Instructional Concurrent Session 10

Modern life has made us increasingly sedentary – and with that comes the growing impact of gravity pulling us down. Scapular depression can create downward traction on the brachial plexus, reduce subacromial space for the rotator cuff, and contribute to persistent neck pain.
 

This session will focus on evaluating resting scapular position and assessing dynamic scapular control, and provide attendees with practical, easy-to-apply treatment techniques designed to restore optimal alignment and function. 

Attendees will learn the difference targeted scapular intervention can make. Whether you primarily treat hand patients or shoulder conditions, this presentation offers valuable insights you can immediately integrate into your clinical practice.

Level: Intermediate

This session will spotlight several of the Clinical Practice Posters presented at this year's Annual Meeting. Presentations of interesting cases and novel treatment or educational approaches will be followed by time for discussion and audience questions. Come to learn, innovate, and collaborate.

Level: Entry

Working with patients after tendon repair can be daunting and anxiety provoking. Risk of rupture, adhesions, and poor outcomes can be particularly stressful for clinicians, who may doubt how to proceed with care, despite knowing guidelines for treatment. Lack of confidence not only can limit patient progress but also may impact patient experience with their recovery. Moreover, anxiety on the part of the treating clinician can interfere with effective communication both with the patient and the referring physician.

This presentation will first give participants the opportunity to reflect and discuss fears when treating patients with tendon repairs, discuss how they navigate care, and identify the strengths and challenges in their approaches to date. Next, the presenters will review fundamental principles of tendon healing and explore the ramifications of care that is either too conservative or too aggressive. Then the presenters will identify indicators for advancement so that therapists can confidently know when to progress patients as well as how to confidently communicate a balance of progressing movement in a protected way with patients and conveying concerns clearly with physicians. The session will end with a group case-based discussion. Participants will be allowed to ask questions throughout the presentation and are encouraged to share challenging cases.

Level: Entry, Intermediate

This instructional session examines how technology shapes the real-world workflows of hand therapy and how digital systems can either support clinical expertise or quietly disrupt it. While upper extremity rehabilitation is inherently complex, much of today's strain stems from the technology layered around care rather than from patient complexity itself.

The session focuses on how electronic medical records, clinical decision support, outcome platforms, wearable data, automation, and digital communication tools influence daily practice. Participants will explore how template design, interoperability gaps, and documentation logic affect clinical reasoning, time use, and collaboration.

Real-world scenarios will highlight common friction points such as excessive clicks, duplicative documentation, rigid templates, disconnected outcome tracking, and reporting requirements that divert attention from patients. These examples will be examined using a framework that distinguishes productive clinical complexity from unnecessary technological complication.

Interactive polling and case-based workflow mapping will help participants identify inefficiencies in their own settings and consider practical improvements. Attendees will leave with clear criteria for evaluating and advocating for technology that aligns with clinical care, protects professional judgment, and supports resilient practice.

Brachial plexus injuries (BPI) present some of the most complex and uncertain rehabilitation trajectories in hand therapy. In this instructional session, participants will follow a two-year case study that serves as a clinical roadmap for a patient with a complex BPI who underwent a free functional gracilis muscle transfer to restore elbow flexion. Using a structured clinical timeline, the session will illustrate rehabilitation principles across multiple phases of recovery, including postoperative protection, transfer activation, and progressive neuromotor and functional training. 

Attendees will gain an overview of upper extremity surgical options for complex BPI and explore the tenets that guide rehabilitation after free functional muscle transfer, with emphasis on cortical retraining and facilitating volitional activation of a newly innervated muscle. Multimodal interventions–including neuromuscular electrical stimulation for home use, orthotic management, functional capacity evaluation, aquatic therapy, and emerging technologies such as the Zimmer emFieldPro–will be integrated within current evidence and clinical reasoning to demonstrate how they support functional progression. The session will also address strategies to promote long-term adherence over a prolonged recovery trajectory, highlighting patient-centered decision-making and interprofessional communication to translate complex reconstruction into functional outcomes when no standardized rehabilitation roadmap exists.

Level: Entry, Intermediate