Why Is It Important to See a Certified Hand Therapist?

Think about all the things we do with our hands. We touch, hold, write, cook, eat, and button shirts with our hands and the list goes on. What if you lost complete or partial function of your hand? How would that affect your quality of life? What changes would you have to make to adapt? After an injury, wouldn’t you want the best treating your  Hand therapy 1most precious tools? That is why it is so important to see a certified hand therapist.

A certified hand therapist is specially trained in the most intricate details of the hand, wrist, forearm, elbow, upper arm, shoulder, and brachial plexus (the nerves and corresponding vascular bundles exiting the neck). This knowledge, affords you the assurance that you have the best treating your injury, and that your CHT can effectively treat and rehabilitate even the most complicated injuries and surgeries. Your CHT knows the proper protocols for open or sutured wounds, scars, broken bones, the reduction of swelling, and new incisions and stitches. According to Kim Turner, PT, CHT, “You don’t have to be afraid to start therapy after injury or surgery. When you are in the hands of a highly trained certified hand therapist, you will get a better outcome with your injury the earlier you start.” CHTs work closely with the physician and patient to provide a continuum of care. In fact, hand surgeons trust and refer their patients only to certified hand therapists. This is because the anatomy of the arm and hand frequently requires very delicate surgery, often with microscopic techniques. The technical complexity of  these kinds of surgeries necessitates a high level of competence by therapists with advanced skills in upper quarter rehabilitation.  CHTs are knowledgeable about these advanced surgical techniques and postoperative therapy programs.  With some injuries and conditions, it is essential to seek the help of certified hand therapist for the design and implementation of exercise programs to increase motion, dexterity, and/or strength immediately following an injury or surgery. Also, if a patient waits too long to seek the help of a certified hand therapist, they risk the development of scar tissue build-up and stiffness, which can cause pain and limitations in function. Kim treated a patient where this happened. “The course of actual recovery took twice as long because the patient was too scared to come in for treatment before the stitches were out,” states Kim. For these reasons, many athletes, musicians, and artists seek out CHTs for the treatment of their activity related injuries.

Certified hand therapists can also help with the  management of acute or chronic pain, desensitization following nerve injury or trauma, and sensory re-education after nerve injury. Certified hand therapists are the only therapists able to provide custom splinting to prevent or correct injuries. They also provide training in the performance of daily life skills through adapted methods and equipment. Another essential a CHT provides is a conditioning program prior to returning to work.

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Kim Cochran, OT, CHT pictured above treating one of our Hartland patients, Christina Monson.

For those suffering from osteoarthritis (painful swollen joints in the hands or wrist), a certified hand therapist can provide instruction  on proper exercise and mechanics to protect joints, manage pain, and  increase function. Other conditions or injuries that would be important to seek the help of a CHT also include deQuervain’s Tenosynovitis, digital amputation, distal radius fractures, ulnar-sided wrist pain, tendon lacerations/ruptures (both flexor and extensor), phalangeal (finger) fractures, wrist fractures, trigger finger, swan neck deformities, boutonniere deformities, and rheumatoid arthritis. They can also treat conditions, such as carpal tunnel syndrome, lateral epicondylitis (tennis elbow), and rotator cuff injuries.

Advanced Hand Rehab is available at all seven Advanced Physical Therapy Center locations. For more information, go to http://www.AdvancedHandRehab.com or call:

Grand Blanc – (810) 695-8700

Clio – (810) 687-8700

Flint – (810) 732-8400

Hartland – (810) 632-8700

Goodrich – (810) 636-8700

Davison – (810) 412-5100

Clarkston – (248) 620-4260


Get to Know Fe’Neda Bradshaw, MPT

BRADSHAW_FE'NEDA 11 (reduced size)Fe’Neda Bradshaw, MPT has been in the physical therapy field for nearly twenty years. She has been a valued member of the Advanced Physical Therapy Center team since 2009. She is a graduate of the University of Michigan-Flint Master of Physical Therapy Degree Program

Fe’Neda loves interacting with people and that is what led her to become a physical therapist. Since graduating, she has taken several continuing education courses including the Graston Technique (instrument assisted soft-tissue mobilization), Strain/Counter-strain manual therapy, and vestibular rehabilitation. She also has a certification in kinesiology taping.

Fe’Neda finds it personally rewarding to help patients achieve their functional goals and feels her specialty lies in treating low back and neck pain. She also enjoys working with pediatric patients with orthopedic injuries and conditions.

Many of Fe’Neda’s patients have commented about the amount of care and concern she shows. “I make it a point to do my best when treating each patient. I want my patients to know the intent I have for them and feel a difference after being in my hands,” says Fe’Neda. One such patient calls Fe’Neda a “miracle worker”. The patient had been experiencing vertigo for many years without relief. After one treatment from Fe’Neda, the patient’s vertigo was gone.

