falls, and tells you which movements are off limits at home. Doing more than the protocol allows, such as gripping a steering wheel or a pickleball paddle too soon after a flexor tendon repair, is one of the main ways a repair fails.

Returning to grip-heavy activities is usually the last stage of hand therapy, and it is guided by measurements rather than by the calendar alone. Therapists commonly compare grip and pinch strength with your other hand, check that the fingers make a full fist and straighten fully, and watch you perform the task itself before giving the go-ahead.

The details depend on what you do. Someone who types all day may need short breaks and a review of mouse and keyboard position. A tradesperson may need graded practice with tools that vibrate or require a hard squeeze. Golfers often start with putting and short chips before full swings, and pickleball players usually return to drilling before games, since a sudden volley puts a quick, hard load through the wrist and fingers.

If the injured hand tires quickly, aches the next morning or swells after a session, that is useful information rather than failure. Your therapist uses it to set the next step.