Ask an Expert: How Can an Occupational Therapist Help Me with CMC Thumb Arthritis?

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Q: What is CMC thumb arthritis?

A: Thumb CMC joint arthritis (also known as basilar joint arthritis, osteoarthritis) is a “wear and tear” injury between a wrist bone and the base of the first thumb bone. Over time, the cartilage wears down and destruction of the bone surfaces occurs. Common symptoms include joint pain that increases with use, swelling, decreased motion, and stiffness. The injury is also more common in women and primarily affects individuals over 45 years old.

Q: How can an occupational therapist help me?

A: There are a variety of ways an occupational therapist can help with this injury. The first thing that can be done is fabrication of a custom splint for the patient to wear each day. By wearing a splint, it will decrease the amount of force on the joint, therefore, decreasing the “wear and tear”. The therapist will also provide exercises which can strengthen the muscles around the thumb to decrease the pain. And finally, the therapist will educate the patient on a variety of adaptive techniques/adaptive equipment that can be used to decrease pain of the involved structures.

 

Josh Eppinger, MOT, OTR/L is an occupational therapist and Certified Hand Therapist at Frederick Health Physical Therapy and Sports Rehab: Aspen Ridge in Frederick, Maryland. He received his Bachelor of Arts in Human Performance and Health and Master of Occupational Therapy from the West Virginia University School of Medicine. Josh’s professional interests include orthopedic injuries to the hand and upper extremity splinting.

The Value of Physical Therapy in Osteoarthritis of the Knee

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Osteoarthritis of the knee is the most common type of osteoarthritis, or OA, in the United States. According to the American Physical Therapy Association (APTA), nearly 12.4 million Americans ages 65 or older suffer from symptoms of knee OA, including morning stiffness, pain during or after activity, discomfort after sitting, knee popping or grinding, swelling, and joint tenderness.

Physical therapy is a proven, effective treatment for knee OA. The goal of treatment is to reduce pain, get you moving again, and help you enjoy life’s little pleasures — whether that’s a walk in the park or dancing at a family gathering.

The APTA’s 2023 report highlighted the cost-effectiveness of treating knee osteoarthritis with physical therapy. They used quality-adjusted life years (QALYs) to measure both how long someone lives and their quality of life, making it easier to compare treatments like reducing pain or improving mobility. On average, physical therapy for knee osteoarthritis provides a net benefit of nearly $14,000 per episode of care, including all the hidden costs of your time, pain, missed life events, and the dollars paid for services. Compared to steroid injections, patients who received physical therapy had a 0.07 higher QALY, with only a slight increase in medical costs.

Physical therapy offers patients valuable benefits, including knowledge to help reduce the risk of opioid addiction and cost savings by avoiding invasive steroid injections and surgeries. Additionally, it provides long-term advantages such as improved mobility, balance, strength, and flexibility. These enhancements contribute to better overall health and a lower risk of developing conditions that may require additional healthcare services in the future.

Your physical therapist can refer you to an orthopedic surgeon to discuss your options for dealing with knee OA. If you choose surgery after consulting with healthcare professionals, physical therapy plays a crucial role in both preparation and recovery, as noted by the APTA. Pre-surgery physical therapy (“prehab”) helps improve strength and flexibility, setting you up for a smoother recovery. After surgery, your physical therapist will create a personalized program based on your condition and goals to help restore function and mobility.

If you’re dealing with knee OA, give physical therapy a try. It’s an investment in getting back to the things you love without pain.

Laughter, Care, and Sometimes Bears: Mary Salmon’s Home Health Journey in Frederick County

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For decades, Mary Salmon has dedicated her heart and hands to helping others in Frederick County, Maryland. When asked what’s kept her with Tx:Team, for almost 19 years, she doesn’t hesitate: “I work with some of the most awesome therapists,” Mary says. “We all pride ourselves on doing the best we can for our patients. Some of the therapists I work with are people I started my career with. I love our team.”

Her commitment to patient care has been unwavering since 1997, when she first stepped into home care. Home health care has provided her with countless memorable experiences, from rural adventures to heartwarming victories. She shares a fond story of a patient once confined to bed who, with her help, regained the ability to transfer and walk in his home, despite being in hospice. “There are so many stories from home care, especially since we work in rural areas,” she reflects.

And rural areas bring their own challenges—sometimes including wildlife! Mary had a patient up on the mountain who warned her to be careful coming up the driveway as there was a bear sitting on a rock at the front of the property. Then there’s the infamous rooster story: “Once, on a patient’s chart, there was a note that said, ‘Be careful of the rooster.’  I arrived at the house and looked around, not seeing the rooster, I ran into the home.  Jumped in and said, ‘I made it!’ The lady replied, ‘Oh, you don’t have to worry about the rooster—the fox got him yesterday.’”

