DANSVILLE — When you think of all the things you do with your hands it is hard to imagine no longer being able to use them.


People who experience an injury to their hands, elbows, wrists, or shoulders may have a longer healing period. However, there are specialists who are highly trained to care for you, and get you back into the swing of things sooner than you think.


Noyes Health has the only certified hand therapist in the area. Noyes Health Occupational Therapist and Certified Hand Therapist Nicki Fink has worked continuously to bring quality care to our region.


“I have been a therapist for almost 20 years now, and when I was in school one of my affiliations got to do some observation on a hand therapist. I just kinda fell-in-love with it,” Fink said. “I knew that was what I wanted, and that was going to be a goal of mine. I wanted to pursue the certification.”


“A hand therapist can be either a physical or an occupational therapist. However, 85 percent of hand therapists are OT’s, and about 14 percent are PT’s,” Fink continued. “It is a blend of PT and OT theory of practice. There are one percent that are both.”


The concept of a hand therapist is a rare one; there are only 6,228 of them in the whole world. Most of them are here in America, some in Canada, Australia, New Zealand, and a handful on military bases.


Fink enjoys being a certified hand therapist.


“There is really nothing you can do without the use of your hands except talk,” she said. “When you think about it you need your hands to feed yourself, to dress yourself, to write, to do most occupations, so I get great satisfaction from helping people to regain their function and get back to doing what it is they do.”


“The most common diagnoses I see are fractures, tendon repair, nerve compression syndrome, lots of lacerations, and things like that,” Fink continued. “Every diagnoses is different. It can be as little as a few therapy visits or over a year. It depends on what is wrong with them.”


Fink sees from six to 10 patients in an afternoon. She divides her time between the Dansville and Geneseo locations.


“I love getting them back to doing the things that they love,” she said. “Someone who works in a factory, an office, or a homemaker. It just gives you great satisfaction to help someone regain their functional independence, and be able to use their hands the way they want to use them.”


Fink found her calling in occupational therapy and hand therapy in her freshman year of college.


“Typically you don’t find a hand therapist in a rural community. Typically you find hand therapists in a large or major city such as Rochester and Buffalo,” she said. “Often I get asked why I am in a rural area. My first response is ‘my home is in a rural area,’ so what a great service as a specialist to be able to provide within a rural community. In this area I see farming accidents, factory accidents, and many guards from the department of corrections come through. I get referrals from many different types of physicians; primary care physicians and hand surgeons in particular.”


It is a rigorous process to be a certified hand therapist, Fink mentioned.


According to the Hand Therapy Certification Commission's website, a certified hand therapist is an occupational or physical therapist who has a minimum of five years of clinical experience, including 4,000 hours or more of direct practice in hand therapy. In addition to this, the hand therapist must also complete tests in advanced clinical skills and upper quarter rehabilitation. There are only about 50 percent that pass the board. There are constant changes in the field, so a certified hand therapist has to recertify every five years.


“In hand therapy the name can be deceiving, since it is not just the hand,” Fink said. “Everything from the hand up to the neck is connected. You are not just considered to be an expert in hands, you know the hand, the wrist, the elbow, and the shoulder, because everything is connected. A lot of people get confused, and think we only do the hands, but we do the entire arm.”


Fink said she loves to see the smile on her patient's faces when they can do things again.


“I have always found it very rewarding,” she said. “We are trying to promote more awareness of the profession. People often think if you break a bone, or have surgery to one of your joints you just go see a PT, and that is true for some conditions. There are many conditions that occupational therapists treat, and there is this speciality in hand therapy where we do have some advanced training and knowledge in the upper body.”


Many patients come from as far as the Wellsville and Rochester areas to see Fink.


“You have to have good communication with the surgeon and know what to do and when,” Fink added. “The tendons in the hand and forearm are like guitar strings. If you do the wrong thing at the wrong time you can risk rupturing them. Early on in one’s career those first few patients can make you a little nervous. As time goes on you gain a great level of confidence. I work with great surgeons.”


Fink has provided the service close to home, so that people can get the service here, and not have to go 40 minutes to the city.


Besides Fink there is also a certified wound care therapist and a lymphedema therapist. They are considered rare as well.


Noyes Health Physical Therapy Director Michael Donegan said they are happy to have Fink working for them.


“We are very fortunate to have her,” he said. “There are a limited number of hand therapists.”


Fink mentioned there is a hard part to the profession.


“Sometimes you get a patient that has a major traumatic injury, and sometimes you know you can’t restore them to their prior function,” she said. “We as therapist want to restore people to their original function, but it is not always possible. It can be hard at times. I have seen some pretty catastrophic farm accidents, amputations, and things like that. Car accidents and motorcycle accidents are very life changing as well. You have to prepare them to accept their new level of function.”


Fink has practiced hand therapy since 2000, and became certified in the field in 2007. Before that she worked in occupational therapy since 1997. For the last three years she has worked at Noyes Health. She established her roots in hand therapy at Warsaw Hospital.


Fink's hours are Monday and Wednesday from 2 to 6 p.m at Geneseo location, and Tuesday and Thursday from 1:30 to 6 p.m. at the Dansville location.