Restoring your quality of life

How we can help

How we can help

Are you experiencing pain, swelling or other symptoms caused by an injury or condition in your hands, wrists or elbows? Hand Works is an occupational therapy service specialising in the management of hand and upper limb injuries and conditions. We have 8 clinics based around the Perth Metropolitan area.

What is Hand Therapy

What is Hand Therapy

Hand therapy is a specialty practice area of Occupational Therapy, typically concerned with treating upper-extremity injuries and conditions, optimising the functional use of the hand and arm.

Problems We Treat

Problems We Treat

Carpal Tunnel Syndrome

The carpal tunnel is an area on the palm side of our wrist, between our small wrist bones, and some connective tissue, which forms the roof of this tunnel. Inside this area, there are 9 tendons and a nerve which makes it very busy and compact. If you bend your wrist forwards, or clench a fist, this can squash the nerve. If you do this repetitively, it can eventually compress or irritate the nerve, which can lead to numbness, pain, weakness. Symptoms typically involves your thumb, index and middle fingers. Your doctor can diagnose this with ultrasound or Nerve Conduction Studies can be arranged. That said, our therapists can assess your wrist and get an idea if imaging is warranted and commence treatment straight away. If managed early, it can respond very well with non-operative treatment.

De Quervain’s Tenosynovitis

This injury often occurs from repetitively moving your thumb and wrist joints e.g. When picking up a baby, high volumes of computer work or repetitive lifting and gripping. Symptoms include pain and inflammation of the two tendons that moves the thumb up and out to the side of your palm. The pain usually radiates up the thumb side of the forearm and wrist. Pain can occur with tasks that involve twisting of the wrist down or even side to side. Conservative treatment for De Quervain’s includes splinting, activity modification, tendon gliding exercises, taping and once pain has settled, a gradual strengthening program to prevent aggravation of the tendons. If pain is still persistent after a period of conservative management a corticosteroid injection or surgery may be recommended. Our hand therapists are able to assist with recommendations to a hand surgeon if this is required.

Dupuytren’s Condition

Dupuytren’s is a disease whereby the fascia (connective tissue) in the palm of the hand contracts and develops thickened cords and nodules, over time these cords and nodules can pull the fingers into the palm. The most common fingers effected are the ring finger and little finger. Little is known about progression of the disease and cause, however it is suggested those who have Celtic or European Ancestry are at increased risk of developing this condition. Generally, treatment is not required until you are unable to place your hand flat on the table or it limits your day to day function. Treatment options are limited to surgical interventions, whereby your surgeon will discuss suitable options to improve your symptoms. Post operatively, you will likely be required to see a hand therapist to assist with managing the acute wound, swelling, pain and finger stiffness. After the wound has healed and sutures removed (if required) your hand therapist will fabricate a thermoplastic orthosis to prevent your scar from tightening and further pulling your finger(s) down into the palm. Your therapist will also guide you through an individualised home exercise program to assist with scar management, finger movement and strength to optimise your return to meaningful activities.

Elbow fractures or dislocations

Elbow fractures or dislocations usually occurs following a fall, high impact blows or through a sporting injury. It can be painful and functionally limiting. Following injuries like this, your doctor will often refer you for an X-ray and further treatment. At Hand Works Occupational Therapy, our hand therapist will be able to provide you with a waterproof thermoplastic orthosis that is made custom to your elbow to immobilize and protect the joint. If there are no fractures to the elbow following a dislocation Injury, you may have injured your ligaments and surrounding soft tissue in the elbow. In our rooms, our therapists are able to perform a battery of provocative tests to assess the stability and strength of your elbow and if suited, will manage this injury conservatively with a period of splinting, strengthening and proprioception exercises. If a high-grade injury is suspected, you may be referred on for further imaging and advice. If there is a significant fracture to the elbow, this will be treated surgically, followed by an extensive hand therapy rehabilitation program to regain your movements, strength and hand function.

Finger Dislocations

Finger dislocations occur due to a sudden force applied to a finger, most commonly seen in sporting injuries, forceful twisting injuries and falls. The goal of therapy is to increase the stability of the involved joint in the finger whilst maintaining finger movements. Once a thorough examination has been completed, an appropriate splint may be fabricated to help support the finger while the injured structures (most commonly ligaments) heal. This splint/orthosis aids in reducing the risk of re-injury while allowing the appropriate structures to heal, as well as helping to reduce the swelling and pain. Your therapist may also provide you with specific finger exercises to complete to finger stiffness and ultimately improve your hand function and strength.


