Upper-extremity rehabilitation: conditioning and orthotics for the athlete and performing artist

Rehabilitation of athletes or musicians with hand injuries begins immediately after injury. Accurate diagnosis of the injury and tissues involved is followed by specific acute and rehabilitative therapies to correct the injury and determine any biomechanical changes that may have occurred. Medication and physical methods aid in decreasing inflammation and pain. Mobility is progressively restored, with the aid of appropriate heating modalities, as soon as signs and symptoms allow. Proprioception and neuromuscular coordination are then retrained. This is followed by balanced muscle strength training. Finally, sport-specific endurance and biomechanical skills are developed. Emotional aspects of the injury may be dealt with by investigating the physical and emotional stresses of the performance, and discussing them with the patient. Some patients may also be helped by psychologic counseling. Orthotics may be used to decrease swelling, decrease pain, and inhibit unwanted motion. Some variations allow for progressive range of motion and strength building. Attention to these details maximizes the chances of successful return to performance in the athlete or performing artist with a hand injury.