SPOTLIGHT ON ELECTIVES: HAND AND UPPER EXTREMITY REHABILITATION

Posted by vanessa on May 22, 2018

The first patient she treated for an upper extremity injury was in 1973. A Philadelphia police officer was shot at close range in both elbows and suffered nerve and joint injuries. Her second patient lost the back of his hand, also due to gunshot wounds.  That was how Sue Michlovitz, PT, PhD, FAPTA, Certified Hand Therapist, became interested in rehabilitation of the hand and upper extremity.

Hand therapists treat a wide range of patient populations and problems that include arthritis, crush injuries and other trauma, complications of diabetes (tendon and nerve issues), and issues that result from spinal cord injuries or stroke.  Additionally, Dr. Michlovitz works with musicians and visual artists.  She also works with athletes, particularly college athletes. Injuries in athletes range from hand fractures to shoulder dislocations.

Dr. Michlovitz has been teaching the Hand and Upper Extremity Rehabilitation Elective at Columbia since 2008.  The 1.5-day course focuses on treatment of patients who have injuries or diseases that result in impairment, functional loss or disability of the hand and upper extremity. Students are required to have taken the Management of Orthopedic Conditions course, since material covered in that course as well as anatomy serves as a starting point for class discussion, which includes non-operative and post-operative care of tendon, nerve, bone and joint disorders.

Over the 10 years that Dr. Michlovitz has been teaching the course, it has evolved to keep pace with changes in the practice, such as surgical innovations and post-operative care practices. She uses an online component to post cases and other materials for the students to review prior to class.  Additionally, she brings an occupational therapist into the class since they are key in rehabilitation of the hand and upper extremity. (Dr. Michlovitz points out that 85% of hand therapists are occupational therapists; 14% are physical therapists, and 1% are both). There is a lab component, which requires the student to make three different types of splints: for the thumb, wrist and trigger finger.

Hand and upper extremity rehabilitation is a highly collaborative field, as it involves working with surgeons and occupational therapists, and others such as athletic trainers.  Dr. Michlovitz would like to see more physical therapists that are knowledgeable about treating the hand and upper extremity. She hopes that her students will be excited about the opportunity to work in this area, and be motivated to seek out further educational opportunities or residencies.  She appears to be succeeding.  Kyle Zreibe, CUDPT 2019, commented, “This course gave me great perspective on the roles that physical therapists play in treating dysfunctions of the hand. The highlight of this elective was the chance to learn how to make custom-made orthoses for all the different joints in the fingers and wrist.  I look forward to continuing to develop these skills while in clinic.” Kayla Coutts, also CUDPT 2019, added, "I learned more about how OTs and PTs can work together in practice."

Outside of teaching, Dr. Michlovitz, who has been named in 2018 as a Catherine Worthingham Fellow of the APTA, goes on medical missions to Guatemala with the non-profit organization Guatemala Healing Hands Foundation. There, they treat children with congenital issues or traumatic injuries. She enjoys collaborating with people from other countries, getting to know different cultures and making new friends.

When she’s not teaching, treating patients, or traveling, Dr. Michlovitz is pursuing an MFA in media arts and photography at Maine Media College, Rockport Maine.

Students showing off their splints. Photo by Sue MichlovitzDr. Sue Michlovitz, PT, PhD, FAPTA, Certified Hand Therapist

 

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