Have you ever wondered what it would be like to practice in a different country? Or perhaps what hand therapy practice looks like in Northern Ireland? Today we dive into the day and life of Karen Murphy, MS, OTR, CHT, AHT as the owner and director of Health Pub Professions. Karen's explores hand therapy in Northern Ireland and the differences from the US. She shares her passion for hand therapy and give us an inspiring episode.

Karen graduated with a BSc (Hons.) in Occupational Therapy from the University of Ulster in 2000. After 2 years in traveling posts in the UK and Northern Ireland, Karen moved to upstate New York. Her practice there involved neurological rehabilitation within a hospital setting, and in outpatient clinics.

In 2004, Karen began her Hand Therapy journey culminating in gaining her CHT qualification in 2007. In that time, she also completed her MSc in Advanced Occupational Therapy at A.T. Still University of Health Sciences, Arizona.

In 2009, Karen moved home to Northern Ireland and became the sole founder of the practice of Hand Therapy in the Northwest of the Island. She built a team and developed the provision of specialist services in the area. In 2013 she began working in a Private Hospital and became Director of Health Hub Professionals NI Ltd in 2018, where she built a multiprofessional team of specialists in Private health care.

In recent years, Karen has joined the Global Partnership Committee of the British Association of Hand Therapists, who work to provide free upper limb therapy along with surgeons in low- and middle-income countries. Presently Karen has visited and worked in Phnom Penh, Cambodia twice, and has plans to work on other projects in the future.

Karen enjoys the intricacies of the upper limb and loves to see her patients satisfied through their entire recovery and management. As one of the very few CHT’s working in Private practice in Northern Ireland, as the healthcare system in the country is rapidly changing, Karen’s caseload is busy and varied!

You can find her at:

www.healthhubprofessionalsni.com

Email: karenmurphyhands@gmail.com

Health Hub Professionals NI/www.healthhubprofessionalsni.com

Many of you are studying for the CHT exam or have already put many hours into passing the specialty hand therapy exam. Don't you wonder how this exam came about or even how hand therapy became a subspecialty? Well, today we talk with Wisconsin native Mary Dimick, who previously served as the president of the Hand Therapy Certification Commission, also known as the HTCC. She gives us a background of how HTCC and the practice analysis developed as well as how the CHT exam continues to reflect current hand therapy practices.

Mary Dimick, OTR, CHT graduated in occupational therapy from the University of Wisconsin and has been a Certified Hand Therapist since 1991. Mary’s passion for hand therapy developed early in her career while treating level-one trauma patients for 20 years at the University of California San Diego. This experience in the very early days of the hand therapy profession shaped the entirety of Mary’s career. Mary spent the next 20 years in clinical practice and management positions supporting hand therapy practice. She also taught seminars and published scientific articles and book chapters on hand therapy.

Mary served in leadership roles for the American Society of Hand Therapists from 1982-1992. As chair of the Task Force on Legal Issues, which eventually became the Certification Committee, she helped lead ASHT toward certification. When Mary left her position on the ASHT board, it was to serve on the board of the newly formed Hand Therapy Certification Commission.

Mary has been involved with the CHT credential since its inception. In 1985, she led the ASHT task force that tookthe first step toward establishing the standards of hand therapy practice by conducting an empirical study to delineate the role of a hand therapist. The results of this study, published as the lead article in the inaugural issue of the Journal of Hand Therapy (10/1987), produced the original Definition and Scope of Practice of the Profession of Hand Therapy (adopted by the ASHT membership in April 1987). This practice analysis formed the blueprint for the first Hand Therapy Certification Examination (HTCE). Mary has been involved with each of the 6 practice analyses over the past 40 years and is currently participating in the seventh which will be performed this year (2025).

Mary just completed her term as President of the Hand Therapy Certification Commission. As a founder of HTCC, she remains on the board and plans to continue to serve the profession she loves.

For those of you who work in hand therapy clinics, it can be intimidating to see high- level athletes. This population has specific demands above and beyond the regular day-to-day activities of daily living. Join us as we discuss what typeof issues affecting these patients with Jean-François Ouellet, BSc (OT), CHT! He works with a team of physicians and therapists who specialize in treatment of these conditions. In addition, he provides key concepts to get athletes backto their sport with less downtime. Please join us as Jean-François provides a fascinating discussion on how to address this population!