When asked if any achievement stands out from her career, Mary humbly replies, “Not really. I’ve just tried to be the best PT I could be and help my peers when they have questions or difficulties.” Her approach to patient care is deeply personal, shaped by her own life experiences. “It’s like I have known them forever. If I can make someone smile or laugh when they’re not feeling well, they’re already on the road to recovery,” she shares. “It’s so rewarding.”

Along the way, Mary has gained as much from her patients as she’s given. “There is so much history in Frederick, and I enjoy my patients and their stories of life. It is truly amazing what we can learn when we listen to our patients. This has been one of the most enjoyable parts of my job.” The bond with her colleagues, many of whom have been with her since the beginning, is something she knows she will deeply miss. “We grow and learn from each other,” Mary explains. “This has been a truly amazing job.”

Her plans for retirement? More adventure. Mary has lived all over the world, loves to travel, and is excited to begin this new chapter while continuing to be a dedicated mom to her son and daughter and grandma to her four grandchildren. But her work with people hasn’t ended—she’s spent years volunteering as a ski instructor for individuals with disabilities and plans to continue that work. “Those experiences helped me to grow beyond words,” she shares. “In the disabled community, people can be so resilient. The motto is, ‘If I can do this, I can do anything.’ It’s a great reminder for all of us to keep putting one foot forward.”

Though the road ahead is new, Mary is ready for it. “Life is an adventure,” she says. “I will now begin a new chapter that is altogether exciting and scary, but invigorating just the same.”

We thank Mary Salmon for her nearly two decades of unwavering dedication, resilience, and compassion with Tx:Team. Her legacy of care has left a lasting impact on our patients, colleagues, and community. We wish her nothing but joy and adventure in this well-deserved new chapter.

Ask an Expert: Why Does My Doctor Want Me to Do Therapy for Arthritis?

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Q: My pain is caused by arthritis and therapy can’t get rid of my arthritis. Why does my Dr. want me to do therapy?

A: Pain and stiffness arising from arthritis often causes you to be less active and even avoid certain movements. A tailored physical therapy program is targeted to help you move better and move more. The goal is to overcome weakness arising from being less active and to fight stiffness and pain with exercises and stretches to keep you limber.

 

Jaydeep Samant, PT, MHS, is a physical therapist and the leader of our therapy team at Putnam County Hospital in Greencastle, Indiana. Originally from Mumbai, Jaydeep received his Bachelor’s degree in PT in 2016 in India. In 2018, he graduated with a Master’s in Health Sciences degree from the University of Indianapolis and has been a practicing PT since graduation. Jaydeep specializes in treating orthopedic, neuromuscular conditions, sports injuries, joint replacements and any acute musculoskeletal conditions.

Occupational Therapy for Arthritis Management: Gail’s Story

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If arthritis is making everyday tasks like gripping your toothbrush or getting in and out of your car a struggle, occupational therapy could be the key to regaining your independence. Occupational therapists are experts in helping you overcome these challenges through education, exercises, assistive devices, and orthotics.

Occupational therapy teaches you joint protection techniques, like using your entire arm instead of just your wrist to turn a doorknob, while also guiding you in pacing activities to prevent fatigue. You’ll learn how to adapt tasks and environments to fit your needs, such as swapping a doorknob for a lever that’s easier to open. They often perform home evaluations to identify safety risks and recommend modifications that make daily living easier. Custom orthotics, like wrist splints, help reduce pain and protect your joints from further damage. And, with exercises tailored to your daily struggles—such as bicep curls for lifting groceries or stretches for reaching overhead—you’ll regain strength and mobility, as highlighted by the Arthritis Foundation.

A heartwarming example of occupational therapy’s transformative power comes from Somerby Peachtree City in Peachtree City, Georgia. Christon Cardell, a Tx:Team occupational therapist, worked with Gail, a patient whose arthritis had made it impossible to wash or blow dry her own hair due to limited arm mobility. Gail relied on beauty salons just to manage these basic tasks—until Christon changed her life. After therapy, Gail joyfully shared, “I was able to raise my arms over my head, shampoo my own hair, and blow it dry. Now I get to go to the salon for enjoyment, but it’s not out of necessity.”

Gail’s journey didn’t stop there. “Therapy has been more than helpful, and I’ve continued the exercises… to keep doing things on my own with ease and not go backwards,” she added. “I am so appreciative of the therapist and her helpfulness; I can do things on my own with increased ease and less pain and don’t have to rely on others. Arthritis is still a problem, but the therapy has been essential to keep me moving!”

Gail’s story is a touching reminder of the life-changing impact occupational therapy can have for those living with arthritis—not just in restoring mobility, but in reclaiming independence, dignity, and a renewed sense of freedom. Occupational therapists work in outpatient clinics, hospitals, and even in your own home. With most health insurance plans covering occupational therapy, it’s an accessible option to help you stay active and independent, no matter your age or stage of arthritis.