Instructional Concurrent Session 3

This presentation will be a case for hand therapy's role with patients who have undergone masculinizing mastectomies and/or radial free forearm flap phalloplasty, two gender-affirming surgical procedures that affect upper extremity function in the postoperative period. In addition to orienting participants to the unique clinical needs of gender-affirming surgery patients and providing an overview of these two specific surgical procedures as they relate to the upper extremity, participants will be guided through scar care interventions for this population. As a hand therapist with training in medical illustration, this has been developed as an illustrated self-management guide that will both help guide clinicians who have never treated gender-affirming surgery patients and guide patients in self-management techniques that will optimize their surgical outcomes.

Level: Entry

The session will equip hand therapists with practical, contextually relevant knowledge regarding the impact of core stabilization and posterior chain activation on the functional recovery of the hand and upper limb following injury or surgical intervention. This content explores the impact of pelvic, spinal, and scapular integration, plus static and dynamic postural control, on upper limb function in daily activities (activities in daily living and instrumental activities of daily living). Participants will learn methods to evaluate core and posterior chain contributions relevant to upper limb rehabilitation. This exploration will enable learners to recognize hand therapy interventions that incorporate functional strengthening and exercise principles. Attendees will use case scenarios and clinical examples to develop intervention programs focused on movement efficiency, load sharing, and endurance that support better patient outcomes.

Level: Intermediate, Advanced

This course provides a focused exploration of the anatomy, biomechanics, and clinical implications of forearm rotation, emphasizing the complex interplay between the radius, ulna, interosseous membrane, and associated musculature. Learners will examine how pronation and supination contribute to functional movement and how disruptions in these mechanisms lead to common and complex clinical presentations.

Through case-based learning and evidence-informed discussion, the course reviews key conditions such as radial head fractures, Essex-Lopresti injuries, Monteggia and Galeazzi fracture-dislocations, distal radioulnar joint (DRUJ) instability, triangular fibrocartilage complex (TFCC) injuries, and tendinopathies affecting the pronator and supinator muscle groups. Special attention is given to mechanisms of injury, diagnostic considerations, red flags, and the functional consequences of impaired rotational control.

By the end of the course, learners will be equipped with a deeper understanding of forearm rotational mechanics and the injuries that compromise them, supporting more accurate assessment, clearer documentation, and more effective interdisciplinary communication in clinical practice.

Health care in general contributes significantly to environmental degradation through waste generation, energy use, and supply chain practices. Rehabilitation services–including hand and upper extremity therapy–are not exempt from these impacts, yet the profession lacks a clearly articulated, evidence-informed framework for environmentally sustainable clinical practice.

Sustainability, for the purposes of this project, is defined as environmental sustainability within hand and upper extremity therapy–specifically practices that reduce material waste, optimize resource use, and support long-term ecological and community health in the context of hand therapy. While sustainability can be conceptualized across personal, professional, organizational, and environmental domains, this PSA will explicitly focus on environmental sustainability as it relates to clinical decision-making, materials, and systems of care.

This project responds directly to priorities identified by leaders in hand therapy and occupational therapy advocacy, while addressing a documented gap in the U.S.-based hand therapy literature. Rather than summarizing the work of professional leaders, students will conduct original scholarly synthesis, analysis, and tool development to advance sustainable occupational therapy practice.

Myofascial trigger points are hyperirritable spots within a taut band of skeletal muscle that can produce pain and limit function in the upper extremities. Dry needling (DN) has emerged as a prominent intervention to alleviate these trigger points and consequently improve the efficacy of rehabilitation therapies aimed at the upper extremities. Additionally, DN has proven effective for scar, fascial adhesions, and tendinopathy. This presentation explores the clinical applications, efficacy, and the underlying mechanisms of DN in treating myofascial trigger points and fascia for upper extremity rehabilitation therapists.  Additionally, many states have approved DN for OT scope of practice, making this valuable intervention more accessible for many upper extremity rehab therapists.

Trigger points cause referred pain, muscle weakness and inhibition, reduced range of motion, and can alter muscle activation patterns. They are often found in muscles subjected to repetitive strain, poor posture, or acute trauma. Referred pain from trigger points can mimic or contribute to common diagnoses seen in patients with upper extremity complaints, such as carpal tunnel syndrome or lateral epicondylalgia.

DN involves the insertion of fine, filiform needles into the skin and muscle directly at the trigger points. Unlike acupuncture, which is rooted in traditional Chinese medicine, DN is based on Western anatomical and neurophysiological principles. The technique aims to disrupt the contracted sarcomeres within the trigger point, promoting muscle relaxation and pain relief.  When utilizing DN for scar and fascial adhesions, the primary effect is on the fibroblasts and mechanical signaling through the connective tissue.  
DN is minimally invasive and cost-effective.  Given the specialized nature of DN, it is imperative for therapists to undergo comprehensive training. This presentation will introduce the technique, provide evidence for its use in many upper extremity pathologies, and will review the training requirements and rules in various states for PTs and OTs.
 

Level: Entry