Jean-François Ouellet graduated from McGill University with a B Sc. (O.T.) in 2003 and holds a current registration to practice in the province of Quebec (Canada) as anOccupational Therapist. He has been working in private practices since 2003 exclusively treating elbow, wrist and hand injuries. He has been a Certified Hand Therapist since 2009. He was coordinator of the Montreal Hand Interest Group for 8 years. He worked as an assistant-teacher fororthotic labs at McGill University from 2009 to 2014. He has been an invited speaker at numerous Quebec Hand Surgery Conferences (ASCPEQ) as well as for the Canadian Society of Hand Therapists (CSHT). He served as President forCSHT from 2021 to 2024. During his term, the executive committee was able to connect with therapists from all around the world while developing links with different societies such as the American, the French and the Australianones. Jean-François has been mentoring other therapists and has a passion for sharing his knowledge. He regularly teaches wrist and hand examination courses to GPs.

Over the last ten years of practice, he has developed expertise in the treatment of sport-related wrist and handinjuries. He works with professional athletes from various fields and associations (NHL, PWHL, MLS, UFC, CFL, Olympians, performing artists, tennis Canada, QMJLH,…). He joined Kinatex Brossard in 2023 where he works full-time as an O.T. and a mentor for his colleagues.

He can be reached at:

email: ergojfo@gmail.com

LinkedIn: https://www.linkedin.com/in/jean-fran%C3%A7ois-ouellet-72667029/

Here are the 2 references he discusses during the podcast episode:

Elite Athlete’s Hand and Wrist Injury in Hand Clinics, 2012;guest editor: Michelle G. Carlson, MD

https://pubmed.ncbi.nlm.nih.gov/22883906/

Sports Injuries of the Hand and Wrist, editors: Mike Hayton,Chye Yew Ng, Lennard Funk, Adam Watts, Mike Walton

https://link.springer.com/book/10.1007/978-3-030-02134-4

Please join Hand to Shoulder podcast members Ann and Cassie as they interview Kantessa Stewart out of Southwestern Ohio Orthopedics discussing a hand therapy technique called CMMS for addressing stiff joints. Kantessa talks through launching the program and how patients with stiff joints benefit from casting to relieve stiffness. Learn clinical pearls regarding materials and length of time in between castings. We hope you gather takeaways of confidence and empowerment to try a new technique.

Kantessa Stewart has been an Occupational Therapist since 1999 and a Certified Hand Therapist since 2007. She received a Certificate in the Advanced Practice of Hand and Upper Quarter Rehabilitation from Drexel University in 2007. Kantessa has spent the majority of her career in out-patient orthopedics starting in hospital based for the first 10 years of her career moving to a physician-owned practice for the last 15 years. She has developed Transitional Work Programs providing specialized Hand Therapy in Manufacturing Facilities, expanded a small Hand Therapy program within a local hospital, and opened Hand Therapy Satellite Clinics for the physician owned practice where she is employed.

Kantessa has worked diligently to expand the knowledge of Hand Therapy in western Ohio, develop sound programs with skilled therapists, provide continuous learning opportunities for staff and started the Dayton Hand Therapy Group scheduling bimonthly continuing education. She has lectured on various topics of the upper extremity at both State and National Conferences including ASHT, OOTA and ASSH, Virtual Platforms and has taught Orthosis Fabrication at local colleges. Currently she is employed within the Hand Center of Southwestern Ohio/Orthopedic Associates as a Clinical Manager, carrying a full patient caseload. She collaborates with the surgeons on protocol development, assists in Journal Club planning, organizes staffing in therapy clinics and serves as a Clinical Specialist within the Hand Therapy Department. Kantessa thrives on challenges and strives to search for solutions for patients not responding to traditional therapy techniques. Her interest in CMMS began after taking a Virtual CMMS Course taught by Robyn Midgley. Since then she has worked hard to utilize Judy Colditz’s technique in the clinic to help patients with limited motion not responding to their courses of treatment. Kantessa continued to further develop her understanding of the CMMS technique by mentoring from Judy Colditz to problem-solve difficult cases. She assists in leading the bimonthly CMMS Discussion Group sponsored by BraceLab and is working with a team of Hand Therapists to develop a 1 and 2 day Hands-on Casting Motion to Mobilize Stiffness course for ASHT which is due to be released this year. Kantessa is passionate about sharing the CMMS technique with other therapists because of the change it has made in her own practice and the successful outcomes she has seen with her patients. Kantessa is excited to be presenting on the CMMS technique at IFSHT and the Texas Hand Society meeting in 2025.

