Hand Therapy

Hand Therapy is a type of rehabilitation performed by an occupational or physical therapist on patients with conditions affecting the hands and upper extremities. The therapist completing evaluations and treatments has a high degree of specialization and education in the area of hands and upper extremities, which helps speed up patients’ return to productive lifestyles.

Getting Started

– Patients need a referral from their medical provider

– Medical provider can write specific treatment plans for patient or refer per therapist recommendation for treatment. They can also specify if a patient needs a custom orthotic only with no additional treatment.

– Then a patient will have an evaluation visit.

– Following evaluation, a plan of care is sent to the patient’s medical
provider for their signature.

Treatment Sessions

– Each hand therapy session is 30 minutes to 1 hour in length

– Evaluation Visit: Patient’s condition diagnosis is addressed along with a functional evaluation of how patient is limited by condition. Depending on what the condition requires for treatment, patient may be fit with custom or prefabricated orthotic during this session.

– Further Treatment: If additional therapy is needed, patient is usually seen 2 times per week for manual treatment and modalities specific to condition with a progression into an individualized home exercise program prescribed by therapist to prevent re-injury of upper extremity as condition improves.

– Length of time that patient receives hand therapy varies, but usually patients are seen for 6 to 8  weeks.

Treatment Benefits

– Preventative, non-operative or conservative treatment of repetitive stress injuries such as lateral and medial epicondylitis, dequervain’s syndrome, shoulder impingement, trigger finger, carpel tunnel syndrome, cubital tunnel syndrome and ganglion cysts, as well as for chronic conditions including arthritis and hemiplegia that affect the upper extremity

– Management of acute or chronic pain throughout the upper extremity

– Desensitization following nerve injury, surgery or trauma

– Sensory re-education after nerve injury

– Soft tissue, scar tissue management and hands on therapy for improving range of motion  and strength following surgery or injury

– Design and implementation of home exercise programs to increase motion dexterity, and/or strength following injury or surgery

– Custom Splint fabrication for prevention or correction of injury and dynamic splinting to improve functional performance

– Training in the performance of daily life skills through adapted methods and equipment

– Conditioning prior to returning to work to optimize strength and active range of motion needed to optimally complete work tasks

– Strengthening and dexterity improvement for children to reach age appropriate goals for small motor function


Snoqualmie Hospital Rehabilitation Clinic
9801 Frontier Avenue SE, Snoqualmie, WA 98065
t (425) 831-2376 f (425) 831-3071
Hours: By Appointment









Wendy Waterval-Van Ooyen
OTR, Occupational Therapist

Occupational Therapist

Wendy graduated with a Masters in Occupational Therapy degree from the University of Washington’s School of Rehabilitation Medicine. Her postgraduate training focused on neuro-rehabilitation and Pediatrics. She has completed continuing education in hand   therapy, manual therapy, kinesio taping and Handwriting without Tears™. Wendy worked at Bellevue School District prior to joining Snoqualmie Valley Hospital. Wendy currently serves on the executive board of the Washington Occupational Therapy Association as Budget and Audit Chair.

Her treatment approach is to perform a functional assessment of each patient and prescribe a treatment plan that is specific to his or her needs. She enjoys working with all ages and conditions that limited upper-extremity performance.