Fe’Neda is a caring individual who gives up a lot of her time to help others outside of work. She serves as president of her church’s youth choir, is a member of the Young Women of Excellence empowerment program, and participates in the American Cancer Society and the American Heart Association. When she is not working with patients or volunteering, she likes to go walking in her neighborhood or workout in the gym. She also likes to practice her hobbies, which are playing the piano and violin and playing volleyball.

Fe’Neda is a Flint native, but now resides in Clarkston with her husband and two sons. She treats patients, mainly, out of Advanced Physical Therapy Center’s Goodrich clinic but has gone above and beyond by working at various APTC clinics over the years to help cover patient needs as they arise.

Goodrich Clinic
7477 S. State Rd., Ste. B
Goodrich, MI  (810) 636-8700

Get to Know the Director of Advanced Hand Rehab, Renae Remillard, OTRL

BH-14-23621 retouch REMILLARD     For patients who need upper extremity rehabilitation, Renae Remillard, OTRL is one of the best. Renae is an expert when it comes to pre-work screenings and return-to-work assessments. She has specialized training in functional capacity evaluations, which is a battery of tests administered to determine if someone is physically able to perform a particular job. If someone is unable to perform the job at hand, she has the training and knowledge to put together a Work Conditioning program specifically designed for the patient.
Renae received a Master of Occupational Therapy Degree from Baker College in 2013, and her future goal is to obtain a national certification in hand therapy, which is a prestigious distinction and a challenging credentialing course that entails thousands of hours of clinical work and experience as well as passing a rigorous exam. Her other continuing education includes the Graston Technique (instrument assisted soft-tissue mobilization) and Kinesiology Taping.
As an occupational therapist, it is Renae’s job to help people gain independence in their daily lives. “I’ve had many patients tell me that their lives have been changed for the better. We hear all the time, ‘You don’t realize how much you use your hands until you can’t.’ I find it amazing to run into a patient years later and find that they still remember a lot about their treatment and our time together. I love being able to help people reach their goals. It makes my job worthwhile,” said Renae.
Renae treats patients out of Advanced Hand Rehab’s Grand Blanc facility and is the director of Advanced Hand Rehab. She is from Fenton, and when not working with patients, she enjoys spending time relaxing on the lake with her fiancé, family and friends and walking her two rescue dogs, Oakley and Larkin. Renae is also very active. She is an avid runner and regularly attends boot camp classes.
Renae considers herself to be an upbeat, positive person. She tries her best, with every patient, to create a welcoming environment. “I truly enjoy my job and try to give each patient one-hundred and ten percent. Our treatment philosophy is to be “hands-on” with all our patients and have their best interests. I think that shows every day in what we do,” states Renae about her team.

Advanced Hand Rehab – Grand Blanc | 10809 S. Saginaw St. | 810.695.8700 | RRemillard@advpt.com

Are You Game Ready?

We have all heard the acronym RICE, right?  This, typically, means Rest, Ice, Compression, and Elevation.  You use it when you have an acute injury, such as an ankle sprain.  We use this same type of treatment in our physical and occupational therapy practice as well. We use taping techniques or wrap the injured area to apply compression, and we use cold packs to apply cold therapy to our patient’s injuries.  We know it is one of the best ways to reduce swelling and help with pain.  As therapists we are introduced to many pieces of therapy equipment and some we invest in and some we don’t.  One we have invested in is the Game Ready System.

Game Ready is the most effective solution for aching athletes and recovering orthopedic Game Ready with a patientpatients. The Game Ready System simultaneously applies active compression with cold therapy, amplifying the body’s recovery efforts.

The Game Ready control unit allows for full customization, making highly effective cold compression therapy. We use it on our athletes, orthopedic patients and patients suffering from a musculoskeletal injury.

How does Game Ready work?

The clinician will select the appropriate pressure and time setting preferences, the ice water filled machine will circulate the cold water throughout the garment wrap and pneumatically applies compression to the desired extremity.

How does Game Ready compare to other Cryotherapy Units?

  • Ergonomic wraps are highly adjustable and allow for complete extremity coverage.
  • Cold fluid circulates the affected area, while simultaneous compression is actively applied.
  • Temperature and compression intensity can be easily adjusted.

This treatment is available at all seven Advanced Physical Therapy Center clinics.  It is just one more way we provide the best care possible for you.