Kantessa’s contact info - stewartkantessa@gmail.com

www.linkedin.com/in/kantessa-stewart-otr-l-cht-853219235

Patients with hypermobility syndromes who present with shoulder instability have traditionally been told to go to therapy. But what if therapy is not enough? Join Dr. Tamara Scerpella as she explains how she evaluates and treats this challenging issue. She goes into details regarding surgical procedure, sling use, protocol and rehabilitation post-surgically for capsular shift or tightening. Listen for key takeaways regarding precautions and contraindications once the glenohumeral joint stability is restored! We hope you enjoy the interview!

Dr. Tamara Scerpella earned her bachelor’s degree at the University of Iowa, where she competed as a Division I gymnast, and her medical degree from the University of Iowa Carver College of Medicine. In 1985 she first came to Wisconsin for her residency in orthopedic surgery at UW Hospitals and Clinics. After three years in private practice in Monroe, Wisconsin, she completed a fellowship in sports medicine and arthroscopic surgery at Union Memorial Hospital in Baltimore. She was a member of the faculty at the State University of New York Upstate Medical University in Syracuse for 16 years before returning to UW-Madison in 2010.

Dr. Scerpella holds the AA McBeath Distinguished Professorship as Chair of the Department of Orthopedics and Rehabilitation. She is also the Chief of the Division of Sports Medicine and Team Physician for UW-Madison Badger Athletics. Among other accolades, she has earned the UW-Madison Slesinger Award for Excellence in Mentoring and the Woman in Science Award from the American Medical Women’s Association. Dr. Scerpella is a national expert in arthroscopic shoulder and knee surgery. An accomplished researcher, she leads a longitudinal study evaluating the impact of youth physical activity on bone health across the lifespan. This study, which Dr. Scerpella began early in her career, is now the longest and one of the most robust of its kind. Her research group has shown that physical activity during childhood and adolescence improves bone health in adulthood. At UW-Madison, she has spearheaded efforts for researchers to acquire high-quality data on patient outcomes, inspiring faculty to improve patient care through research and clinical trials.

Dr. Scerpella strives to be a role model for women in medicine and advocates for gender diversity in the department and nationally, particularly in orthopedic surgery, which is the least diverse of all medical specialties. Only 6% of practicing orthopedic surgeons in the United States are women, according to data reported by the Association of American Medical Colleges, but through Scerpella’s mentorship and leadership, women now comprise 30% of orthopedic surgeon faculty and 37% of total faculty in the department.

Supercharged and ready for rehab! Are you working with a brachial plexus patient that had a nerve transfer? Well, listen up, this is the podcast for you!

Jen Dodson joins the Hand to Shoulder podcast team to discuss rehabilitation theories and principles as well as a timeline of what to expect.

Jen is a part of a qualitative research study involving rehabilitation processes with outcomes. We hope you enjoy listening to Jen as she educates us on rehabilitation following nerve transfer.

Articles she refers to in the podcast episode include:

Hill, J.L., Turner, L.C., Jone, R.D., Jimulia, D. T., Miller, C., & Power, D.M. (2019). The stages of rehabilitation following motor nerve transfer surgery. Journal of Musculoskeletal Surgery and Research, 3, 60.

*Link to Hill’s et. al. 2019 article: https://journalmsr.com/the-stages-of-rehabilitation-following-motor-nerve-transfer-surgery/

Kahn, L. & Moore, A. (2016). Donor Activation Focused Rehabilitation Approach: Maximizing Outcomes After Nerve Transfers. Hand Clinics, 32, 263-277.

Sturma, A., Hruby, L., Farina, D., & Aszmann, O. (2019). Structured Motor Rehabilitation After Select Nerve Transfers. Journal of Visualized Experiments, 150, e58440, doi: 10.3791/59840.

Larocerie-Salgado, J., Chinchalkar, S., Ross, D.C., Gillis, J., Doherty, C.D., & Miller, T.A. (2021). Rehabilitation Following Nerve Transfer Surgery. Techniques in Hand & Upper Extremity Surgery, 26(2), 71-77.

Jennifer "Jen" Dodson has been an Occupational Therapist since 1998, a Certified Hand Therapist since 2004, and is fellowship-trained from the Philadelphia Hand Center in 2002. She received her Post-Professional Occupational Therapy Doctorate from Jefferson University (Formerly Thomas Jefferson) in 2021 along with an Advance Practice Certificate in "Teaching in the Digital Age". Jen spent the majority of her career at a level-one trauma center (16 years) where she served as a clinical specialist. She had the opportunity to start a hand therapy program there and educate various stakeholders on the distinct role CHTs play throughout the continuum of care.

