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Article: Hand Massage in Occupational Therapy

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Hand Massage in Occupational Therapy

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In occupational therapy, hand massage is rarely the goal and almost always the preparation. It makes tissue more supple before exercise, because exercise is always done. Anyone who understands this connection will use a device at home differently and with more effect.

What occupational therapy does for the hand

Occupational therapy for the hand aims at function: gripping, holding, releasing, regulating force. Treatment is provided after injuries, surgeries, for joint diseases, after a stroke, and for nerve damage.

The core of the treatment consists of exercises and building everyday movements. This is complemented by splints, advice on joint protection, and passive measures such as heat, movement by the therapist, and, of course, massage.

Why massage comes first and not last

Warm, relaxed tissue can be moved further than cold and stiff tissue. That's why massage is at the beginning of a session: It creates the mobility needed for subsequent exercises.

The transfer to home is precisely this: a massage device is most effective if the hand is moved afterwards. Five minutes with the device, then five minutes of opening, closing, spreading fingers, thumb to each fingertip. Conversely, massage alone is a pleasant thing that changes nothing for tomorrow.

What can be adopted at home

  • The sequence. First warmth, then massage, then movement. Not the other way around.
  • Short sessions, often. Twice daily for ten minutes is more effective than once a week for half an hour.
  • The forearm is part of it. The finger muscles are located there, not in the hand.

The instructions for this can be found in the article Performing Hand Massage Yourself.

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What cannot be adopted

Anything that requires a diagnosis. After an operation, after a tendon repair, in case of nerve damage, or after a stroke, the treating practice decides what can be massaged and when. There are time windows where incorrect strain can cause real damage.

A device also does not replace a splint or exercise instructions. It is a preparer, not a treater. This classification applies to massage devices in general and is discussed in the article Are Massage Devices Dangerous.

When a device is particularly worthwhile

Precisely when the hand that would need to massage is itself affected. In cases of bilateral complaints or lack of grip strength, self-massage by hand is hardly possible, and a device takes over the part that no one else can.

The same applies to care and for relatives who want to provide daily attention but do not have the strength for a thorough hand massage themselves. The device finder narrows down which design is suitable for this; the selection is available under Massage devices.

The three exercises that are almost always included

  1. Fist and fan. Slowly close the hand into a fist, then spread the fingers as far as possible. Ten times. This moves the full range of motion of the finger joints.
  2. Thumb opposition. Bring the tip of the thumb to each fingertip one after another. This is the movement without which no grip works, and the first to be lost in thumb basal joint arthritis.
  3. Wrist flexion and extension. Forearm resting, hand over the edge of the table, slowly up and down. Relieves the tension that comes from typing.

These three together take two minutes and are the part that comes after the massage. Anyone who only massages and does not move has done half the job.

Who bears the costs

Occupational therapy is prescribable with an appropriate diagnosis and is then covered by health insurance. Home massage devices, on the other hand, are self-purchased and usually not reimbursed. This is not an argument against a device, but a reason to first exhaust the prescribed treatment.

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