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Dry Needling Vs. Acupuncture

Here at Advanced Physical Therapy Center, we use dry needling in our practice every day.  We have several physical therapists on staff that are trained in its use.  Dry needling is within a physical therapist’s scope of practice and is very different from acupuncture. People often get confused on the difference of which is which, when they are used and by whom.  The Dry Needling Institute had a very good commentary explaining the difference.  Please read below.

dry needling kneeAcupuncture and dry needling, while using the same needle types, are two very different treatments. Traditional acupuncture is used for the diagnosis and treatment of pathological conditions including visceral and systemic dysfunction, while dry needling is used for the assessment and treatment of myofacial pain syndromes and dysfunction due to myofacial trigger points, tension areas, muscle spasm, and/or increased tonicity.

Acupuncture achieves pain relief through the release of endorphins and creating balance in the body’s energy levels. Through the release of serum cortisol, acupuncture can also have an anti-inflammatory effect.

Dry needling (DN) also acts via the release of endorphins and serum cortisol but also achieves pain relief and bio-mechanical re-function by deactivating the trigger points at the muscle-cell level and thus eliminating the nociceptive focus of the muscle. The needles also cause localized hemorrhaging, which promotes healing by stimulating collagen and protein formation.  Dry needling is specific in its selection and searching for trigger points relevant to the clients disorder as interpreted by a western assessment and diagnostic protocols.

For physical therapists, DN is more popular because there is no need to train in dry needling 1traditional acupuncture methods in order to practice the technique of dry needling. These therapists are already working with myofascial problems in their clinics and have the ideal background to integrate dry needling techniques, quickly and effectively, into their treatment and rehabilitation protocols.

Dry needling is also a part of our Wellness Program and is perfect for post-graduate patients who have received dry needling during their formal therapy sessions but need a “tune-up” from time-to-time.  This service is available at most of our seven clinics on a cash pay basis.  To contact your nearest APTC to find out more about dry needling, go to our website.



Functional Training vs. Functional Training

There is a little confusion when it comes to the term “functional training” or “functional exercise”.  You may have heard your personal trainer mention it a time or two during your training sessions.  In the fitness industry, they are referring to a movement or a way of teaching clients exercises that are supposed to mimic every day activities.  These exercises are oriented on using big, multi-joint exercises that use lots of muscles including the important “core” abdominal and deep back muscles.  Many times, they include the use of exercise balls and bands, free weights and plyometric exercises.

Functional training has its origins in rehabilitation.  Physical and occupational therapists use functional training for patients who have movement disorders or any injury that is keeping them from performing their activities of daily living.  Interventions are designed to incorporate task and context specific practice in areas meaningful to each patient, with an overall goal of functional independence. The therapists select specific exercises that closely mimic the movements those patients need to perform at home and/or at work and teach them more efficient ways to complete those activities.  These exercises don’t necessarily include the use of weight-bearing activities like they do in the fitness industry.  Thus, if the patient were a marathon runner, training would be targeted toward re-building endurance; and if the patient were a homemaker and cleaning the floors were their goal, rehabilitation would be targeted toward getting down on the floor and up again safely and in the most efficient way possible.  But, if a patient’s job required repeatedly heavy lifting, rehabilitation would be targeted toward heavy lifting. Treatments are designed after careful consideration of the patient’s condition, what he or she would like to achieve and ensuring goals of treatment are realistic and achievable.

Now to confuse things more, let’s throw in Functional Movement Screen (FMS).  A FMS is a screening, administered by a specialist, that measures seven fundamental functional movement patterns on a person to identify movement limitations and left/right muscle asymmetries. It identifies potential issues in order to prevent injuries before they happen.

Here are the seven fundamental movement patterns that the FMS tests:

  • Deep Squat (Lower Body): Assesses functional mobility and symmetry of the hips, knees and ankles.
  • Hurdle Step (Lower Body): Gauges stability and functional mobility of the hips, knees and ankles.
  • In-Line Lunge (Lower Body): Assesses torso, shoulder, hip, and ankle stability and mobility, as well as quadriceps flexibility and knee stability.
  • Shoulder Mobility (Upper Body): Assess shoulder range of motion as well as shoulder blade mobility
  • Straight Leg Raiser (Lower Body): Gauges functional hamstring and calf flexibility while maintaining a stable pelvis
  • Trunk Stability Push-Up (Upper/Lower Body): Used to assess symmetrical core stability
  • Rotary Stability (Upper/Lower Body): Assesses core stability in combination with upper and lower body


The results from these movements are scored on a scale 0 to 3.

0 — Movement was painful, requiring a referral to a healthcare professional.
1 — Inability to perform or complete a functional movement pattern.
2 — Ability to perform a functional pattern, but with some degree of compensation.
3 — Unquestioned ability to perform the functional movement pattern.