Fractures are breaks in bones. These types of injuries often occur from falls, high impact blows, sporting injuries, crush injuries, or twisting type forces. Symptoms of a broken bone can include pain, redness, swelling, difficulty moving a joint and stiffness. To assess for a broken bone, one will be required to have an X-ray or a CT scan of the injured site. Depending on the severity of the fracture, your doctor may recommend immobilisation in an orthosis/splint or a surgical opinion. Fractures that are simple and minimally displaced can be managed in a thermoplastic orthosis. Our hand therapists are well trained at fabricating appropriate splints/orthosis for any type of upper limb fractures. This waterproof thermoplastic is custom fitted and can be remoulded to improve fit as your swelling improves. For fractures that requires surgery, a thermoplastic orthosis can also be made pre or post operatively to immobilize the joint. Our hand therapists are able to liaise with your treating doctor/surgeon to ensure you get the best possible functional outcome and are able to guide you through your rehabilitation.

Hand Stiffness

Hand stiffness may be due to a number of reasons including swelling, muscle tightness, scarring and joint tightness due to a period of immobilisation. At Hand Works, our therapists are able to perform specific assessments to determine the cause of your stiffness and provide you with a tailored exercise program to improve your condition. You may also be fitted with an exercise splint or a splint to improve your range of motion to further assist with your recovery. Depending on severity of your condition, your therapist may also recommend further imaging to rule out other causes of ongoing stiffness.

Ligament injury to the wrist

Ligaments are short, tough bands of connective tissue that hold our bones together to form a joint. In our wrist we have multiple small bones, which are each connected by ligaments. When you 'sprain' your wrist, you may have injured one of these, which can result in pain on certain movements, actions, with weight-bearing or occasionally producing a 'clunking' feeling. Ligaments play a very important role in not only stabilising our joints, but to inform the brain of our body awareness and improve coordination. If injured, our therapist can perform clinical assessment in our rooms, or your doctor can refer for an MRI if a high-grade injury is suspected. Depending on the severity of the condition, our therapist may provide you with a wrist orthosis to protect and immobilise the ligaments for a period of time before commencing you on a home exercise program focusing on mobilising and strengthening the wrist.

Nerve Injuries and Compressions

The nerves that give our hand and upper limb movement and feeling begin from our spine and travel down through our shoulder, elbow, wrist and then hand. Along this course, nerves can become trapped and compressed among muscles, ligaments and tendons. When this happens, we might experience weakness in the muscles of our hand and arm. We might also have altered sensation such as numbness, tingling, burning or pins and needles. We have three different nerves in our arm. These are the Median, Ulnar and Radial nerves. Your doctor may refer you for further examination of the nerve and our hand therapists will be able to conduct a series of assessments to distinguish which nerve is trapped or compressed and where the compression site is. Depending on which nerve is injured or compressed and where, conservative treatment may involve splinting, exercises and other treatment modalities to help you with your condition.

Tendon Injuries

Injury to a tendon may make it very difficult or even impossible to move your fingers or wrist. There are tendons on both the front and back of your hand that allow us the ability to bend or straighten the fingers and wrist. Aggravated or inflamed tendons usually require a period of rest and immobilisation, with the help of a custom-made thermoplastic orthosis that our therapist will be able to make for you. This will then be followed by a period of active mobilisation and strengthening as required. Tendons that are completely torn will require surgical intervention to repair the ends back together. Following surgery, our therapist will guide you through your rehabilitation process providing you with the necessary splinting and advise. Post-operative management usually involves wound management, a period of splinting and exercises to allow the tendon to rest and recover followed by strengthening exercises.

Tennis Elbow and Golfer’s Elbow

These conditions are also referred to as Lateral Elbow Tendinopathy (Tennis Elbow) and Medial Elbow Tendinopathy (Golfer’s Elbow). Both conditions usually occur from repetitive use of the forearm muscles and tendons which inserts in your elbow. These tendons are responsible for the muscles that move your wrist and fingers collectively. Depending on the severity of your symptoms, your doctor may also refer you for further scans such as an ultrasound assessment to further assess the health of this tendons followed by a referral to Hand Works. Symptoms include, but are not limited to, pain at the bony points of the elbow that can radiate up/down the arm and pain with reduced strength when gripping with a straight elbow. Pain is usually caused by inflammation of the tendon in the acute stage and overtime if not treated, can lead to partial or complete tears and chronic degeneration to the tendons. The goal of therapy is to reduce pain and improve function of the arm. Our hand therapists are well trained in conservative management and can provide recommendations to prevent aggravation and enable safe return to meaningful occupations. Management of these conditions are a fine balance between protecting the tendon and loading it to promote healing. Your therapist will explore conservative options which can include resting and functional orthosis, soft tissue muscle release and a home exercise program to strengthen the forearm muscles and promote soft tissue healing.

