Rural Roots, Advanced Care: TheImpact of a Certified Hand Therapist

Kyla Salisbury, MOTR/L, CHT at Livingston HealthCare

April is Occupational Therapy Month, a time to recognize the vital role occupational therapists play in helping people return to the activities that give their lives meaning. Occupational therapy focuses on helping individuals participate in meaningful daily activities, or “occupations.” These can include self-care tasks like dressing and bathing, as well as work duties, household responsibilities, and hobbies. When illness, injury, or disability limits a person’s ability to perform these tasks, occupational therapists provide strategies, exercises, and adaptations to help them regain independence.

Occupational therapists work with patients of all ages and diagnoses in a variety of settings. Patients are often seen after injury, illness, orthopedic surgery, developmental delay, or neurological events. Practice settings include hospitals, outpatient clinics, schools, home health, skilled nursing facilities, and rehabilitation centers.

One specialized area within the occupational therapy profession is certified hand therapy, which focuses on rehabilitation of the upper extremities—hands, wrists, elbows, and shoulders. Becoming a Certified Hand Therapist (CHT) requires extensive additional training in upper limb rehabilitation. To earn this credential, a therapist must have at least three years of clinical experience, including 4,000 hours of direct practice treating the upper extremity. In addition, candidates must pass a rigorous national examination that tests advanced clinical skills and theory. Maintaining this certification requires an ongoing commitment to excellence, as every CHT must recertify every five years to demonstrate continued professional development and competency.

According to the Hand Therapy Certification Commission, there are 6,044 CHTs in the United States, with around 40 practicing in Montana. In Park County, access to certified hand therapy is limited, despite high demand for upper extremity care in a region where many livelihoods depend on hand function, including individuals injured through farming, ranching, manual labor, and the many recreational pursuits Montana has to offer.

Through skilled assessment and individualized treatment, Certified Hand Therapists (CHT) work to prevent dysfunction, restore movement and use, and limit further decline in the upper limb—helping individuals return to daily activities and fully participate in their lives. Hand therapy involves treating a wide range of conditions, including fractures, tendon injuries, nerve damage, arthritis, and post-surgical recovery. One key component of hand therapy is custom splint fabrication. Using specialized thermoplastic materials, therapists design and create individualized splints tailored to each patient’s specific injury and anatomy. Splints may be used to protect healing structures, improve positioning, restore function, or gradually increase motion.

The goal of both occupational therapy and certified hand therapy is to help individuals return to the activities that matter most to them. Whether it’s getting you back to work, caring for your family, returning to sport, or simply performing everyday tasks without pain, therapy is tailored to each patient’s unique goals.

As Occupational Therapy Month is celebrated this April, it serves as a reminder of the important role these professionals play in rural communities like Livingston. Access to a Certified Hand Therapist in rural communities helps ensure that patients can receive highly specialized, evidence-based care supporting recovery, independence, and quality of life close to home.