The screen must be performed by a trained specialist.  During the screen, the specialist is looking for specific movements or patterns that can indicate a limitation or asymmetry. If they find a limitation or asymmetry, this type of movement is less efficient and can put you at risk for injury.  The results from this screen are used in the fitness industry to create what they call “functional training” programs, concentrating on strengthening the weak areas .  Therapists also use this screen in their therapy programs to retrain the patient’s movement patterns.  Overall, the test is a helpful tool for both the fitness and physical therapy industry.

Kelly McCarthyKelly Lubera, PT, DPT is our Goodrich clinic director and is trained in functional training.

Goodrich Clinic
7477 S. State Rd., Ste. B
(810) 636-8700


kennedy_amy aptc 6-26-2017 bhphotographicAmy Kennedy, PT, DPT is located at our Clio clinic and is a specialist in Functional Movement Screen (FMS).

Clio Clinic
303 S. Mill St.
(810) 732-8400


Benefits of Rehabbing in the Water

     Aquatic therapy is a specialized form of physical or occupational therapy. For years, therapists have utilized aquatic therapy with a variety of patient populations with positive results. The special properties of water allow those who are unable to exercise on land to engage in physical activity. The use ofKristin C Davison Pool aquatic therapy
water is specifically recommended for restoration, maintenance and increasing function in patients with acute, transient or chronic disabilities, syndromes or diseases, such as arthritis, strokes, obesity, and Parkinson’s Disease. Best of all, you don’t need to know how to swim to experience its benefits.
Benefits of Aquatic Therapy
  • Warm water facilitates muscle relaxation and increases peripheral circulation.
  • Viscosity of water provides resistance for strength training.
  • Warm water stimulates body awareness, balance, and trunk stability.
  • The reduction of gravitational forces in the pool allows the patient to stand and begin gait training and strengthening exercises without causing further damage to healing structures.
  • Warm water and buoyancy results in decreased pain sensitivity.
  • Improvement of patient morale and confidence can be established by providing a positive medium in which to function.
Clinician Goes to Continuing Education in Aquatic Therapy
     Kristin Coleman, LPTA, ATRIC, recently attended a conference in Chicago for continuing education in aquatic therapy (AT). Kristin has been certified in AT since 2013 through Aquatic Therapy & Rehabilitation International. Kristin is located at our Davison clinic inside the Davison Athletic Club where she performs aquatic therapy in their pool. She offers both private and group therapy sessions (stipulations apply to group sessions, please contact the Davison clinic for details). Aquatic therapy is a great option for those who cannot exercise on land due to issues like arthritis or knee replacement. We also have aquatic therapy available at our Clarkston clinic inside Deer Lake Athletic Club. You can get to know Kristin by reading her biography below.

     Kristin Coleman, LPTA, ATRIC has been a valued part of Advanced Physical Therapy Center’s clinical staff since 2005. She received her physical therapist assistant degree from Baker College of Muskegon in 2004. She is working toward a bachelor’s degree in healthcare management from Baker College as well.

Kristin continues to expand her knowledge and expertise by attending a variety of continuing education classes, for example she has attended the DiMaggio Technique for back and neck pain, the Graston Technique (instrument assisted soft tissue mobilization), Kinesiology Taping, and Muscle Energy Technique (manual therapy for somatic dysfunction). She received a certification in aquatic therapy from the Aquatic Therapy & Rehab Institute in 2013 and has attended courses pertaining to aquatic therapy every year since.
Kristin Coleman     Kristin is from the Flint area, but now lives in Davison. She is the clinic director of Advanced Physical Therapy Center in Davison. In her spare time, she likes to go kayaking, boating and camping. She is a big Tiger’s baseball fan and loves watching and attending their games. She is passionate about animals and has four dogs of her own. She is also a volunteer for the Humane Society and the Toys for Tots program.

     When Kristin is working with her patients, she enjoys educating and giving them the “tools” they need to improve their current condition and prevent future issues. She also takes pleasure in helping patients get back to living their normal lives after surgery. “I love running into previous patients and hearing about their continued success. It’s great to know that I was able to contribute to it,” says Kristin. Her work philosophy is that patients shouldn’t dread coming to therapy, and she tries her hardest to help patient enjoy the process.

     She has acquired many patient success stories over the years, but her favorite is one of her patient who had been involved in a terrible car accident, which left them wheel chair bound. But by the end of their therapy program with Kristin, the patient was able walk out of the clinic for the last time with only the use of a cane for assistance. “I want my patients to know that I am fully invested in their recovery and helping them reach their goals. It is so rewarding to know that you helped a patient live pain-free or helped them to gain mobility,” states Kristin.
Our Davison clinic is located at 2138 Fairway Drive (inside the Davison Athletic Club).  You can contact Kristin at (810) 412-5100.