Thumb Arthritis

Osteoarthritis (OA) is a common condition that may affect one or many joints. It is sometimes referred to as “wear and tear” condition and involves the breakdown and thinning of cartilage over time. Cartilage is like a “cushion” for our joints, it is tough, however flexible allowing our joints to glide smoothly. Many factors can contribute to OA, some of the common causes are a family history of OA, previous injury or trauma to the joint, overuse or participating in repetitive movements related to an occupation or hobby – just to name a few. While there is no cure for OA, there are many strategies that our therapist can help you with to manage the symptoms and delay progression. These may include the use of an orthosis, gentle exercises, massage and stretches, assistive devices and education on activity modification to prevent further exacerbation of your symptoms.

Triangular Fibrocartilage Complex (TFCC)

The TFCC is a group of ligaments and cartilage which support your large forearm bones in the wrist. It acts as an important wrist stabiliser, cushion and shock absorber. When you grip or lean onto your hand, the TFCC helps to transmit force across the wrist joint. It also supports your wrist during rotation. It can be commonly injured with high velocity falls, twists, or repeated weight bearing. It can also be subjected to wear and tear and cause gradual onset of wrist pain particularly over the outside of your wrist. In our rooms, our therapists are able to perform a battery of provocative tests to assess the stability and strength of your TFCC, and if suited, will manage this injury conservatively with a period of splinting, strengthening and proprioception/ coordination exercises. If a high-grade injury is suspected, you may be referred on for further imaging and advice.

Trigger Finger

Trigger finger or trigger thumb occurs when the tendons that bend the finger thickens or develops a nodule, which can catch or ‘lock’ as it passes through the pulley system in our palm. Often there is a painful click or locking of the finger when trying to straighten the finger from a bent position. The goal of therapy is to reduce swelling of the tendon, whilst promoting appropriate gliding of the affected tendon. Our hand therapist will perform a thorough examination of your condition and will be able to make you a custom fit finger splint/orthosis to address the inflamed tendon, followed by specific finger exercises to prevent joint stiffness.

Wounds / Scar Management

Having a wound is a normal process after surgery or from a traumatic injury. Whatever the cause is, it’s important to manage a wound effectively to avoid complications such as infection and disrupted wound recovery. Our therapists will be able to dress and manage your wounds for you. Once your wounds have turn to a scar, our therapists will also be able to provide you with strategies to allow the scar to heal appropriately aiming for it to be flat and smooth. Scar management is vital as it helps to soften the scar, improve the function and also appearance of the scar. A poorly managed scar can lead to extra formation of scar tissue which can lead to secondary problems. Excess scar tissue can cause adhesions/ sticking of the scar to underlying soft tissue which can lead to reduced movement and discomfort even after an injury has healed. At Handworks, our therapists are able to provide you with education and demonstrate techniques on how to reduce the size and improve the appearance of your scar, as well as increasing your movement by getting it 'unstuck' from the other underlying structures. Scars also have the tendency to be hypersensitive and can make day to day tasks difficult. Your therapist will also be able to show you desensitisation techniques to reduce this impact the scar is having on your daily functioning.

Wrist Pain

Our wrist is made up of the two large bones in our forearm called the Radius and Ulna, as well as eight small wrist bones called carpal bones. These bones serve as attachment points for ligaments and tendons. The bones and soft tissues all move together to allow our wrist to perform different ranges of motion. Sometimes this network of bones and soft tissues don’t move together as they should, or parts begin to break down which can lead to pain and discomfort in your wrist. Early intervention for wrist pain is imperative as it prevents further risk of aggravation and injury to the wrist joint. Our hand therapists will be able to carry out a battery of orthopaedic assessments to assess you for different conditions and then establish a treatment plan specific to your condition.

What our Patients Love About Us

What our Patients Love About Us

Welcoming and friendly

Kind, caring and trustworthy

Thorough and informative

Experts in their field

Professional and compassionate

Encouraging and supportive

Passionate and committed

Gentle and understanding

Skilled and knowledgeable

Exceptional injury repair journey