Jen has been a strong advocate for the profession and specialty of hand therapy by serving on the ASHT education council, lecturing on various topics of the upper extremity across the US and Canada as an invited speaker for state and national conferences, served as adjunct faculty, contributed to book chapters, performed curriculum development, and owned her own continuing education business specializing in upper extremity rehabilitation courses. She is currently employed at OrthoCarolina in Charlotte, NC, where she serves as a clinical specialist, coordinates student placement, is an instructor in their AOTA-approved hand therapy fellowship, and is the CHT who works with the surgeons in brachial plexus clinic. She is passionate about serving those who have sustained the most complex traumatic upper extremity injuries and athletes of all levels.

She can be reached at: 3KingsUEspecialist@gmail.com.

Nerve transfer surgery involves reconnecting a functioning nerve fascicle to a damaged or lacerated nerve to restore connection to muscles with absent innervation. This is an extensive surgery that takes a lot of time and education with our patients before and after surgery. Dr. Munaretto explores common nerve transfers he completes at the Hand to Shoulder Center while discussing appropriate candidates and clinical findings. He shares insight into cutting edge research of these procedures and outcomes. Stay tuned for our next podcast with hand therapist Jen Dodson who will be giving us an overview of the principles of rehab following nerve transfer surgery!

Dr. Munaretto earned his Bachelor of Science degree, Magna Cum Laude from the University of Illinois and was elected to the Phi Beta Kappa Honor Society. He received his medical degree from the Medical College of Wisconsin where he received the Gold Humanism Honor Society Award and the Alpha Omega Alpha Honor Society as Junior Medical Student. From there he completed his five-year orthopedic surgery residency at Mayo Clinic in Rochester, MN. Then, Dr. Munaretto proceeded to advance his education and completed a Hand and Upper Extremity Fellowship program at OrthoCarolina in Charlotte, NC. During his time in Charlotte, he visited Drs. Werthel and Valenti, two international shoulder surgery experts in Paris, France and completed a travelling fellowship with them.

Dr. Nick Munaretto is board certified by the American Board of Orthopedic Surgery with a specialty in hand and upper extremity surgery. He has a special interest in peripheral nerve injuries, arthritic conditions of the upper extremity including shoulder and elbow replacement as well as arthroscopic procedures involving the shoulder to hand. His practice philosophy emphasizes compassionate and expert care for every patient and utilizes the most advanced techniques and technology to help patients live their greatest potential. He practices here at the Hand to Shoulder Center.

Wrist instability can be a difficult condition to treat. Today’s episode covers the intricate mechanics of midcarpal instability and the two types of clinical presentations: midcarpal VISI (volar intercalated segmental instability) and the less common midcarpal DISI (dorsal intercalated segmental instability). Clinical testing for each of these conditions will be covered as well as evidence-supported treatment interventions including orthotic management, muscular engagement and the progression with proprioceptive training.

Ann Porretto-Loehrke is a skilled clinician with a passion for teaching and clinical treatment of upper extremity disorders. She has been practicing for 30 years and teaching continuing education courses for the past 20. She is the Clinical Development Coordinator at the Hand to Shoulder Center in Appleton, Wisconsin. Ann is a Certified Hand Therapist (CHT) and a Certified Orthopedic Manual Therapist (COMT) for treatment of the upper quadrant through the International Academy of Orthopedic Medicine (IAOM). Ann received a bachelor’s degree in physical therapy from Marquette University in 1994 and completed a post-professional Doctorate in Physical Therapy (DPT) degree from Drexel University with a specialty in hand and upper quarter rehabilitation in 2007. She is also certified in dry needling through Myopain Seminars, as a Certified Myofascial Trigger Point Therapist (CMTPT). Ann is a lead instructor who co-developed the Hand & Upper Extremity Track through IAOM, a set of 6 manual therapy courses designed specifically for hand and upper extremity specialists. She co-authored a chapter in Rehabilitation of the Hand & Upper Extremity on nerve compression syndromes of the elbow and forearm, as well as published two peer-reviewed articles entitled “Clinical Manual Assessment of the Wrist” and “Taping Techniques for the Wrist” in the 2016 Journal of Hand Therapy’s special edition of the wrist. Ann serves as the planning committee chair for the Wisconsin Hand Experience conference and has presented at American Society of Hand Therapists (ASHT) annual conferences, Canadian Society of Hand Therapist Annual Conference, Philadelphia meeting, TRIA Hand Conference, and Teton Hand Conferences. She also teaches online courses for MedBridge education and facilitated the development of the MedBridge CHT prep program launched in June of 2021.

Ann can be reached at:

Instagram: @anns_happy_hands

Email: annshappyhands@gmail.com

Linked In: https://www.linkedin.com/in/ann-porretto-loehrke-dpt-cht-comt-cmtpt-1080b62a/